多维度姑息护理对终末期血液肿瘤患者营养、心理状况和生活质量的影响

Effects of multi-dimension palliative care on nutritional,psychological status and life of quality among patients with end-stage hematoma

目的:探讨多维度姑息护理对终末期血液肿瘤患者营养、心理状况和生活质量的影响。方法:选择2018年1月至2018年12月于核工业416医院住院治疗的终末期血液肿瘤患者96例,采用随机数字法分为对照组和观察组,分别接受常规护理和多维度姑息护理,1个月后采用全面主观营养评定法(PG-SGA)评估营养状况,采用焦虑(SAS)和抑郁(SDS)自评量表评估心理状况,采用肿瘤生存质量调查表(QLQ-C30)和癌症治疗功能评价量表(FACT-G)评估生活质量。结果:干预前两组PG-SGA评分差异无统计学意义[(5.4±1.8) vs (5.5±1.6),P> 0.05],干预后观察组PG-SGA评分低于对照组[(5.6±1.4) vs (6.3±1.6),P<0.05];干预前两组SAS和SDS评分差异无统计学意义(P> 0.05),干预后观察组低于对照组[SAS:(42.0±9.4) vs (46.9±9.7),SDS:(38.8±8.1) vs (45.6±9.1),P <0.05];干预前两组QLQ-C30及FACT-G评分差异无统计学意义(P> 0.05),而干预后观察组QLQ-C30总分低于对照组[(70.4±10.7) vs (79.0±11.5),P <0.05],而整体健康状况观察组高于对照组[(10.0±1.5) vs (8.9±1.8),P <0.05]。干预后观察组FACT-G总分及功能、社会/家庭和情感3个维度均低于对照组[总分:(76.1±8.3) vs (84.3±8.8);功能:(19.8±3.6) vs (23.1±3.8);社会/家庭:(20.9±3.8) vs (22.9±3.2);情感:(14.6±2.2) vs (16.5±2.4),P <0.05]。结论:多维度姑息护理能有效改善终末期血液肿瘤患者的营养和心理状况,提高生活质量。

Objective:To discuss the effects of multi-dimension palliative care on nutritional,psychological status and life of quality among patients with end-stage hematoma.Methods:From January to December 2018,ninety-six patients with end-stage hematoma were selected from 416 Hospital of Nuclear Industry and randomly divided into control group and observation group by random number method.Patients in control group and observation group were received routine nursing and multi-dimension palliative care.Nutritional status was evaluated by patient-generated subjective global assessment(PG-SGA).Psychological status was assessed by self-raking anxiety scale(SAS)and self-raking depression scale(SDS),and life of quality was appraised by quality of life questionnaire(QLQ-C30)and functional assessment of cancer therapy-general(FACT-G)after one month.Results:There was no significant difference of PG-SGA score between two groups before intervention[(5.4±1.8)vs(5.5±1.6),P>0.05],while PG-SGA score in observation group was lower than control group after intervention[(5.6±1.4)vs(6.3±1.6),P<0.05].There was no significant difference of SAS and SDS score between two groups before intervention(P>0.05),while the scores of SAS and SDS in observation group were lower than control group after intervention[SAS:(42.0±9.4)vs(46.9±9.7),SDS:(38.8±8.1)vs(45.6±9.1),P<0.05].The differences of QLQ-C30 and FACT-G score were not found between two groups before intervention(P>0.05).After one month intervention,total QLQ-C30 score in observation group was lower than control group[(70.4±10.7)vs(79.0±11.5),P<0.05],while total health status score in observation group was high than control group[(10.0±1.5)vs(8.9±1.8),P<0.05].The FACT-G total score and three dimensions including function,society/family and emotion in observation group were significantly lower than control group[total:(76.1±8.3)vs(84.3±8.8),function dimension:(19.8±3.6)vs(23.1±3.8),society/family dimension:(20.9±3.8)vs(22.9±3.2),emotion dimension:(14.6±2.2)vs(16.5±2.4),P<0.05].Conclusion:Multi-dimension palliative care could improve nutritional,psychological status and life of quality among patients with end-stage hematoma.