全程个案管理模式在乳腺癌保乳日间手术中的应用研究

Application research in breast-conserving surgery for breast cancer in the whole process of the whole case management mode

目的研究基于日间手术流程的全程个案管理模式在乳腺癌保乳手术患者中的应用效果。方法选取2020年8月至2021年1月于上海交通大学医学院附属瑞金医院门诊收治的108例乳腺癌保乳手术患者作为研究对象。根据纳入和排除标准,将患者随机分为日间组和对照组,每组各54例。日间组实施保乳日间手术全程个案管理模式,对照组实施常规保乳手术个案管理模式。采用流程耗时、诊疗费用比较两组的流程运行效率、经济支出;运用焦虑自评量表、生活质量信息接收评价量表评估两组患者的术前焦虑水平和信息接收水平。结果日间组等待手术耗时(1567.41±152.05)min,少于对照组的(6017.76±1687.36)min(P<0.001);日间组术后观察耗时(1010.35±157.40)min,少于对照组的(1326.17±529.91)min(P<0.001);日间组全流程耗时(11371.39±2358.78)min,少于对照组的(13215.98±5666.93)min(P=0.035)。日间组术前焦虑评分[(52.15±2.89)分]低于对照组[(57.96±4.07)分],生活质量信息接收评价量表评分[(52.67±5.67)分]高于对照组[(47.9±7.21)分],差异均有统计学意义(P<0.001)。结论乳腺癌保乳日间手术全程个案管理模式能够有效缓解患者的术前焦虑,提高其信息接收水平。

Objective To study the application effect of a whole case management mode based on the day surgery process in patients undergoing breast-conserving surgery for breast cancer.Methods A total of 108 patients with breast cancer undergoing breast-conserving surgery admitted to Ruijin Hospital Shanghai Jiao Tong University School of Medicine from August 2020 to January 2021 were selected as the research objects.Based on the criteria of inclusion and exclusion,the patients were divided into the daytime group and the control group,with 54 cases in each group.The daytime group implemented the whole case management mode of breast-conserving surgery,and the control group implemented the conventional case management model of breast-conserving surgery.The processing efficiency and economic expenditure of the two groups were evaluated and compared by the process time and diagnosis and treatment funds.The anxiety self-rating scale and Information-25 were used to evaluate the preoperative anxiety level and information receiving level of patients in the two groups.Results The waiting time for surgery in the day group was(1567.41±152.05)min,which was lower than that of the control group(6017.76±1687.36)min(P<0.001).The postoperative observation time in the day group was(1010.35±157.40)min,which was less than that of the control group(1326.17±529.91)min(P<0.001).The whole process time of the day group was(11371.39±2358.78)min,which was less than that of the control group(13215.98±5666.93)min(P=0.035).The preoperative anxiety score[(52.15±2.89)points]in the day group was lower than that in the control group[(57.96±4.07)points],and the score of quality of life information reception evaluation scale[(52.67±5.67)points]was higher than that in the control group[(47.9±7.21)points],and the differences were statistically significant(P<0.001).Conclusion The whole case management mode of breast-conserving surgery for breast cancer can effectively alleviate patients’preoperative anxiety and improve their information receiving level.