二元疾病管理理论在卵巢癌化疗患者及其配偶中的应用研究

The application analysis of dyadicillness management theory in chemotherapy-stage ovarian cancer patients and their spouses

目的探讨基于二元疾病管理理论的干预方案对卵巢癌化疗患者及其配偶二元应对、照护需求及患者疾病症状的影响,旨在为提升其疾病应对能力和生命质量提供参考。方法采用随机对照试验法,便利选取2022年7月至2023年6月在复旦大学附属妇产科医院接受规律化疗的72对卵巢癌患者及其配偶为研究对象,使用随机数字表法分为对照组(36对)和观察组(36对),对照组予常规护理干预,观察组在此基础上予基于二元疾病管理理论的干预方案。比较2组患者及其配偶在干预前(化疗前)、干预后(化疗周期结束后)的二元应对水平、照护需求及患者疾病症状方面的差异。应用SPSS 20.0软件进行分析,采用两独立样本t检验、χ^(2)检验和Wilcoxon秩和检验对2组进行比较。结果最终纳入对照组36对,观察组34对,对照组患者年龄为(52.03±9.44)岁,观察组患者年龄为(53.41±10.14)岁。干预后,观察组患者和配偶的二元应对得分分别为(113.50±8.03)、(114.62±10.59)分,高于对照组的(106.64±10.06)、(108.78±10.89)分,差异均有统计学意义(t=-3.14、-2.27,均P<0.05);干预后观察组患者和配偶的照护需求评分分别为(89.65±8.29)、(95.12±7.25)分,低于对照组的(100.25±10.82)、(110.11±7.58)分,差异均有统计学意义(t=4.58、8.45,均P<0.001);干预后观察组患者的疾病症状总分为(20.09±4.70)分,低于对照组的(31.53±6.08)分,差异有统计学意义(t=8.77,P<0.001)。结论实施基于二元疾病管理理论的干预方案能够有效提升卵巢癌化疗患者及其配偶二元支持应对水平,满足其二元照护需求,缓解患者疾病症状,提高患者的生命质量。

Objective To explore the effects of an intervention strategy based on dyadic illness management theory on dyadic coping level,supportive care needs,and patients'disease symptoms with chemotherapy-stage ovarian cancer patients and their spouses,and to provide reference for improving their disease coping ability and quality of life.Methods This study used the method of randomized controlled trial.Seventy pairs of ovarian cancer patients and their spouses who received regular chemotherapy and their spouses from Obstetrics and Gynecology Hospital,Fudan University from July 2022 to June 2023 were selected using convenience sampling method.They were assigned to the control group(36 pairs)and the observation group(36 pairs)by the random number table method.Participants in the control group received routine nursing care and the observation group received the intervention strategy of dyadic illness management theory.Data were collected and compared the differences in dyadic coping levels,care needs,and disease symptoms between two groups of patients and their spouses before intervention(before chemotherapy)and after intervention(after the end of the chemotherapy cycle).SPSS 20.0 software was used for analysis,and t-tests,χ^(2) tests,and Wilcoxon rank sum tests were used to compare the two groups.Results Finally,36 pairs were included in the control group and 34 pairs in the observation group.The age of the control group patients was(52.03±9.44)years old,while that of the observation group patients was(53.41±10.14)years old.After the intervention,the total score of dyadic coping level in the patients and their spouses of the observation group were(113.50±8.03),(114.62±10.59)points,respectively,which were higher than(106.64±10.06),(108.78±10.89)points of the control group with significant differences(t=-3.14,-2.27,both P<0.05);the total score of care needs in the patients and their spouses of the observation group were(89.65±8.29),(95.12±7.25)points,respectively,which were lower than(100.25±10.82),(110.11±7.58)points of the control group with significant differences(t=4.58,8.45,both P<0.001);the total score of disease symptoms in the patients of the observation group was(20.09±4.70)points,which was lower than(31.53±6.08)points of the control group with significant differences(t=8.77,P<0.001).Conclusions The model of dyadic illness management can improve dyadic coping level and supportive care needs of chemotherapy-stage ovarian cancer patients and their spouses,and alleviate patients'disease symptoms.