基于慢性疾病轨迹模式的护理干预在胸腔镜食管癌患者中的效果

Effect of Nursing Intervention Based on Chronic Disease Track Mode in Patients with Esophageal Cancer under Thoracoscope

目的:探讨基于慢性疾病轨迹模式的护理干预在胸腔镜食管癌患者中的效果。方法:选择2018年1月-2021年5月在河西学院附属张掖人民医院心胸肿瘤外科接受胸腔镜手术的120例食管癌患者,采用随机数字的方法,将患者分对照组60例和观察组60例。对照组患者实施常规护理干预,观察组患者在对照组的基础上实施基于慢性疾病轨迹模式的护理干预。比较两组患者干预前后的负性情绪情况[汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)]、自我管理效能[中文版癌症自我管理效能量表(SUPPH)]、生活质量[生命质量测定量表(EORTCQOL-C30)]、疾病知识知晓情况。比较两组的遵医行为情况、术后并发症情况。结果:干预前,两组HAMA评分、HAMD评分、自我管理效能评分生活质量评分、疾病知识知晓评分比较,差异均无统计学意义(P>0.05)。干预后,两组HAMA评分、HAMD评分均低于干预前,自我管理效能评分、生活质量评分、疾病知识知晓评分均高于干预前(P<0.05)。干预后,观察组HAMA评分、HAMD评分均低于对照组,自我管理效能评分、生活质量评分、疾病知识知晓评分均高于对照组(P<0.05)。干预后,观察组遵医行为评分高于对照组(P<0.05)。观察组患者的术后并发症发生率低于对照组(P<0.05)。结论:将基于慢性疾病轨迹模式的干预方法应用于接受胸腔镜手术的食管癌患者人群中,有利于改善患者的不良情绪反应,提升患者的自我管理效能以及生活质量,增加患者的疾病知识知晓水平以及遵医行为水平,降低术后并发症的发生率,值得在临床工作中推广应用。

Objective:To explore the effect of nursing intervention based on chronic disease track mode in patients with esophageal cancer under thoracoscope.Method:A total of 120 patients with esophageal cancer who underwent thoracoscopic surgery in the Cardiothoracic Oncology Department of Zhang Ye People's Hospital Affiliated to Hexi University from January 2018 to May 2021 were selected,used the method of random numbers,all patients were divided into control group 60 cases and observation group 60 cases.The patients in the control group received routine nursing intervention,the patients in the observation group received nursing intervention based on the chronic disease track mode on the basis of the control group.The negative emotions[Hamilton depression scale(HAMD),Hamilton anxiety scale(HAMA)],self-management effectiveness[Chinese version of strategies used by people to promote health(SUPPH)],quality of life[quality of life measurement scale(EORTCQOL-C30)],disease knowledge awareness,and compliance behavior before and after treatment were compared between the two groups.The compliance behavior and postoperative complications of the two groups were compared.Result:Before intervention,there were no significant differences in HAMA scores,HAMD scores,self-management efficiency scores,quality of life scores and disease knowledge awareness scores between the two groups(P>0.05).After intervention,the scores of HAMA and HAMD in the two groups were lower than those before intervention,and the scores of self-management efficacy,quality of life and disease knowledge were higher than those before intervention(P<0.05).After intervention,the scores of HAMA and HAMD in the observation group were lower than those in the control group,and the scores of self-management efficacy,quality of life and disease knowledge were higher than those in the control group (P<0.05). After intervention, the score of compliance behavior in the observation groupwas higher than that in the control group (P<0.05). The incidence of postoperative complications in the observationgroup was lower than that in the control group (P<0.05). Conclusion: The nursing intervention based on the chronicdisease track mode is applied to the population of esophageal cancer patients undergoing thoracoscopic surgery,which is beneficial to improve the patients' adverse emotional reaction, improve the patients' self-managementefficiency and quality of life, increase the patients' knowledge of disease and the level of medical compliance, andreduce the incidence of postoperative complications, it is worth popularizing and applying in clinical work.