以家庭为中心的护理在白血病患儿诱导化疗中的应用

Application of family centered nursing in induction chemotherapy of children with leukemia

目的探讨以家庭为中心的护理在白血病患儿诱导化疗中的应用效果。方法选取2018年1月至2019年12月于本院进行治疗的白血病患儿60例,随机数字表法分为两组,各30例。对照组男14例,女16例,年龄(7.6±1.5)岁;研究组男16例,女14例,年龄(7.3±1.2)岁。对照组进行常规护理,研究组采用以家庭为中心的护理模式进行干预,包含鞘内注射期间、经外周静脉置入中心静脉导管(PICC)置管期间、静脉药物化疗期间护理、心理支持以及并发症护理。对比两组患儿汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)、照护过程评价量表(MPOC)评分以及T淋巴细胞亚群指标。结果干预前,两组白血病患儿HAMD、HAMA评分比较,差异均无统计学意义(均P>0.05);干预后,研究组HAMD、HAMA评分分别为(10.4±2.5)分、(14.4±2.2)分,均低于对照组(15.6±4.2)分、(18.3±3.3)分,差异均有统计学意义(均P<0.05)。干预后,研究组家属MPOC尊重和支持、提供特殊信息、提供基础信息、合作、全面护理评分分别为(5.64±0.87)分、(5.75±0.76)分、(5.78±0.32)分、(5.68±0.82)分、(5.78±0.56)分,均高于对照组(5.01±0.76)分、(3.56±0.76)分、(3.21±0.87)分、(4.27±0.43)分、(4.31±0.65)分,差异均有统计学意义(均P<0.05)。干预前,两组白血病患儿T淋巴细胞亚群各指标比较,差异均无统计学意义(均P>0.05);干预后,研究组CD3+、CD4+以及CD4+/CD8+指标分别为(65.6±6.5)%、(42.5±3.6)%、(1.76±0.21),均高于对照组(55.6±4.6)%、(36.7±3.7)%、(1.43±0.21),CD8+指标为(24.2±2.1)%,低于对照组(26.7±3.2)%,差异均有统计学意义(均P<0.05)。结论选用以家庭为中心的护理模式在白血病患儿诱导化疗中的整体应用效果良好,可有效提升患儿免疫功能和心理状态。

Objective To investigate the effect of family centered nursing in induction chemotherapy in children with leukemia.Methods Sixty cases of children with leukemia treated in our hospital from January 2018 to December 2019 were selected,and were divided into two groups with the random number table,30 cases in each group.There were 14 males and 16 females in the control group,with the age of(7.6±1.5)years old;there were 16 males and 14 females in the study group,with the age of(7.3±1.2)years old.The control group was given routine care,and the study group was given family centered nursing intervention,including nursing during intrathecal injection,peripherally inserted central catheter(PICC)treatment period,intravenous drug chemotherapy period,psychological support,and nursing of complications.The scores of HAMD,HAMA,MPOC,and T lymphocyte subsets indexes were compared between the two groups.Results There were no statistically significant differences in HAMD and HAMA scores between the two groups before the intervention(both P>0.05);after the intervention,the HAMD and HAMA scores in the study group were lower than those in the control group[(10.4±2.5)points vs.(15.6±4.2)points,(14.4±2.2)points vs.(18.3±3.3)points](both P<0.05).After the intervention,the scores of respect and support,providing special information,providing basic information,cooperation,comprehensive nursing of MPOC scale of family members in the study group were(5.64±0.87)points,(5.75±0.76)points,(5.78±0.32)points,(5.68±0.82)points,and(5.78±0.56)points,which were higher than those in the control group[(5.01±0.76)points,(3.56±0.76)points,(3.21±0.87)points,(4.27±0.43)points,and(4.31±0.65)points](all P<0.05).There were no statistically significant differences in T lymphocyte subsets indexes before the intervention(all P>0.05);after the intervention,CD3+,CD4+,and CD4+/CD8+in the study group were(65.6±6.5)%,(42.5±3.6)%,and(1.76±0.21),which were higher than those in the control group[(55.6±4.6)%,(36.7±3.7)%,and(1.43±0.21)],CD8+was lower than that in the control group[(24.2±2.1)%vs.(26.7±3.2)%](all P<0.05).Conclusion The application of family centered nursing mode in the induction chemotherapy for children with leukemia has a good effect,which can effectively improve the immune function and mental state of children.