采用准备-过程-结果三维评价模式实施延续护理在乳腺癌患者中的实践效果

Practical results of three dimensional evaluation model based on preparation-process-outcome in transitional care in patients with breast cancer

目的评价准备-过程-结果三维评价模式实施延续护理在乳腺癌患者中的实践效果。方法将142例首次接受术后内分泌药物辅助治疗的乳腺癌患者按照随机数字表法分为延续护理组78例和对照组64例，对照组采取常规院外随访护理，延续护理组根据准备-过程-结果三维评价模式制订延续护理方案，对延续护理措施结构、过程和结果进行评价和监控，分别于干预3、6、12个月评价患者服药依从性，分别于患者出院前及干预3、6、12个月时，对患者生命质量进行评估。 结果延续护理组患者干预6个月和12个月时中文版压力知觉量表（CPSS）评分分别为（30.4 ± 3.2）、（27.9 ± 2.5）分，对照组分别为（33.7 ± 3.6）、（31.5 ± 3.4）分，差异有统计学意义（t=5.746、12.834，P〈0.01）；延续护理组患者干预3、6、12个月时焦虑自评量表（SAS）评分分别为（49.3 ± 3.9）、（44.7 ± 3.5）、（37.6 ± 2.9）分，对照组分别为（52.2 ± 4.1）、（47.8 ± 3.9）、（42.9 ± 4.4）分，差异有统计学意义（t=3.696、5.304、9.682，P〈0.01）；延续护理组患者干预3、6、12个月时药物占有比值分别为（99.1 ± 0.8）%、（98.7 ± 1.1）%、（96.7 ± 1.3）%，对照组分别为（93.5 ± 3.6）%、（92.3 ± 4.1）%、（87.2 ± 3.8）%，差异有统计学意义（t=14.524、13.568、16.834，P〈0.01）；延续护理组患者干预3、6、12个月时生命质量评分分别为（107.6 ± 4.2）、（107.1 ± 4.3）、（109.7 ± 4.4）分，对照组分别为（103.6 ± 4.8）、（101.4 ± 4.2）、（97.5 ± 3.9）分，差异有统计学意义（t=5.524、7.967、18.623，P〈0.01）。结论从准备、过程和结果3个维度对延续护理措施制订及实施进行控制，有助于改善患者压力、焦虑等不良情绪，提高患者服药依从性，从而有利于患者整体生命质量的提高.

Objective To investigate the practical results of three dimensional evaluation model based on preparation-process-outcome in transitional care in patients with breast cancer.MethodsA total of 142 cases of patients with breast cancer received postoperative endocrine drugs adjuvant therapy for the first time were randomly divided into transitional care group （n=78） and control group （n=64）. Patients in the control group were received routine follow-up care outside the hospital. Patients in transitional care group were accepted transitional care based on three dimensional evaluation model based on preparation-process-outcome, and structure, process and results of the transitional care were evaluated and monitored. After intervention 3, 6 and 12 months, the medication compliances of patients were evaluated. Before the patients discharged and after intervention 3, 6 and 12 months, the qualities of life were assessed.ResultsAfter intervention 6 and 12 months, the scores of Chinese Perceived Stress Scale （CPSS） in the transitional care group were （30.4±3.2）, （27.9±2.5） points, respectively, and in the control group were （33.7±3.6）, （31.5±3.4） points, respectively, the differences were statistically significant （t=5.746, 12.834, P〈0.01）. After intervention 3, 6 and 12 months, the scores of Self-rating Anxiety Scale （SAS） in the transitional care group were （49.3±3.9）, （44.7±3.5）, （37.6±2.9） points, respectively, and in the control group were （52.2±4.1）, （47.8±3.9）, （42.9±4.4） points, respectively, the differences were statistically significant （t=3.696, 5.304, 9.682, P〈0.01）. After intervention 3, 6 and 12 months, the values of the medicine possession ratio （MPR） in the transitional care group were （99.1±0.8）%, （98.7±1.1）%, （96.7±1.3）%, respectively, and in the control group were （93.5±3.6）%, （92.3±4.1）%, （87.2±3.8）%, the differences were statistically significant （t=14.524, 13.568, 16.834, P〈0.01）. After intervention 3, 6 and 12 months, the quality of life score in the transitional care group were （107.6±4.2）, （107.1±4.3）, （109.7±4.4） points, respectively, and in the control group were （103.6±4.8）, （101.4±4.2）, （97.5±3.9） points, the differences were statistically significant （t=5.524, 7.967, 18.623, P〈0.01）.ConclusionsFrom the preparation, process and outcomes of the three dimensions to control the development and implementation of transitional care could improve the recent stress, anxiety and other negative emotions of the patients, improve the medication compliance of patients, and thus contribute to improving the overall quality of life of patients.