居家舒缓疗护干预对晚期肿瘤患者生命质量及家属应对能力的影响

Effects of home-based palliative care intervention on quality of life in patients with advanced cancer and coping strategies of their family members

目的探讨居家舒缓疗护干预对晚期肿瘤患者生命质量及家属应对能力的影响。方法选取2017年11月至2019年3月间山东省立第三医院收治的118例晚期肿瘤患者,采用随机数字表法分为研究组和对照组,每组59例。对照组患者采用常规干预,研究组患者采用居家舒缓疗护干预,比较两组患者生命质量评分、患者家属满意度、应对方式(SCSQ)评分及家属应对能力评分情况。结果干预后,研究组患者社会功能、情绪功能、躯体功能、认知功能、角色功能和总体健康状况子量表评分均高于对照组,经济困难、便秘、失眠、疼痛、疲劳、腹泻、食欲不振、呼吸困难及恶心和呕吐评分均低于对照组,差异均有统计学意义(均P<0.05)。研究组患者家属对居家舒缓疗护干预的满意度高于对照组,差异均有统计学意义(均P<0.05)。研究组患者积极应对评分高于对照组,消极应对评分低于对照组,差异均有统计学意义(均P<0.05)。研究组患者家属护理技能评分高于对照组,差异均有统计学意义(均P<0.05)。结论晚期肿瘤患者采用居家舒缓疗护干预,可提高患者生命质量,增加家属应对能力,临床应进一步推广应用。

Objective To explore the effect of home-based palliative care intervention on the quality of life of patients with advanced cancer and coping strategies of their family members.Methods A total of 118 patients with advanced tumors who admitted to Shandong Provincial Third Hospital from November2017 to March 2019 were selected and divided into a study group and a control group by random number table method with 59 patients in each group.The study group was given home-based palliative care intervention and the control group was given convertional nursing.Quality of life scores,family member satisfaction,the simple coping style questionnaire(SCSQ score),and the family coping ability scores were compared.Results After the intervention,the social function,emotional function,physical function,cognitive function,role function and subscale of overall health status were higher in the study group than in the control group(all P<0.05),and the economic difficulty,constipation,insomnia,pain,fatigue,diarrhea,loss of appetite,dyspnea,and nausea and vomiting were lower in the study group than in the control group(all P<0.05).Family member satisfaction was higher in the study group than in the control group(P<0.05).The positive coping score was higher in the study group than in the control group(P<0.05).The scores of family member coping ability was higher in the study group than in the control group(P<0.05).Conclusion Home-based palliative care intervention has a great impact on quality of life of patients with advanced cancer and coping strategies of their family members,which should be further promoted and applied clinically.