PDCA循环对肝癌患者术后情绪及生活质量的影响研究

Effect of PDCA circulation on postoperative mood and quality of life of liver cancer patients

目的探讨计划、实施、检查、处理(PDCA)循环对肝癌患者术后情绪及生活质量的影响。方法回顾性分析80例肝癌患者的临床资料,依据对患者临床管理方法的不同将其分为PDCA循环组和常规管理组,每组40例。比较两组患者的焦虑、抑郁评分及生活质量评分。结果术后,两组患者的汉密尔顿焦虑量表(HAMA)评分和汉密尔顿抑郁量表(HAMD)评分均低于本组术前,差异均有统计学意义(P<0.05)。术后,常规管理组患者的HAMA评分和HAMD评分均明显高于PDCA循环组,差异均有统计学意义(P<0.01)。术后,两组患者的身体功能、生理功能、心理功能和社会功能评分均较本组术前有不同程度的升高(P<0.05);术后,PDCA循环组患者的生活质量各项评分均明显高于常规管理组,差异均有统计学意义(P<0.01)。随访期间,PDCA循环组死亡患者15例,常规管理组死亡患者18例。经Log-Rank检验结果显示,两组患者的总生存情况比较,差异有统计学意义(P=0.032)。结论 PDCA循环管理干预后,肝癌患者术后负面情绪、生活质量和生存情况均有明显改善,值得临床广泛应用,且有在其他医疗领域中进行推广的意义。

Objective To explore the effects of plan, do, check, action （PDCA） cycle on postoperative mood and quality of life in patients with liver cancer.Method Eighty patients with liver cancer were enrolled and were divided into PDCA cycle group and routine management group according to clinical management methods, 40 patients in each group. The anxiety score, depression score and the quality of life of patients in two groups were compared. Result After surgery, the Hamilton anxiety scale HAMA scores and Hamilton depression scale （HAMD） scores in each group were significantly lower than those before treatment （P〈0.05）. And both of the scores in routine management group were significantly higher than those in PDCA cycle group （P〈0.01）. The physical function, physiological function, psychological function and social function scores were increased with different degrees after the treatment in both groups （P〈0.05）, and all these scores in routine management group were significantly lower than those in PDCA cycle group （P〈0.01）. During the follow-up, 15 patients died in PDCA cycle group and 18 in routine management group. The Log-Rank test results showed that there was statistically significant difference between two groups in the total survival （P=0.032）.Conclusion The PDCA cycle can significant improve postoperative negative emotions, quality of life, and survival of patients with liver cancer, which is worthy of being widely used clinically and popularized to other medical fields.