聚焦解决模式在老年膀胱癌灌注化疗患者中的应用

Application of Solution Focused Approach to the Elderly Patients with Bladder Carcinoma Undergoing Catheterization Chemotherapy

目的:探讨聚焦解决模式在老年膀胱癌灌注化疗患者中的应用价值。方法:选取医院2015年2月至2016年2月膀胱灌注化疗患者53例为对照组予常规护理,2016年3月至2017年3月膀胱灌注化疗的患者57例为干预组予聚焦解决模式护理干预。采用癌性疲乏量表(Cancer Fatigue Scale,CFS)、一般自我效能量表(General Self-Efficacy Scale,GSES)、汉密顿焦虑量表(Hamilton Anxiety Scale,HAMA),汉密顿抑郁量表(Hamilton Depression Scale,HAMD)、生活质量(Quality of Life Questionnaire-30,QLQ-30)评估2组护理效果。结果:干预后干预组患者躯体疲乏、认知疲乏、情绪疲乏及总分均低于对照组,差异有统计学意义(P<0.01)。干预后干预组GESE高于对照组,HAMA和HAMD低于对照组,差异有统计学意义(P<0.01)。干预后干预组患者躯体功能、认知功能、角色功能、情绪功能、社会功能均高于对照组,差异有统计学意义(P<0.01)。干预组患者疲劳及疼痛症状低于对照组,差异有统计学意义(P<0.01)。结论:聚焦解决模式能改善膀胱癌灌注化疗患者癌性疲乏症状,提高患者自我效能感,减少焦虑、抑郁情绪,提高生活质量,促进康复。

Objective:To explore the application value of solution focused approach in catheterization chemotherapy for the elderly patients with bladder carcinoma.Methods:All 53 patients who accepted bladder catheterization chemotherapy from February,2015 to February,2016 in our hospital were taken as the control group and they received conventional care,another 57 patients who accepted bladder catheterization chemotherapy from March,2016 to March,2017 were chosen as the intervention group and they were given solution focused approach,cancer fatigue scale(CFS),general self-efficacy scale(GSES),Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA)and quality of life questionnaire-30(QLQ-30)were adopted to assess nursing effects of both groups.Results:After the intervention,total scores and the scores of somatic fatigue,cognitive fatigue and emotional fatigue of the intervention group were lower than these of the control group,and the difference had statistical meaning(P<0.01).After the intervention,GESE of the intervention group was higher than that of the control group,HAMA and HAMD were lower than these of the control group,and the difference showed statistical meaning(P<0.01).After the intervention,somatic function,cognitive function,role function,emotional function and social function of the intervention group were higher than these of the control group,and the difference presented statistical meaning(P<0.01).Fatigue and pain of the patients in the intervention group were lower than these of the control group,and the difference showed statistical meaning(P<0.01).Conclusion:Solution focused approach could improve chronic fatigue symptoms of the patients undergoing bladder catheterization chemotherapy,raise self-efficacy sense of the patients,relieve anxiety and depressions,lift quality of life and promote the recovery of the patients.