头颈肿瘤气管切开带管出院患者家庭参与式延续护理的实施

Implementation of family integrated transitional care for discharged head and neck cancer patients carrying tube after tracheotomy

目的 探讨头颈肿瘤气管切开带管出院患者实施家庭参与式延续护理的效果。方法 将头颈肿瘤气管切开带管出院患者78例随机分为观察组和对照组各39例,对照组采用常规出院指导和健康教育,观察组在此基础上实施家庭参与式延续护理,由护理团队对患者家属进行气管切开照护技能培训,通过互联网技术对患者及家属进行院外延续护理。比较两组患者家属气管切开护理技能水平和居家照护能力,同时比较两组患者气管切开相关并发症发生率、再入院率。结果 出院时观察组患者家属气管切开护理技能考核评分显著高于对照组,出院时及出院后1个月、3个月两组家属照护能力评分比较,差异有统计学意义(均P<0.05);出院后3个月观察组气管切开并发症发生率及相关再入院率显著低于对照组(均P<0.05)。结论 家庭参与式延续护理为头颈肿瘤气管切开带管出院患者供了连续、优质、专业的居家护理支持,可提高其家庭照顾者居家照护能力,有效降低患者并发症发生率。

Objective To explore the implementation effect of family integrated transitional care for discharged head and neck cancer patients carrying tube after tracheotomy.Methods A total of 78 discharged head and neck cancer patients carrying tube after tracheotomy were randomized into an intervention group and a control group,with 39 cases in each group.The control group received routine discharge guidance and health education,while the intervention group additionally implemented family integrated transitional care,which including training family members the skills of nursing after tracheotomy,and providing out-of-hospital transitional care guidance to the patients and their families through the Internet.The nursing skill level of tracheotomy and home care ability of the family members and the incidence of tracheotomy-related complications and the readmission rate of the two groups were compared.Results At discharge,the evaluation score of tracheotomy-related nursing skills in family members in the intervention group was significantly higher than that in the control group,and there was a significant difference in their scores of home care ability at discharge,1 month and 3 months after discharge(P<0.05 for all).In addition,3 months after discharge,the incidence of tracheotomy-related complications and readmission rate in the intervention group were significantly lower than those in the control group(P<0.05 for both).Conclusion Family integrated transitional care provides continuous,high-quality and professional home care support for discharged head and neck cancer patients carrying tube after tracheotomy,which can improve the home care ability of family caregivers and effectively reduce the incidence of complications.