症状管理动态模型在淋巴瘤化疗患者全程管理中的应用研究

Application of symptom management dynamic model in the whole-course management of lymphoma patients with chemotherapy

目的:分析症状管理动态模型在淋巴瘤化疗患者全程管理中的应用效果。方法:将2020年5月1日至2021年2月28日在某三级甲等肿瘤专科医院住院的初治淋巴瘤患者作为研究对象,按入院先后顺序分为干预组(106例)和对照组(100例),干预组实施基于症状管理动态模型的全程管理模式,对照组给予常规护理联合症状日记的管理模式,共干预6个化疗周期,分别在第1个化疗周期前、第3个化疗周期后、第6个化疗周期后3个时间点,对比两组患者延迟化疗发生情况、化疗合并症及生活质量的差异。结果:化疗并发症方面,第6个化疗周期后,干预组患者延迟化疗发生率低于对照组(P<0.05),Ⅳ度骨髓抑制发生率低于对照组(P<0.05);生活质量方面,重复测量方差分析结果显示,两组患者情绪功能得分存在时间效应及交互效应,恶心及呕吐、食欲丧失得分存在时间、组间及交互效应,疲乏、经济困难得分存在时间及组间效应,便秘、腹泻得分仅存在时间效应(均P<0.05)。结论:症状管理动态模型干预可以降低淋巴瘤患者延迟化疗、骨髓抑制的发生率,提高患者生活质量,为实现淋巴瘤患者全程管理提供参考。

Objective:To explore the application effect of symptom management dynamic model in the whole-course management of lymphoma patients undergoing chemotherapy.Methods:Patients with preliminary hospitalized in the lymphoma ward of a tertiary grade A tumor hospital from May 2020 to February 2021,were assigned into the intervention group(106 cases)and the control group(100 cases)according to the order of admission.The intervention group received the whole-course management based on the symptom management dynamic model.The control group was given routine nursing combined with symptom diary,and the total intervention time was 6 cycles,respectively before the first cycle of chemotherapy and after the end of the sixth cycle of chemotherapy.The differences in chemotherapy complications,total burden of symptoms,quality of life and delayed chemotherapy between the two groups were compared.Results:Chemotherapy complications:After 6 cycles of intervention,the incidence of delayed chemotherapy in the intervention group was lower than that in the control group(P<0.05),the incidence of bone marrow suppression in the intervention group was lower than that in the control group(P<0.05);Quality of life:Repeated measures analysis of variance showed that the emotional function scores of the two groups existed time and interaction effects,nausea and vomiting,loss of appetite scores existed time,inter-group and interaction effects,fatigue and financial burden scores existed time and inter-group effects,constipation and diarrhea scores only existed time effect(all P<0.05).Conclusion:Symptom management dynamic model intervention can reduce the incidence of delayed chemotherapy and myelosuppression in lymphoma patients,improve their quality of life,and provide reference for the implementation of the whole-course management of lymphoma patients.