以结局为导向的循证护理在非小细胞肺癌肺叶切除术患者中的应用价值

The application value of outcome-oriented evidence-based nursing in patients with non-small cell lung cancer undergoing lobectomy

目的探讨以结局为导向的循证护理在Ⅰ~Ⅱ期非小细胞肺癌(NSCLC)肺叶切除术患者中的应用价值。方法选择2020-06-01-2022-06-30濮阳惠民医院收治的行胸腔镜下肺叶切除术的Ⅰ~Ⅱ期NSCLC患者126例,采用随机数字表法分为常规护理组(n=63)和循证护理组(n=63)。2组患者均行胸腔镜下肺叶切除术和规范的放化疗治疗,常规护理组给予常规护理,循证护理组在常规护理组基础上给予结局为导向的循证护理干预。干预3个月后,比较2组锻炼依从性,采用肺功能检测仪检测患者的肺功能[用力肺活量(FVC)、第1秒用力呼气容积与用力肺活量比值(FEVl/FVC)],采用Champion健康信念模式评分量表(CHBMS)评估患者的健康信念、采用焦虑自评量表(SAS)评估患者的心理状态,采用生活质量核心量表(QLQ-C30)评估患者的生活质量。结果干预3个月后,循证护理组锻炼总依从率(98.41%)明显高于常规护理组(80.95%),差异有统计学意义,χ^(2)=9.157,P=0.003;循证护理组FVC、FEVl/FVC、CHBMS评分分别为(2.92±0.24)L、(80.44±4.67)%、(105.68±6.89)分,均高于常规护理组的(2.79±0.34)L、(77.82±5.13)%、(89.44±7.88)分,差异有统计学意义,F值分别为3.221、4.637、76.240,P值分别为0.043、0.011、<0.001;循证护理组SAS评分、QLQ-C30功能与症状评分和总健康状况评分分别为(44.14±4.78)分、(72.94±5.38)分、(6.54±0.967)分,低于常规护理组的(48.33±4.69)分、(79.54±6.21)分、(7.63±0.99)分,差异有统计学意义,F值分别为12.298、20.334、20.831,均P<0.001。结论以结局为导向的循证护理干预可提高Ⅰ~Ⅱ期NSCLC患者肺叶切除术后患者的健康信念,改善心理状态,增强锻炼依从性,促进肺功能恢复,从而提高生活质量。

Objective To explore the application value of outcome-oriented evidence-based nursing in patients with stage III non-small cell lung cancer(NSCLC)undergoing lobectomy.Methods Totally 126patients with stageⅠ-ⅡNSCLC who underwent thoracoscopic lobectomy at Puyang Huimin Hospital from June 1,2020to June 30,2022were collected and randomly divided into routine nursing group and evidence-based nursing group,with 63patients in each group.Both groups of patients underwent thoracoscopic lobectomy,standardized radiotherapy and chemotherapy.The routine nursing group received routine nursing,while the evidence-based nursing group received outcome-oriented evidence-based nursing intervention on the basis of the routine nursing group.After 3months of intervention,the exercise compliance was compared between the two groups;the lung function detector was used to detect the pulmonary function[forced vital capacity(FVC),forced expiratory volume in the first second to forced vital capacity ratio(FEVl/FVC)],Champion health belief model rating scale(CHBMS)was used to evaluate the health beliefs,self rating anxiety scale(SAS)was used to evaluate the mental status,and core quality of life scale(QLQ-C30)was used to evaluate the quality of life.Results After 3 months of intervention,the total compliance rate of exercise in the evidence-based nursing group(98.41%)was significantly higher than that in the routine nursing group(80.95%),and the difference was statistically significant,χ^(2)=9.157,P=0.003;the scores of FVC,FEV1/FVC,and CHBMS in the evidence-based nursing group were(2.92±0.24)L,(80.44±4.67)%,and(105.68±6.89)points,respectively,which were higher than those in the routine nursing group(2.79±0.34)L,(77.82±5.13)%,and(89.44±7.88)points,the differences were statistically significant,Fvalues were 3.221,4.637,76.240,and Pvalues were 0.043,0.011,<0.001,respectively;the SAS score,QLQC30function and symptom score,and overall health status score in the evidence-based nursing group were(44.14±4.78)points,(72.94±5.38)points,and(6.54±0.96)points,respectively,which were lower than those in the routine nursing group(48.33±4.69)points,(79.54±6.21)points,and(7.63±0.99)points,the differences were statistically significant,with Fvalues were 12.298,20.334,and 20.831,respectively,all P<0.001.Conclusion Outcome-oriented evidence-based nursing interventions can improve the health beliefs,psychological state,exercise compliance,promote lung function recovery,and ultimately improve the quality of life of patients with stageⅠtoⅡNSCLC after lobectomy.