基于支持性照护理论食管癌患者术后延续护理方案的构建与应用

Construction and application of postoperative transitional care scheme for esophageal cancer patients based on supportive care theory

目的:构建食管癌患者术后延续护理方案并分析其临床应用效果,以期改善食管癌患者术后生活质量。方法:通过查阅文献、焦点小组讨论、德尔菲法等,在支持性照护理论指导下构建食管癌患者术后延续护理方案。便利抽取2019年1月—12月在某三级甲等医院胸外科进行手术治疗的60例食管癌患者作为对照组,采用常规护理干预;2020年1月—12月的60例患者作为干预组,采用基于微信小程序的延续护理方案。两组患者在出院前1天,术后1个月、3个月、6个月,采用食管癌患者特异性支持照护需求量表、家庭弹性量表、食管癌专用生活质量量表进行评估。结果:两组食管癌患者特异性支持照护需求总分、家庭弹性总分的组别、时间和交互效应差异均有统计学意义(P<0.05),生活质量评分的组别和时间效应差异有统计学意义(P<0.05)。结论:本研究构建的食管癌患者术后延续护理方案合理、可行,有利于患者的康复。

Objective:To construct transitional care scheme for patients with esophageal cancer and analyze its clinical application effect.Methods:The scheme was constructed under the guidance of supportive care theory,by using literature review,group discussion and Delphi method.A total of 60 patients with esophageal cancer who underwent surgical treatment in the Department of Thoracic Surgery of a tertiary grade A hospital from January to December 2019 were selected as the control group,received routine nursing care.From January to December 2020,60 patients were selected as the intervention group and received transitional care based on WeChat mini program.Two groups of patients were evaluated at four time points:1 day before discharge,1 month,3 months and 6 months after surgery.The Specific Support and Care Needs Scale for Patients with Esophageal Cancer(SSCNS-E),Family Resilience Scale Chinese version(FRAS-C),and Esophageal Cancer Quality of Life Scale(QLQ-OES 18)were used as tools.Results:There were statistically significant differences in the total score of SSCNS-E and FRAS-C between the two groups of esophageal cancer patients in terms of group,time,and interaction effects(P<0.05).There were statistically significant differences in the group and time effects of QLQ-OES 18 scores(P<0.05).Conclusion:The postoperative transitional care scheme for esophageal cancer patients constructed in this study is reasonable and feasible,and conducive to the rehabilitation of patients.