Distress management in cancer patients:Guideline implementation based on CAN-IMPLEMENT

Objective:To standardize the distress management of gastric cancer patients receiving chemotherapy,the adapted Cancer-related Distress Management Guidelines were implemented in nursing practice among gastric cancer patients receiving chemotherapy based on A Guideline Adaptation and Implementation Planning Resource(CAN-IMPLEMENT).Methods:Based on the theoretical framework of CAN-IMPLEMENT,A multidisciplinary team was established,barriers and facilitators obstacles of guidelines implementation in medical oncology units were assessed,corresponding solutions were formulated,the guidelines implementation process was monitored,and implementation results were evaluated.Results:The multidisciplinary team developed review criteria,standardized work paths,assessment tools,training manuals for healthcare professionals,education manuals for patients and their caregivers.After guidelines implementation,the completion rate of the distress management record came up to 97.9%(189/193).From September 2017 to December 2018,the compliance of medical staff on most items in the audit checklist was improved,ranging from 57.1%(100/175)to 100.0%(193/193).The positive distress rate of gastric cancer patients receiving chemotherapy was decreased from 22.7%(32/141)to 9.3%(18/193)(P<0.05),and the Median(range)of the distress score declined from 2(0e9)to 0(0e7)(P<0.001).Conclusions:The implementation of guidelines based on CAN-IMPLEMENT promotes the establishment of a distress management system in the medical oncology units.The review standards,standardized work paths,and evaluation tools for distress in cancer patients formulated by the multidisciplinary team had clinical applicability and effectiveness.Quality control in the practice of distress management was effective.The compliance of healthcare professionals with distress management was improved.The distress of gastric cancer patients receiving chemotherapy was alleviated effectively.

知信行健康教育对慢性阻塞性肺疾病患者心理状态及生活质量的影响

探讨知信行健康教育对慢性阻塞性肺疾病(COPD)患者心理状态及生活质量的影响。方法 入选病例:我院COPD患者470例,选取时期为2020年1月~2021年12月,随机分为2组,普通组235例提供常规健康宣教,知信行组235例实施知信行健康教育,比较2组不良情绪、肺功能、血气指标、疗护依从性及生活质量。结果 护理后焦虑自评量表、恐惧视觉模拟及汉密尔顿抑郁量表评分,知信行组低于普通组,P<0.05;护理后患者一秒用力呼气容积(FEV1)及血氧分压(PaO2),知信行组均高于普通组,其二氧化碳分压(PaCO2)低于普通组,P<0.05;患者疗护依从性,知信行组高于普通组,P<0.05;护理后简易生活质量量表(SF-36)各维度评分,知信行组均高于普通组,P<0.05。结论 知信行健康教育开展后,可有效改善慢性阻塞性肺疾病患者不良心态及生活质量。