基于个案管理的个性化护理及临终关怀对晚期原发性肝癌患者的影响

Effects of personalized nursing and hospice care based on case management on patients with advanced primary livercancer

目的探讨基于个案管理的个性化护理及临终关怀对晚期原发性肝癌患者心理状况及生理应激的影响。方法选取2019年7月至2020年10月间上海中医药大学附属曙光医院诊治的100例晚期肝癌患者为研究对象,应用随机数表法分为观察组与对照组,每组50例。对照组给予临终关怀护理,观察组给予基于个案管理的个性化护理。比较护理前后焦虑自评量表(SAS)、抑郁自评量表(SDS)、心率、收缩压(SBP)和舒张压(DBP)变化,统计两组患者疼痛缓解情况。结果两组患者护理后,SDS、SAS评分均下降,且观察组低于对照组(P<0.05)。观察组护理后疼痛缓解效果优于对照组(P<0.05)。两组患者的心率、SBP和DBP均升高,但观察组低于对照组(均P<0.05)。结论晚期原发性肝癌采用基于个案管理的个性化护理,可有效改善其心理状态,减轻疼痛,减少生理应激,提升生活质量,建议临床推广运用。

Objective To explore the effects of personalized nursing and hospice care based on case management on psychological status and physiological stress in patients with advanced primary liver cancer.Methods One hundred patients with advanced liver cancer treated at Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine were selected from July 2019 to October 2020.They were randomly divided into an observation group and a control group with 50 patients in each group.The observation group was given personalized nursing based on case management and the control group was given hospice care nursing.Changes in self-rating anxiety scale(SAS),self-rating depression scale(SDS),heart rate,systolic blood pressure(SBP)and diastolic blood pressure(DBP)were compared before and after nursing.Pain relief was investigated in the two groups.ResultsAfter nursing,SDS and SAS scores decreased in the two groups,and the scores were lower in the observation group than in the control group(all P<0.05).The pain relief effect was better in the observation group than in the control group after nursing(P<0.05).After nursing,heart rate,SBP and DBP increased in the two groups,and they were significantly lower in the observation group than in the control group(all P<0.05).Conclusion Individualized care and hospice care based on case management can effectively improve psychological state,relieve pain,reduce physical stress,and improve quality of life in patients with advanced primary liver cancer.It was suggested to be popularized in clinical practice.