个案管理师介导的微信平台在喉癌患者心理干预中的应用研究

The application of case management based WeChat platform in the psychological intervention of patients with laryngeal cancer

目的：探讨个案管理师使用微信平台在喉癌患者治疗过程及延伸护理中的意义。方法将2014年11月至2015年5月在头颈外科纳入个案管理、并行喉癌部分切除及全切的30例患者作为研究对象。个案管理师全程关注患者，提供全方面支持，并建立患者微信群，使用微信平台对患者进行在线咨询回复、普及健康教育知识、提供心理辅导等。纳入个案管理之初，即应用社会支持量表（SSRS）和焦虑量表（SAS）对患者进行心理评估，实施干预3个月后进行复测，比较干预前后结果。结果干预前患者主观支持得分（25．13±4．81）分，干预后（28．33±4．41）分；对支持的利用度干预前（7．20±1．99）分，干预后（9．90±1．97）分；焦虑程度干预前（41．40±9．22）分，干预后（35．27±5．90）分，干预前后差异均有统计学意义（t ＝－2．685、－5．280、2．917，均 P ＜0．05）。结论由个案管理师介导的微信平台在喉癌患者心理健康管理中效果明显，有效促进了患者的康复。

Objective To explore the significance of case managers using WeChat platform in the treatment process and extended care for patients with laryngeal cancer.Methods From November 2014 to May 2015, 30 patients with partial resection or total resection of laryngeal cancer in the department of head and neck surgery were selected as a research subjects.Case managers provided fully supports,such as establishing WeChat group,replying online consultations,popularizing health education knowledge,providing psychological counselings.Psychological assessment of the patients was conducted by social support scale（SSRS）and anxiety scale（SAS）in the beginning of case management.Results comparison was performed before and after three months intervention.Results The score of subjective support of patients before intervention was （25.13 ±4.81）points,which after intervention was （28.33 ± 4.41）points.The score of support availability before intervention was （7.20 ±1.99）points,which after intervention was （35.27 ±5.90）points.The differences were statistically significant（t =-2.685,-5.280,2.917,all P 〈0.05）.Conclusion The WeChat platform mediated by the case management is effective in the management of the psychological health of patients with laryngeal cancer,which can effectively promote the rehabilitation of patients.