患者参与的情景模拟健康教育在晚期肺癌患者癌痛管理中的应用

Effect of Patient Participation in Scenario Simulation Health Education on Management of Cancer Pain in Patients with Advanced Lung Cancer

目的探讨患者参与的情景模拟健康教育在晚期肺癌患者癌痛管理中的应用效果,旨在提高晚期肺癌患者癌痛应对和管理能力。方法采用便利抽样法,选取2019年5月至2020年5月在同济大学附属上海市肺科医院肿瘤科住院的晚期肺癌患者60例为研究对象,按其住院时间先后顺序分为对照组(n=30)和观察组(n=30)。对照组患者给予肺癌疼痛常规护理及健康教育,观察组在其基础上给予患者参与的情景模拟健康教育干预,主要围绕主题为正确认识癌痛、癌痛自我评估、癌痛应对、躯体功能应对和心理情绪调试5个脚本展开。采用慢性疼痛自我效能感量表、中文版简式-简明心境问卷分别于患者入院第1天及第7天评估患者的疼痛管理效能及心境状态。结果入院第1天,两组患者的慢性疼痛自我效能和心境状态得分比较,差异均无统计学意义(P>0.05)。入院第7天,观察组患者的慢性疼痛自我效能感量表总分及其各维度得分高于对照组,中文版简式-简明心境问卷得分低于对照组,组间比较差异均有统计学差异(P<0.05)。结论患者参与的情景模拟健康教育可有效提高晚期肺癌患者慢性疼痛自我效能,改善患者心境状态,进而提高其生活质量,值得临床进一步应用和推广。

Objective To explore the effect of patient participation in scenario simulation health education on management of cancer pain in patients with advanced lung cancer,in order to improve the capability to cope with and manage cancer pain in those patients.Methods A total of 60 patients with advanced lung cancer hospitalized in the Oncology Department of Shanghai Pulmonary Hospital affiliated to Tongji University from May 2019 to May 2020 were selected by convenience sampling.They were divided into the control group(n=30)and the observation group(n=30)according to the order of hospitalization.The patients in the control group were given routine nursing and health education for lung cancer pain,while the patients in the observation group were given scenario simulation health education on this basis.The scenario simulation health education mainly focused on the following 5 scripts:correct understanding of cancer pain,self-assessment of cancer pain,coping with cancer pain,coping with physical function and emotional regulation.The pain management efficacy and mood status of the patients were assessed on Day 1 and Day 7 of admission using the Chronic Pain Self-efficacy Scale and the Profile of Mood States-Short Form(Chinese version).Results On Day 1 of admission,there were no significant differences in the scores of chronic pain self-efficacy and mood state between the two groups(P>0.05).On Day 7 of admission,the total score of the Chronic Pain Self-efficacy Scale and the score of each dimension in the observation group were higher than those in the control group;the score of the Profile of Mood States-Short Form(Chinese version)in the observation group was lower than that in the control group,with significant differences(P<0.05).Conclusion Since patient participation in the scenario simulation health education can effectively improve the chronic pain self-efficacy,mood status and quality of life in patients with advanced lung cancer,it is worthy of further clinical application and promotion.