肺癌化疗病人焦虑抑郁管理的最佳证据应用

Application value of the best evidence in the management of anxiety and depression in lung cancer patients treated with chemotherapy

目的:将现有的与肺癌化疗病人焦虑抑郁管理相关的最佳证据应用到临床实践,提高护士在肺癌化疗病人焦虑抑郁管理中证据应用的依从性,促进肺癌化疗病人情绪状态的改善。方法:根据澳大利亚JBI-PACES系统的标准程序,检索现有的最佳证据,形成6条相应的审查指标,对20名护士及20例病人开展为期10个月的质量审查。结果:在证据应用后质量审查时,护士对评价工具、教育和培训、健康教育、渐进式肌肉放松训练和有氧运动5条审查指标的执行率均达到100%,对团体心理治疗的执行率达到90%,所有审查指标的执行率提高了25%~100%。同时,病人的肺癌化疗相关知识水平也明显提高(P<0.05~P<0.01),病人的焦虑抑郁发生率明显降低(P<0.01)。结论:基于循证的肺癌化疗病人焦虑抑郁管理最佳证据的应用,改善了护理实践,但仍需进行持续质量审查,以不断完善焦虑抑郁管理。

Objective:To apply the best available evidence of the management of anxiety and depression in lung cancer patients during postoperative chemotherapy to improve the compliance of nurses and promote the improvement of emotional state of patients.Methods:According to the standard procedure of JBI-PACES in Australia,the best available evidence was searched to formulate six audit criteria.A 10-month quality review in 20 nurses and 20 patients were conducted.Results:After the evidence was applied in the quality review,the implementation rate of the five review indicators(including evaluation tools,education and training,health education,progressive muscle relaxation training and aerobic exercise of nurses) reached 100%,the implementation rate of group psychotherapy reached 90%,and the implementation rate of all review indicators increased by 25% to 100%.Meanwhile,the knowledge level of lung cancer chemotherapy of patients was also significantly improved(P<0.05 to P<0.01),and the incidence rates of anxiety and depression of patients significantly reduced(P<0.01).Conclusions:Evidence-based quality review,the application of the best available evidence of the management of anxiety and depression in lung cancer patients during postoperative chemotherapy improves the nursing practice.However,the quality review is needed to continue for improving the management of anxiety and depression.