护联体内胃肠道肿瘤患者中医延续护理方案的构建与实践研究

A Traditional Chinese Medicine continuous nursing program for patients with gastrointestinal cancer in the nursing consortium:development and practical effect

目的探讨以护联体为载体的胃肠道肿瘤患者中医延续护理方案的构建及临床应用效果。方法以渥太华决策支持框架为理论指导,在文献回顾的基础上,经过两轮专家函询和5例患者预试验,最终形成护联体内胃肠道肿瘤患者中医延续护理方案。于2021年3月至2022年8月在某三级甲等中医医院收治的胃肠道肿瘤患者中进行应用验证,评价方案实施前后患者生活质量、自我护理依从性和社区服务利用率。结果观察组生命质量评分提高(F_(交互)=1.183,P<0.05),角色功能评分提高(F_(交互)=10.358,P<0.01),情绪功能评分提高(F_(交互)=6.171,P<0.01),中医适宜技术利用率提高(χ^(2)=13.495,P<0.001),膳食调理执行率提高(χ^(2)=4.566,P=0.033),合理运动率提高(χ^(2)=9.078,P=0.003),五行音乐执行率提高(χ^(2)=19.858,P<0.001),社区服务利用率提高(χ^(2)=66.706,P<0.001)。结论以护联体为载体的胃肠道肿瘤患者中医延续护理方案具有科学性且安全实用,可提高社区服务利用率,促进胃肠道肿瘤患者生活质量和自我护理依从性。

Objective To develop a Traditional Chinese Medicine(TCM)continuous nursing program for patients with gastrointestinal cancer in the nursing consortium,and to assess its practical effect.Methods Guided by the Ottawa Decision Support Framework and a literature review,we developed a TCM continuous nursing program for patients with gastrointestinal cancer in the nursing consortium,and determined its final version after revising it in accordance with the results of two rounds of expert consultation and a pre-test in five patients.Then from March 2021 to August 2022,we tested the effect of the program in patients with gastrointestinal cancer(experimental group)in a grade A tertiary TCM hospital,whose pre-and post-intervention quality of life,self-care compliance and community service utilization rate were evaluated and compared with those of the control group.Results Compared with the control group,after intervention,the observation group had significantly improved scores of quality of life(F_(interaction)=1.183,P<0.05),role-physical(F_(interaction)=10.358,P<0.01),and role-emotional(F_(interaction)=6.171,P<0.01),and much higher rates of utilizing appropriate TCM techniques(χ^(2)=13.495,P<0.001),eating a healthier diet(χ^(2)=4.566,P=0.033),reasonably exercising(χ^(2)=9.078,P=0.003),listening to the music of five elements classified by relevant TCM theory(χ^(2)=19.858,P<0.001),and utilizing community services(χ^(2)=66.706,P<0.001).Conclusion The program has proven to be scientific,safe and feasible,and can improve the utilization rate of community services,quality of life and self-care compliance in gastrointestinal cancer patients.