PDCA循环式护理干预在弥漫性大B细胞淋巴瘤化疗患者中的应用评价

Efficacy of PDCA cycle of nursing intervention in patients undergoing chemotherapy for diffuse large B-cell lymphoma

目的 探讨PDCA循环式护理干预对弥漫性大B细胞淋巴瘤(DLBCL)化疗患者的应用效果。方法 选取2018年6月至2019年12月间复旦大学附属华山医院收治98例DLBCL化疗患者,采用随机数表法分为观察组和对照组,每组49例。观察组患者采用PDCA循环式护理干预,对照组患者采用常规护理,比较两组患者干预前后的生活质量、焦虑自评量表(SAS)和抑郁自评量表(SDS)评分、护理满意度及不良反应发生情况。结果 干预前,两组患者生活质量评分比较,差异无统计学意义(P>0.05)。干预后,观察组患者功能和总体健康评分均高于对照组,症状和特异性评分均低于对照组,差异均有统计学意义(均P<0.05)。干预前,两组患者SAS和SDS评分比较,差异无统计学意义(P>0.05)。干预后,两组患者SAS和SDS评分均低于干预前,且观察组均低于对照组,差异均有统计学意义(均P<0.05)。观察组患者不良反应总发生率为12.2%,低于对照组的38.8%,差异有统计学意义(P<0.05)。观察组患者护理满意度为98.0%,高于对照组的83.7%,差异有统计学意义(P<0.05)。结论 PDCA循环式护理干预可有效改善DLBCL化疗患者的生活质量和心理状况,降低不良反应发生率,提高护理满意度,有确切的应用效果。

Objective To explore the effect of Plan-Do-Check-Act(PDCA) cycle of nursing intervention in patients with diffuse large B-cell lymphoma(DLBCL) on chemotherapy. Methods A total of 98 patients with DLBCL on chemotherapy were included at Huashan Hospital Affiliated to Fudan University from June 2018 to December 2019. They were divided into an observation group and a control group with 49 patients each. The observation group received PDCA cycle interventions and the control group received routine nursing. Quality of life, self-rating anxiety scale(SAS) and the self-rating depression scale(SDS) scores, nursing satisfaction, and incidence of adverse reactions were compared between the two groups before the intervention and at the time of discharge. Results There was no significant difference in quality of life scores between the two groups before the intervention(P>0.05). After the intervention, physical function and overall health scores were higher in the observation group than in the control group(all P<0.05). However, scores for the symptoms and specificity were lower in the observation group than in the control group(all P<0.05). No significant difference was observed in SAS and SDS scores between the two groups before the intervention(P>0.05). After the intervention, SAS and SDS scores decreased in both groups and the scores were lower in the observation group than in the control group(all P<0.05). The overall incidence of adverse reactions was 12.2% in the observation group which was lower than 38.8% of the control group(P<0.05). Patient satisfaction was 98.0% in the observation group which was higher than 83.7% of the control group(P<0.05). Conclusion PDCA cycle of nursing intervention can effectively improve quality of life and psychological status, reduce the incidence of adverse reactions, and improve patient satisfaction with the care in patients with DLBCL on chemotherapy with exact application efficacy.