多维模式干预对胰腺癌化疗患者自我管理水平与不良反应的影响

Effect of multidimensional model intervention on the self-management level and adverse event of patients undergoing chemotherapy for pancreatic cancer

目的 探讨多维模式干预对胰腺癌化疗患者自我管理水平与不良反应的影响。方法 将101例胰腺癌患者按干预方式的不同分为常规组47例及多维组54例,常规组应用常规化疗管理模式,多维组应用多维模式干预。对比两组患者腹部疼痛程度[视觉模拟评分法(VAS)评分]、功能状态[卡氏功能状态(KPS)评分]、自我管理水平、睡眠质量[匹兹堡睡眠质量指数(PSQI)]、癌因性疲乏[癌症疲乏量表(CFS)]、化疗期间不良反应发生情况及满意度。结果 化疗后,两组患者VAS评分均低于化疗前,KPS评分均高于化疗前,多维组患者VAS评分低于常规组,KPS评分高于常规组,差异均有统计学意义(P﹤0.05)。化疗后,两组患者自我管理水平问卷各条目评分均高于化疗前,且多维组患者自我管理水平问卷各条目评分均高于常规组,差异均有统计学意义(P﹤0.05)。化疗后,两组患者PSQI各维度评分及总分均低于化疗前,且多维组患者PSQI各维度评分及总分均低于常规组,差异均有统计学意义(P﹤0.05)。化疗后,两组患者CFS各维度评分及总分均低于化疗前,且多维组患者CFS各维度评分及总分均低于常规组,差异均有统计学意义(P﹤0.05)。常规组患者满意度低于多维组,化疗不良反应总发生率高于多维组,差异均有统计学意义(P﹤0.05)。结论 多维模式干预能够提高胰腺癌化疗患者的自我管理水平,降低患者腹部疼痛程度,改善患者机体功能状态与睡眠质量,减轻患者癌因性疲乏,降低化疗不良反应发生率。

Objective To investigate the effect of multidimensional model intervention on the self-management level and adverse events of patients undergoing chemotherapy for pancreatic cancer.Method A total of 101 pancreatic cancer patients were divided into conventional group(47 cases)and multidimensional group(54 cases)according to different in-tervention methods.The conventional group received the conventional chemotherapy management model,and the multidi-mensional group received the multidimensional model intervention.The abdominal pain level[visual analogue scale(VAS)score],functional status[Karnofsky performance status(KPS)score],self-management level,sleep quality[Pitts-burgh sleep quality index(PSQI)],cancer-related fatigue[cancer fatigue scale(CFS)],the occurrence of adverse events during the chemotherapy,and satisfaction of the two groups were compared.Result After the chemotherapy,the VAS scores of the two groups were lower,and the KPS scores were higher than those before the chemotherapy,the VAS score of the multidimensional group was lower than that of the conventional group,and the KPS score was higher than that of the conventional group,and the differences were statistically significant(P<0.05).After the chemotherapy,the scores of each item of the self-management level questionnaire of the two groups were higher than those before the chemotherapy,and the scores of the multidimensional group were higher than those of the conventional group,and the differences were statistically significant(P<0.05).After the chemotherapy,the PSQI dimensional scores and total scores of the two groups were lower than those before chemotherapy,and the scores of the multidimensional group were lower than those of the conventional group,and the differences were statistically significant(P<0.05).After the chemotherapy,the CFS dimen-sional scores and total scores of the two groups were lower than those before chemotherapy,and the scores of the multidi-mensional group were lower than those of the conventional group,and the differences were statistically significant(P<0.05).The satisfaction in the conventional group was lower than that in the multidimensional group,and the total inci-dence of adverse events to chemotherapy was higher than that in the multidimensional group,the differences were statisti-cally significant(P<0.05).Conclusion The multidimensional model intervention could improve the self-management level of pancreatic cancer chemotherapy patients,reduce their abdominal pain,improve their physical functional status,sleep quality,and reduce cancer-related fatigue,the risk of chemotherapy adverse events.