结构-过程-结果三维质量评估模式在老年肺癌患者术后延续性护理中的应用

Application of three-dimensional quality assessment model of structure-process-outcome in continuous nursing of elderly patients with lung cancer after operation

目的探讨结构-过程-结果三维质量评估模式在老年肺癌患者术后延续性护理中的应用效果。方法采用目的抽样法,将2016年1—12月郑州大学第一附属医院完成肺癌根治术出院的48例老年肺癌患者设为对照组,实施常规延续性护理。将2017年6月—2018年6月我院完成肺癌根治术后出院的51例老年肺癌患者设为观察组,实施基于结构-过程-结果三维质量评估模式构建的延续性护理方案。采用癌症患者自我管理效能感量表(SUPPH)、肿瘤生存质量调查表(QLQ-30)评估干预的效果。结果出院后6个月,观察组SUPPH各维度得分均高于对照组,差异有统计学意义(P<0.05)。出院后6个月,观察组患者QLQ-30中躯体功能、角色功能、社会功能、总体健康情况得分高于对照组,疲劳、疼痛、失眠、食欲缺乏、便秘、腹泻得分低于对照组,差异有统计学意义(P<0.05)。结论基于结构-过程-结果三维质量评估模式构建的延续性护理有助于提升老年肺癌患者自我管理效能感及生活质量。

Objective To explore the application of three-dimensional quality assessment model of structure-process-outcome in continued nursing care for elderly patients with lung cancer after operation.Methods By purposive sampling,48 elderly patients discharged after radical resection of lung cancer from January to December 2016 were taken as control group and received routine continuous nursing care.Another 51 elderly patients discharged after radical resection of lung cancer from June 2017 to June 2018 were taken as the observation group.Continuous nursing program based on structure-process-outcome quality assessment model was applied for the observation group.The effect of intervention was assessed by using Strategies Used by People to Promote Health(SUPPH)and Quality of Life Questionnaire-30(QLQ-30).Results At 6 months after discharge,the scores of each dimension of SUPPH scale in the observation group were statistically higher than those in the control group(P<0.05).In the observation group the scores of"physical function","role function","social function"and"overall health"of QLQ-30 scale were higher than the control group,the scores of"fatigue","pain","insomnia","lack of appetite","constipation",and"diarrhea"were all lower than the control group with statistical significance(P<0.05).Conclusions The continuous nursing care based on the three-dimensional quality assessment model of structure-process-outcome for elderly patients with lung cancer can help to improve their sense of self-efficacy and quality of life.