鼻咽癌放化疗患者院外随访现状及影响因素分析

Analysis of out of hospital follow-up status and influencing factors of patients with nasopharyngeal carcinoma undergoing radiotherapy and chemotherapy

目的:调查并分析鼻咽癌放化疗患者出院后第1、3、6个月的随访及生存质量现状,比较失访与未失访患者的一般资料、生存质量情况,总结鼻咽癌放化疗患者院外随访的临床经验。方法:采用自行设计的一般资料调查表及头颈癌生存质量量表对84例鼻咽癌放化疗出院患者通过电话随访进行问卷调查,分析随访现状及影响因素。结果:鼻咽癌放化疗患者出院后第1、3、6个月的随访完成率分别为84.52%、77.38%、55.95%,患者的生存质量处于中低水平。第1个月随访时失访患者在生存质量总分及家庭社会维度的得分低于未失访者,差异具有统计学意义(P<0.05);第3个月随访时失访患者在社会家庭状况维度的得分低于未失访者,差异具有统计学意义(P<0.05);第6个月随访时失访患者在功能状况维度的得分低于未失访者,差异具有统计学意义(P<0.05)。结论:医护人员应扩充院外随访的形式,提高院外随访率,同时应关注鼻咽癌放化疗患者的中长期生存质量,针对不同时期的患者构建具体的院外延续护理方案。

Objective:To investigate and analyze the status of follow-up and quality of life of patients with nasopharyngeal carcinoma undergoing radiotherapy and chemotherapyat 1,3 and 6 months out of the hospital,compare the general materials and quality of life of patients without follow-up and those without follow-up,and summarize the clinical experience of out-of-hospital follow-up of patients with nasopharyngeal carcinoma undergoing radiotherapy and chemotherapy.Methods:The self-designed general data questionnaire and head and neck cancer life quality scale were used to investigate 84 patients with nasopharyngeal carcinoma undergoing radiotherapy and chemotherapy.The follow-up status and influencing factors were analyzed.Results:The followup rates of patients with nasopharyngeal carcinoma were 84.52%,77.38%and 55.95%at 1,3 and 6 months after out-of-hospital.The patients’quality of life was in the low to medium range.At the first month of follow-up,the total score of quality of life and family social dimension of the lost patients were lower than those of the non-lost patients,and the difference was statistically significant(P<0.05).At the third month of follow-up,the score of social and family status of the lost patients was lower than that of the non-lost patients,and the difference was statistically significant(P<0.05).At the 6th month of follow-up,the scores of the lost patients in the functional status dimension were lower than those of the non-lost patients,and the difference was statistically significant(P<0.05).Conclusion:Medical staff should expand the form of out-of-hospital follow-up,improve the rate of out-of-hospital follow-up,and pay attention to the medium and long-term quality of life of patients with nasopharyngeal carcinoma undergoing radiotherapy and chemotherapy,and construct specific out-of-hospital extended care programs for patients in different periods.