问题导向干预对肝癌介入治疗患者术后胃肠功能及主观幸福感的影响

Effect of problem oriented intervention on gastrointestinal function and subjective well-being in patients with liver cancer after interventional therapy

目的探讨问题导向干预对肝癌介入治疗患者术后胃肠功能及主观幸福感的影响。方法选取160例肝癌介入治疗患者,以问题导向干预实施时间为分界,将2018年6月至2019年6月问题导向干预实施前接受常规护理干预的80例肝癌介入治疗患者作为对照组,将2019年7月至2020年6月问题导向干预实施后收治的80例肝癌介入治疗患者作为观察组。比较两组患者的术后胃肠功能恢复指标、主观幸福感[总体幸福感量表(GWB)]、心理压力[成人心理压力量表(APSS)]、生活质量[癌症患者生命质量测定量表之肝癌量表(QLICP-LI)]、并发症发生情况及护理满意度。结果观察组患者术后肠鸣音恢复时间、首次排气时间、首次排便时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。干预后,观察组患者GWB量表各维度评分均高于本组干预前和对照组,APSS量表评分低于对照组,QLICP-LI量表各维度评分均高于对照组,差异均有统计学意义(P﹤0.05)。观察组患者并发症总发生率为10.00%(8/80),与对照组患者的15.00%(12/80)比较,差异无统计学意义(P﹥0.05)。观察组患者的护理满意度为90.00%(72/80),高于对照组患者的76.25%(61/80),差异有统计学意义(P﹤0.05)。结论围手术期问题导向干预可促进肝癌介入治疗患者术后胃肠功能的恢复,提高主观幸福感,减轻心理压力,提高生活质量及护理满意度。

Objective To explore the effect of problem oriented intervention on gastrointestinal function and subjective well-being in patients with liver cancer after interventional therapy.Method A total of 160 patients with liver cancer undergoing interventional therapy were selected,and 80 patients with liver cancer undergoing routine nursing intervention from June 2018 to June 2019 before the implementation of problem oriented intervention were selected as the control group,and 80 patients with liver cancer undergoing interventional therapy from July 2019 to June 2020 after the implementation of problem oriented intervention were selected as the observation group.The recovery indicators of gastrointestinal function,subjective well-being[general well-being schedule(GWB)],psychological stress[adult psychological stress scale(APSS)],quality of life[quality of life instruments for cancer patients-liver cancer(QLICP-LI)],complications,and nursing satisfaction were compared between the two groups.Result The recovery time of bowel sounds,the first exhaust time,and the first defecation time in the observation group were significantly shorter than those in the control group,the differences were statistically significant(P<0.01).After intervention,the scores of each dimension of the GWB scale in the observation group were higher than those before the intervention and control group,the APSS scale score in the observation group was lower than that in the control group,and the scores of all dimensions of the QLICP-LI scale were higher than those in the control group,the differences were statistically significant(P<0.05).The total incidence of complications in the observation group was 10.00%(8/80),which was not significantly different from 15.00%(12/80)in the control group(P>0.05).The nursing satisfaction in the observation group was 90.00%(72/80),higher than 76.25%(61/80)in the control group,the difference was statistically significant(P<0.05).Conclusion Perioperative problem oriented intervention can promote the recovery of gastrointestinal function,improve subjective well-being,alleviate psychological pressure,improve quality of life and nursing satisfaction in patients with liver cancer after interventional therapy.