卵巢癌患者个案管理实践方案的构建及初步应用

Construction and preliminary application of a case management practice program for ovarian cancer patients

目的构建卵巢癌患者个案管理实践方案并应用于临床,初步探究其应用效果。方法通过文献分析法、质性研究和专家会议法构建卵巢癌个案管理实践方案。将方案实施前(2022年8月至2023年6月)和实施后(2023年7月至2024年3月)在复旦大学附属妇产科医院纳入并实施常规临床护理的卵巢癌患者设为对照组和试验组,每组16例。比较两组患者干预前后的支持性照护需求、疾病症状及非计划再入院率的差异。采用支持性需求简明问卷(Supportive Care Needs Survey Shortform 34,SCNS-SF34)收集患者的支持性照护需求。采用安德森症状评估量表(M.D.Anderson Symptom Inventory,MDASI)评估患者的疾病症状。结果构建的卵巢癌个案管理实践方案包含卵巢癌个案管理师的资质与专业能力、实践核心以及具体的实施路径。方案实施后,试验组患者SCNS-SF34总得分和各维度评分均低于对照组(P均<0.001),MDASI总得分和各维度得分均低于对照组(P均<0.05)。两组患者的非计划再入院率差异无统计学意义。结论构建的卵巢癌患者个案管理实践方案具备科学性,该方案能有效满足卵巢癌患者的照护需求,并缓解疾病症状。

Objective To develop a nurse-led case management practice program for ovarian cancer patients,and to investigate its application effect initially.Methods The case management practice model of ovarian cancer was formed through literature analysis,qualitative research and expert meeting method.Ovarian cancer patients who were given conventional nursing interventions from Aug 2022 to Jun 2023 and from Jul 2023 to Mar 2024 in Obstetrics and Gynecology Hospital,Fudan University were selected as the control group(n=16)and the intervention group(n=16).The patients’supportive care needs,disease symptoms and unplanned readmission rates were compared before and after intervention between two groups.Supportive Care Needs Survey Shortform 34(SCNS-SF34)was used to collect patients’supportive care needs,and M.D.Anderson Symptom Inventory(MDASI)was used to assess disease symptoms.Results The ovarian cancer case management practice program was constructed and revised to determine the qualification and professional competence of the ovarian cancer case manager,the core of practice,and the specific implementation pathway.After intervention,the total score and scores of all dimensions of SCNS-SF34 in the intervention group were lower than those of the control group(P<0.001),the total score and scores of all dimensions of MDASI in the intervention group were lower than those of the control group(P<0.05).There was no statistically significant difference in unplanned readmission rates between the two groups.Conclusion The case management practice program for ovarian cancer patients was constructed with scientific validity,which can effectively meet the care needs of patients and alleviate their disease symptoms.