基于个案管理的延伸护理干预对食管癌放疗患者自我效能、自护能力和生活质量的影响

Effect of extended nursing intervention based on case management on self-efficacy,self-care ability and living quality of patients with esophageal cancer radiotherapy

目的探讨基于个案管理的延伸护理干预对食管癌放疗患者自我效能、自护能力和生活质量的影响。方法选取医院2019年6月—2020年6月收治的80例食管癌放疗患者为研究对象,按照性别、年龄、肿瘤部位、肿瘤分期组间匹配的原则分为对照组和观察组,每组40例。对照组患者采用常规护理,观察组在对照组基础上对患者进行个案管理的延伸护理,分别运用中文版癌症自我管理效能感量表(SUPPH)、自我护理能力测定量表(ESCA)和生命质量测定量表(QLQ-C30)评估对比两组患者干预前后自我效能感、自护能力和生活质量的差异。结果干预前,两组患者SUPPH评分比较差异无统计学意义(P>0.05);观察组患者干预3个月后自我决策、自我减压、正性态度及自我效能总分均高于对照组,组间比较差异有统计学意义(P<0.05)。干预前,两组患者ESCA评分比较差异无统计学意义(P>0.05);观察组患者干预3个月后自我护理技能、自我责任感、自我概念、健康知识水平评分均高于对照组,组间比较差异有统计学意义(P<0.05)。干预前,两组患者QLQ-C30评分比较差异无统计学意义(P>0.05);观察组患者干预3个月后躯体、角色、社会、情绪和认知评分均高于对照组,组间比较差异有统计学意义(P<0.05)。结论基于个案管理的延伸护理干预应用于食管癌放疗患者,可有效提高其自我效能感,提升自我护理能力,改善生活质量。

Objective To explore the eff ect of extended nursing intervention based on case management on self-effi cacy,self-care ability and living quality of patients with esophageal cancer radiotherapy.Methods To select 80 esophageal cancer radiotherapy patients admitted to the hospital from June 2019 to June 2020 was as the research objects.According to the principle of matching between gender,age,tumor location,and tumor stage,they were divided into a control group and an observation group,with 40 cases in each group.Patients in the control group received routine nursing care,and patients in the observation group carried out extended nursing of case management on the basis of the control group.The diff erences in self-effi cacy,self-care ability and quality of life between the two groups of patients before and after intervention were evaluated and compared with the Chinese-version strategies used by people to promote health(SUPPH),exercise of self-care agency scale(ESCA)and quality of life measurement scale(QLQ-C30).Results There was no signifi cant diff erence in SUPPH score between the two groups of patients before the intervention(P>0.05).The total scores of self-determination,self-decompression,positive attitude and self-effi cacy in the observation group were higher than those in the control group after 3 months of intervention,and the diff erences between the groups were statistically signifi cant(P<0.05).There was no signifi cant diff erence in ESCA score between the two groups of patients before the intervention(P>0.05).The self-care skills,self-responsibility,self-concept,and health knowledge level scores of patients in the observation group were higher than those in the control group after 3 months of intervention,and the diff erences between the groups were statistically signifi cant(P<0.05).There was no signifi cant diff erence in QLQ-C30 score between the two groups of patients before the intervention(P>0.05).The physical,role,social,emotional and cognitive scores of patients in the observation group were higher than those in the control group after 3 months of intervention,and the diff erences between the groups were statistically signifi cant(P<0.05).Conclusion The extended nursing intervention based on case management applied to patients undergoing radiotherapy for esophageal cancer can eff ectively improve their sense of self-effi cacy,enhance their self-care ability,and improve their quality of life.