三元联动延续性护理用于胃癌根治手术患者的干预效果分析

Analysis of Intervention Effect on Continuity Nursing in Three Element Linkage for Gastric Cancer Patients with Radical Gastrectomy

目的研究三元联动延续性护理用于胃癌根治术患者的干预效果。方法纳入80例胃癌根治术患者作为研究对象,其中2014年4月至2015年4月40例为对照组,行常规护理;2015年5月~2016年5月40例为观察组,行"医院-社区-家庭"三元联动延续性护理。比较两组患者术后自我护理能力、不良反应及生存质量。结果观察组出院半年和1年时自我概念、自护责任感、自护技能及健康知识水平评分均显著高于入院时和对照组(P<0.05),对照组出院半年时自我概念、自护技能及健康知识水平评分均显著高于入院时(P<0.05)。对照组出院1年时自护责任感、自护技能及健康知识水平与入院时差异无统计学意义(P>0.05)。两组出院半年和1年时QLQ-STO22评分较入院时均显著降低(P<0.05),观察组出院半年和1年时评分显著低于对照组(P<0.05)。两组不良反应发生率差异无统计学意义(P>0.05)。观察组胃肠道反应、白细胞减少、血小板降低及疲乏无力严重程度较对照组显著降低(P<0.05)。结论 "医院-社区-家庭"三元联动延续性护理用于胃癌根治术患者能显著改善患者生活质量,有利于减轻不良反应,提高自护能力。

Objective To study the intervention effect of continuity nursing in three element linkage based on hospital-community-family to gastric cancer patients with radical gastrectomy.Methods 80 gastric cancer patients underwent radical gastrectomy were enrolled in this study.40 cases from April2014 to April 2015 were control group with routine nursing.40 cases from May 2015 to May 2016 were observation group with continuity nursing of three element linkage based on hospital-communityfamily.The postoperative self-care ability,adverse reactions and quality of life were compared between two groups.Results The scores of self-conception,self-care responsibility,self-care skills and health knowledge in the observation group at 6,12 months after discharge were significantly higher than those in control group and at admission（P〈0.05）.The scores of self-conception,self-care skills and health knowledge in the control group at 6 months after discharge were significantly higher than those at admission（P〈0.05）.There were no significant differences of self-care responsibility,selfcare skills and health knowledge in the control group at 1 year after discharge and at admission（P〈0.05）.The scores of QLQ-STO22 in the two groups at 6,12 months after discharge were significantly lower than those at admission（P〈0.05）.The scores of the observation group after discharge at 6,12 months were significantly lower than those of the control group（P〈0.05）.There was no significant difference in the incidence of adverse reactions between the two groups（P〈0.05）.The severity of gastrointestinal reaction,white blood cell reduction,thrombocytopenia and fatigue in the observation group were significantly lower than those in the control group（P〈0.05）.Conclusion The continuity nursing of three element linkage based on hospital-community-family are used for gastric cancer,which can significantly improve the quality of life,the self-care ability and help to alleviate the adverse reactions.