姑息护理对老年晚期妇科恶性肿瘤患者心理和生活质量的影响

Influence of palliative care on the psychological condition and quality of life of the elderly patients with advanced gynecologic malignancies

目的 分析姑息护理对老年晚期妇科恶性肿瘤患者心理和生活质量的影响.方法 选取2014年9月~2015年9月在该院治疗的106例老年晚期妇科恶性肿瘤患者按照数字表法分为对照组72例和观察组34例.对照组采取常规护理,观察组采取姑息护理. 以症状自评量表（Symptom Check List-90, SCL-90）、癌症治疗功能评价系统的一般量表（Functional Assessment of Cancertherapy-Generic Scale,FACT-G）分别作为评价心理状态、生活质量的工具,并观察比较两组护理前后的心理和生活质量.结果 护理后观察组的躯体化、强迫症状、人际关系、抑郁、焦虑、敌对、恐怖因子评分显著低于护理前、对照组护理后;组内护理前后对比、组间对比,差异均有统计学意义（均P＜0.05）;护理后观察组的躯体维度、社会/家庭维度、情感维度、功能维度均显著高于护理前、对照组护理后;组内护理前后对比、组间对比,差异均具有统计学意义（均P＜0.05）.结论 姑息护理对老年晚期妇科恶性肿瘤患者具有积极的作用,可有效地控制临床症状,显著改善患者的心理状态,帮助患者实现最佳的生活质量,具有临床开展的必要性.

Objective To analyze the influence of palliative care on the psychological condition and quality of life of the elderly patients with advanced gynecologic malignancies.Methods A total of 106 cases of elderly patients with advanced gynecologic malignant tumor treated in our hospital from September 2014 to September 2015 were divided into two groups by the method of mathematical table.The control group included 72 patients who were given the routine nursing care.While the observation group included 34 patients who adopted the palliative care.The psychological condition and quality of life was evaluated by the self-assessment lists of Symptom Check List-90（SCL-90） and cancer treatment function evaluation system of general scale （Functional Assessment of Cancertherapy-Generic Scale,FACT-G）,and the psychological condition and quality of life of the two groups before and after nursing was observed and compared.Results After treatment,the scores of somatization,obsessive-compulsive symptoms,interpersonal sensitivity,depression,anxiety,hostility,phobic of observation group was significantly lower than that before the treatment and than that of the control group after treatment.Comparison within groups before and after nursing and comparison between groups was made and the differences were statistically significant（P〈0.05）.After treatment,the physical dimension,social /family dimension,the emotional dimension and functional dimensions of the observation group were significantly higher than that before nursing and higher than that of the control group before and after nursing.Comparison within groups before and after nursing and comparison between groups was made and the differences were statistically significant（P〈0.05）.Conclusion The palliative care plays an active role for the elderly patients with advanced gynecological cancer, which can effectively control the symptoms,significantly improve the patients＆#39; mental state, helping patients achieve the best quality of life.And it is necessary to carry out clinical development.