晚期直肠癌合并肠造口患者心理痛苦筛查及精准护理研究

Psychological pain screening and precise nursing for advanced rectal cancer patients with enterostomy

目的采用心理痛苦筛查工具对晚期直肠癌合并肠造口患者进行心理痛苦筛查,并探讨精准护理效果。方法选取本院肿瘤内科住院的晚期直肠癌合并肠造口患者105例,随机分成观察组52例、对照组53例。2组患者入院和出院时均采用美国国立综合癌症网(NCCN)推荐的心理痛苦管理筛查工具(DMSM)对患者进行心理痛苦筛查。对照组行常规观察和心理护理,观察组在常规护理的基础上采取个性化精准护理。分析2组患者入院和出院时的心理痛苦评分、影响因素、生活质量和患者满意度。结果入院时,心理痛苦评分无显著差异(P> 0. 05);出院时,心理痛苦分值均低于入院时,且观察组出院心理痛苦评分DT≥2以上发生率显著低于对照组,差异有统计学意义(P <0. 05)。观察组患者出院时心理痛苦影响因素改善程度显著优于对照组,影响患者心理痛苦因素的11个条目中8个条目内容均显著改善(P <0. 05)。入院时2组生活质量评分差异无统计学意义(P> 0. 05);出院时,观察组生活质量评分及护理满意度均显著高于对照组(P <0. 05)。结论采取个性化的精准护理能够显著降低患者心理痛苦程度,有效加快晚期直肠癌合并肠造口患者身心健康的恢复,显著提高患者的生活质量和护理满意度。

Objective To study psychological pain screening for advanced rectal cancer patients with enterostomy and its precise nursing.Methods A total of 105 advanced rectal cancer patients with enterostomy were randomly divided into observation group(n=52)and control group(n=53).The psychological pain screening were performed in patients of two groups at admission and discharge by using psychological pain management screening tool(DMSM)recommended by the National Comprehensive Cancer Network(NCCNN).The control group was given routine observation and psychological nursing,and the observation group was given individual precise nursing based on routine nursing.Psychological pain scores,influencing factors,quality of life and patients′satisfaction in two groups were compared.Results Mental pain score showed no significant difference at admission(P>0.05),and was lower at discharge than on admission,and the incidence of mental pain score more than 2 points at discharge in the observation group was significantly lower than that in the control group(P<0.05).The improvement of psychological influencing factors in the observation group was significantly higher than that in the control group(P<0.05).Out of 11 items,8 item score in the observation group was significantly improved(P<0.05).There was no significant difference in the quality of life score at admission(P>0.05),and quality of life score and nursing satisfaction of the observation group were significantly higher than that of the control group(P<0.05).Conclusion Individualized and precise nursing can effectively reduce psychological pain,promote the recovery of mental and physical health,and improve quality of life and nursing satisfaction.