肺癌化疗药学监护路径对化疗患者健康行为及生活质量的影响观察

Influence of Pharmaceutical Care Pathway on Health Behaviors and Quality of Life of Lung Cancer Patients with Chemotherapy

目的:观察药学监护路径对肺癌化疗患者健康行为及生活质量的影响。方法:110例肺癌化疗患者随机分为两组,剔除脱落病例后对照组(常规临床路径管理)纳入48例,干预组(常规临床路径联合药学监护路径管理)纳入50例。记录两组患者化疗前、化疗2周期及4周期后健康行为以及生活质量评分;组间比较采用独立样本t检验,各指标不同时间点下变化采用重复测量方差分析。同时比较化疗期间两组患者的药品不良反应。结果:健康行为方面,经过2、4周期后,干预组健康行为各维度得分及总分均明显高于对照组(P<0.01)。经重复测量方差分析,两组患者各维度得分及总分比较均有明显差异(P<0.01);总分及各维度得分在不同时间点差异有统计学意义(P<0.01);除人际关系外,其余维度在干预和时间因素之间存在交互作用(P<0.05)。不同时间点两两比较,与入院时比较,对照组2周期后健康责任、运动锻炼、压力管理维度得分及总分明显升高(P<0.05);干预组2周期、4周期后各维度得分及总分均明显升高(P<0.01)。在生活质量方面,经过2、4周期后,干预组生活质量各维度得分及总分均明显高于对照组(P<0.01)。经重复测量方差分析,两组患者各维度得分及总分均有明显差异(P<0.05);时间、交互效应差异有统计学意义(P<0.05)。不同时间点两两比较,与入院时比较,干预组2周期及4周期后各维度得分及总分均明显升高(P<0.01)。干预组恶心呕吐、腹泻、静脉炎及药品不良反应总发生率明显低于对照组(P<0.05)。结论:临床药学监护路径可明显改善肺癌化疗患者健康行为,提高患者生活质量,可保证患者治疗的安全性。

Objective:To investigate the influence of pharmaceutical care pathway on health behavior and quality of life in patients with lung cancer undergoing chemotherapy.Methods:110 Patients with lung cancer for chemotherapy were randomly divided into two groups.The control group(48 cases)were received conventional clinical pathway management,and the intervention group(50 cases)were received conventional clinical pathway combined with pharmaceutical pathway management.In addition,health behavior and quality of life scores were recorded at the time of before and after 2 and 4 cycle chemotherapy,independent sample t test was used for inter-group comparison,and repeated measure variance analysis was used for variation of each index at different time points.And all adverse reactions during the study were recorded.Results:In terms of healthy behaviors,after 2 and 4 cycles,the total scores and scores of all dimensions of healthy behaviors in the intervention group were significantly higher than those in the control group(P<0.01).By repeated measures of variance analysis,there were significant differences in total score and scores of all dimensions between the two groups(P<0.01).The total score and scores of each dimension were significantly different at different time points(P<0.01).Except interpersonal relationship,the other dimensions had interaction effect between intervention and time factors(P<0.05).In addition,compared with the time of admission,the total scores and scores of health responsibility,exercise and stress management in the control group increased significantly after 2 cycles(P<0.05).Total scores and scores of all dimensions were significantly increased in the intervention group after 2 and 4 cycles(P<0.01).In terms of quality of life,the scores and total scores of all dimensions of quality of life in the intervention group were significantly higher than those in the control group(P<0.01).By repeated measurement analysis of variance,the scores of each dimension and the total score of the two groups were significantly different(P<0.05).There were also significant differences in time and interaction effects(P<0.05).In addition,compared with the time of admission,total scores and scores of all dimensions in the intervention group increased significantly after 2 cycles and 4 cycles(P<0.01).Meanwhile,the incidence of nausea,vomiting,diarrhea,phlebitis and adverse drug reactions in the intervention group was significantly reduced(P<0.05).Conclusion:The pathway of clinical pharmaceutical care can significantly improve the health behavior and quality of life of in patients with chemotherapy,as well as can ensure the safety of treatment for patients.