电话回访及上门访视对居家癌痛患者服药依从性效果的影响

Influence of telephone interviews and home visits on medication compliance of cancer pain patients at home

目的评价护士主导的电话随访及上门访视对居家癌痛患者服药依从性的效果影响,为制定提高居家癌症晚期患者的生活质量提供依据。方法于2013年10月—2015年6月,采用电话回访及上门访视对血液肿瘤科治疗出院后的86例神志清、能够交流、会疼痛评分的晚期癌痛患者进行追踪干预,首先成立癌痛护理小组,制定随访流程并进行培训。给患者建立癌痛随访档案,发放由癌痛护理小组编制的《癌症与疼痛》教育手册和带闹铃的药盒、《癌痛日记》本。科室开通24 h咨询热线,每3 d电话随访,每周上门访视1次,实地查看患者服药的情况,镇痛效果,观察药物的不良反应,癌痛日记情况,关注患者内心感受,并给予指导宣教督促。建立微信公众号,设立微信朋友圈,组织疼痛知识讲座等方式加强与患者及家属的沟通,增加信任度,促使患者保持良好的服药依从性。采用SPSS 17.0统计学软件,统计出追踪干预前后3个月患者的疼痛分值及服药依从性。结果 2013年10月—2015年6月在血液肿瘤科治疗86例晚期癌痛患者通过追踪干预,患者轻度疼痛、中度疼痛、重度疼痛以及服药完全依从性、部分依从性、不依从性差异均存在统计学意义(P<0.05)。结论护士主导的电话回访及上门访视可以提高居家癌痛患者服药的依从性,改善生活质量。

Objective To evaluate the influence of nurse led telephone interviews and on-site visit on the medication com- pliance of advanced cancer pain patients at home, and provide reference for improving the quality of life of patients. Meth- otis Between October,2013 and June,2015,86 cases of advanced cancer pain patients discharged from our Department, with clear mind and ability to communicate and finish the pain scores, were followed up by telephone interviews and home visits. The cancer pain care team was established and the follow-up process was drafted, the members were trained accord- ing to the foll6w-up process. Then periodic follow-up records for cancer pain patients were created, and the cancer pain ed- ucation manual prepared by the team, pill box with alarm and cancer pain diaries book were provided for every patients. 24 h hotline was set up, and telephone interviews were performed every three days and home visits were performed every week to observe the management of medicines, analgesic effect, adverse reactions and pain dietary; the guidance, propaganda and education were given based on the inner feelings of patients. The Wechat public account was established to communicate with patients and perform lectures on pain, improve the medication compliance of cancer pain patients. The pain scores and medication compliance were analyzed by using SPSS 17.0 statistical software. Results The trace and intervention by telephone interviews and home visits to cancer pain patients at home relieved the pain（ mild, moderate and severe） of pa- tients and improved the medication compliance （ full, partial and noncompliance ）, the difference was significant （ P 〈 0.05 ）. Conclusion The nurse led telephone interviews and on-site visit can improve the medication compliance of canc- er pain patients at home and their quality of life.