社区管理模式对中晚期肺癌癌痛患者生活质量的研究

A study on the influence of community management mode on quality of life in patients with advanced lung cancer pain

目的:探讨社区管理模式对中晚期肺癌癌痛患者生活质量的影响。方法:收集2016年5-11月在南京市止马营社区卫生中心等8个卫生中心辖区内确诊且不在住院期间的肺癌伴有中、重度疼痛患者64例。同时具备"生物-心理-社会"干预模式及中医药干预因素的患者作为干预组,缺乏其中任一项者为对照组。每组32例。采用欧洲癌症研究治疗组织开发的生命质量核心量表(EORTC QLQ-C30)比较干预前、干预6个月后两组患者的生活质量,以数字评分疼痛分级法(NRS)评价患者的癌痛缓解程度。结果:在社区管理模式下,肺癌伴中、重度疼痛患者镇痛效果明显提高(P<0.01);干预6个月后,干预组较对照组在躯体功能、社会功能、情绪功能、疲倦、疼痛、恶心呕吐、失眠、食欲以及整体生活质量方面得到较大改善(P<0.05);在角色功能、认知功能、腹泻便秘、呼吸困难、经济困难方面比较,两组无统计学差异(P>0.05)。结论:"生物-心理-社会"社区管理模式有助于提高肺癌伴中、重度疼痛患者的镇痛效果,树立生活信心,改善生活质量,值得深入研究及推广。

Objective:To investigate the effect of community management on quality of life in patients with advanced lung cancer pain.Methods:64 cases from May 2016 to November 2016 in 8 health centers were collected.Patients who meet biological-psychologicalsocial intervention model and TCM intervention were selected as the intervention group,and patients who lack any one of above was selected as the control group,32 cases in each.Results:The analgesic effect of biological-psychological-social intervention model was significantly improved(P<0.01).In 6 months,physical function,social function,emotional function,tiredness and pain,nausea,vomiting,insomnia,appetite and overall life quality of patients in the intervention group were obviously improved(P<0.05).There was no significant difference between the groups in role function,cognitive function,diarrhea or constipation,dyspnea and economic difficulties(P>0.05).Conclusion:The biological-psychological-social intervention mode could improve the analgesic effect and quality of life,build life confidence,and is worth further studying and popularizing.