医护一体化干预对口腔癌手术患者心理状态及并发症的影响

Effect of doctor-nurse integration management on psychological state and complications of patients with oral cancer receiving surgery

目的探讨医护一体化干预对口腔癌手术患者心理状态及并发症的影响。方法依据干预方式的不同将200例口腔癌患者分为观察组(n=110)和对照组(n=90),对照组患者接受常规干预措施,观察组患者在常规干预的基础上接受医护一体化干预措施。干预前及干预6个月后,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)评估两组患者的心理状况;采用自拟口腔癌疾病相关知识调查问卷,比较两组患者的疾病相关知识知晓度;比较两组随访复查期间并发症发生情况,包括口腔感染、出血和皮瓣坏死等。结果干预前,两组患者SAS、SDS评分比较,差异均无统计学意义(P﹥0.05)。干预6个月后,两组患者SAS、SDS评分均低于本组干预前,且观察组患者SAS、SDS评分均低于对照组患者,差异均有统计学意义(P﹤0.05)。观察组患者术前注意事项、术后自我护理、营养管理、康复要求、饮食要点及随访检查评分均明显高于对照组患者,差异均有统计学意义(P﹤0.05)。两组患者口腔感染、出血发生率比较,差异均无统计学意义(P﹥0.05),观察组患者皮瓣坏死发生率低于对照组患者,差异有统计学意义(P﹤0.05)。结论医护一体化干预模式能够改善口腔癌手术患者焦虑、抑郁情绪,提高其对疾病相关知识的知晓度,降低皮瓣坏死发生率。

Objective To explore the effect of doctor-nurse integration management on psychological state and complications of patients with oral cancer.Method By specific interventions administered,the 200 oral cancer patients included in the analysis were divided into two groups as study group(n=110)and control group(n=90),respectively,the control group received routine nursing care,while study group patients were administered with nursing management based on doctor-nurse integration mode.Before and 6 months after intervention,self-rating anxiety scale(SAS)and selfrating depression scale(SDS)were employed to assess the psychological state of all patients;a specifically designed questionnaire of oral cancer knowledge assessment was used to investigate the mastery of disease-related knowledge in the two groups;the incidence of complications,including oral infections,hemorrhage and flap necrosis,during follow-up were compared between the two groups.Result Similar scores of SAS and SDS were obtained in the two groups before intervention(P>0.05).While in 6 months after intervention,the scores of SAS and SDS showed notable decreased in both groups,with significantly lower scores of SAS and SDS in study group compared to control group(P<0.05).The scores regarding precautions before surgery,postoperative self-care,nutrition management,rehabilitation requirements,dietary instruction and follow-up scores in the study group were significantly higher than those in the control group(P<0.05).The incidence of oral infection and hemorrhage were comparable in the two groups(P>0.05),however,lower rate of flap necrosis was observed in study group than in control group(P<0.05).Conclusion The doctor-nurse integration management facilitates the improvement of anxiety and depression and also the knowledge of disease among patients with oral cancer undergoing surgery,thereby reducing the incidence of flap necrosis in oral cancer.