延续护理对喉癌患者术后生存质量及心理状态的影响

Effect of Continuing Nursing on Postoperative Quality of Life and Psychological Status of Laryngeal Cancer Patients

为了研究喉癌患者术后的生存质量、心理状态与延续护理之间的关系,本研究采用多因素回归和生存分析评估2014~2017年诊断为喉癌并经过手术治疗的237例患者。本研究使用临床指南标准来指导诊断、初治、监测、复发治疗以及总体质量测量。研究结果显示,高质量护理在诊断(HR=0.80,95%CI(0.66~0.97))、初治(HR=0.75(0.63~0.88))、监测(HR=0.54(0.44~0.66))、复发治疗(HR=1.54(1.26~1.89))、临终护理(HR=0.69(0.52~0.92))、表现(HR=0.41(0.33~0.52))和总体质量测量(HR=0.66(0.54~0.80))等因素上与生存率显著相关。在控制其他变量(包括护理质量)条件下,手术初治与术后放疗(HR=0.66(0.53~0.82))以及大量的外科护理(HR=0.64(0.43~0.96))具有显著生存优势。研究结论初步表明,喉癌患者的高质量延续护理与提高生存率相关,复发治疗的高质量延续护理与生存率相关系数较低,对喉癌切除术后患者实施高质量延续性护理,可提高患者生活质量。

To study the relationship between quality of life, psychological status and continuation of care in patients with laryngeal cancer, multivariate regression and survival analysis were used to assess 237 patients diagnosed with laryngeal cancer after surgery between 2014 and 2017. Quality indicators using clinical guidelines were used for diagnosis, Initial treatment, monitoring, relapse treatment, and overall quality measurement. The results showed that high-quality care was significantly related to the survival rate in diagnosis (HR=0.80, 95%CI (0.66~0.97)), initial treatment (HR=0.75 (0.63~0.88)), monitoring (HR=0.54 (0.44~0.66)), relapse treatment (HR=1.54 (1.26~1.89)), last care (HR=0.69 (0.52~0.92)), performance (HR=0.41 (0.33~0.52)), overall quality measurement (HR= 0.66 (0.54~0.80)) and so on. Under control of other variables (including quality of care), surgical initial and postoperative radiotherapy (HR=0.66 (0.53~0.82)) and extensive surgical care (HR=0.64 (0.43~0.96)) had a significant survival advantage. The preliminary results of the study showed that high-quality continuation of care for patients with laryngeal cancer was associated with improved survival rates;high-quality continuation of care for recurrent treatment was associated with lower survival. The data suggested that the survival outcome of patients with laryngeal cancer was not completely explained by the difference in high-quality care. Preliminary findings suggested that it was necessary to develop sensitive and effective quality indicators for the treatment of laryngeal cancer in patients with laryngeal cancer. High-quality continuity of care for patients undergoing resection of laryngeal cancer can improve quality of life.