临床路径在肿瘤患者癌痛管理中的应用效果

Effects of clinical pathway in cancer pain management among cancer patients

目的探讨临床路径在肿瘤患者癌痛管理中的应用效果。方法选取浙江省宁波市第一医院放化疗病区接受阿片类药物止痛治疗的癌痛患者共114例,将2018年3—12月收治的癌痛患者56例作为观察组,采用自行设定的临床路径实施护理,将2017年5月—2018年2月收治的癌痛患者58例作为对照组,实施常规护理。采用疼痛数字评分法(NRS)比较两组患者疼痛控制效果,调查两组患者的服药依从性和疼痛控制满意度。结果随着时间进展,两组肿瘤癌痛患者NRS评分呈降低趋势,两组比较的交互作用、时间和组间差异均有统计学意义(P<0.01)。出院前1d观察组患者爆发痛发作的NRS评分(4.78±0.59)分,低于对照组的(5.56±0.74)分;观察组患者爆发痛的发作频率(2.70±0.71)次/d,低于对照组的(3.21±0.84)次/d;比较差异均有统计学意义(P<0.01)。观察组患者服药依从性为(6.69±0.97)分,高于对照组的(6.02±1.10)分;观察组患者疼痛控制满意度(87.84±7.21)分,高于对照组的(75.93±6.95)分;差异均具有统计学意义(P<0.01)。结论应用临床路径对肿瘤患者实施癌痛管理和护理,可有效控制患者的疼痛,提高患者服药依从性和护理服务满意度。

Objective To explore the effects of clinical pathway in cancer pain management among cancer patients.Methods We selected 114 cancer patients with pain and opioids pain management in Radiotherapy and Chemotherapy Center at Ningbo First Hospital of Zhejiang Province.A total of 56 cancer patients with pain from March to December 2018 were in observation group with nursing based on self-design clinical pathway;a total of 58 cancer patients with pain from May 2017 to February 2018 were in control group with routine nursing.The Numerical Rating Scale(NRS)was used to compare the effects of pain management of patients between two groups.We also investigated the medication compliance and pain management satisfaction of patients between two groups.Results As time progressed,the NRS scores of cancer pain patients in the two groups decreased,and the interaction,time and intervention differences between the two groups were statistically significant(P<0.01).One day before discharge,the score of NRS in breakout pain attack of patients of observation group was(4.78±0.59)lower than that(5.56±0.74)of control group;times of breakout pain of patients of observation group was(2.70±0.71)times per day less than(3.21±0.84)times per day of control group;the differences were statistical(P<0.01).The medication compliance of patients of observation group was(6.69±0.97),higher than(6.02±1.10)of control group;patients'satisfaction with pain management of observation group was(87.84±7.21),higher than(75.93±6.95)of control group;the differences were also statistically significant(P<0.01).Conclusions Application of clinical pathway in pain management and nursing for cancer patients with pain can effectively management patients pain and improves patients'medication compliance and satisfaction with nursing.