智能手机软件对鼻咽癌放化疗后并发症的管理和干预研究

发布时间：2018-03-05 07:40

本文选题：智能手机　切入点：应用程序　出处：《郑州大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:应用智能手机软件分析鼻咽癌患者接受同期放化疗出院后的毒副作用和并发症、以及对生存质量的影响,并调查智能手机应用软件在鼻咽癌患者出院后随访中应用的可行性。方法:本研究采用随机对照实验。选择2015年3月1日-2016年3月25日期间,在我院放疗科接受同期放化疗的患者132名。随机分为对照组65名,干预组67名。对照组出院后采用传统的健康指导及随访方式。干预组患者出院时指导患者下载及使用自行设计的智能手机软件,软件包括个人信息、复诊提醒、并发症的评估、知识库、互动5个模块,具体内容包括鼻咽癌患者接受同期放化疗后出现的急慢性毒副反应及并发症的观察与治疗等疾病相关知识,康复锻炼、鼻腔冲洗等的操作视频。在两组患者出院时收集患者一般资料;出院时及出院6个月收集两组患者放化疗并发症情况及生存质量(QLQ-C30);出院3个月及出院6个月时收集两组患者鼻腔冲洗及张口锻炼依从性情况;出院6个月时收集干预组患者使用智能手机软件情况。结果:1.放化疗毒副反应及并发症比较两组患者出院时,口腔黏膜炎、张口困难、口干、听力下降、鼻塞的发生率差异无统计学意义(p0.05),具有可比性。两组患者出院后6个月,在口腔黏膜炎、张口困难、口干、鼻塞4个方面比较,差异具有统计学意义(p0.05),听力下降方面两组比较差异无统计学意义(p0.05)。2.生活质量得分比较出院时两组患者在功能方面、症状方面及总生存质量得分方面差异无统计意义(p0.05),具有可比性。两组患者出院时及出院后6个月,干预组总生存质量分别为42.14±10.64、72.03±10.07,对照组总生存质量分别为44.15±13.31、60.15±12.17。出院后6个月,干预组除认知功能领域、气促症状、经济困难项目外,均优于对照组,差异均有统计学意义(p0.05)。3.两组康复锻炼依从性比较出院3个月、6个月时,干预组在张口锻炼依从性上明显高于对照组,差异具有统计学意义(p0.05)。出院3个月时,患者在鼻腔冲洗依从性上,差异无统计学意义(p0.05)。出院6个月时,干预组鼻腔冲洗依从性高于对照组,差异有统计学意义(p0.05)。4.智能手机软件使用情况干预组患者使用智能手机应用软件6个月后,对其使用情况进行调查,96%患者通过智能手机软件推送消息形式提醒出院后定期复诊可以接受;89%的患者认为智能手机软件的内容设置能满足出院后的健康知识需求;87%的患者平均每周可使用一次智能手机软件;82%的患者认为选择晚上时间推送消息最为合适。结论:1.接受放化疗出院后的鼻咽癌患者并发症及毒副反应较多,生存质量较差。2.智能手机应用程序的使用可提高放化疗鼻咽癌患者出院后锻炼依从性,降低放化疗毒副反应和并发症。3.智能手机应用程序的使用可提高患者生存质量及患者满意度,具有可行性。
[Abstract]:Objective: to analyze the side effects and complications of nasopharyngeal carcinoma (NPC) patients after receiving radiotherapy, chemotherapy and discharge, and to analyze the effects on quality of life (QOL) of nasopharyngeal carcinoma patients by using smart phone software. To investigate the feasibility of the application of smartphone application software in the follow-up of nasopharyngeal carcinoma patients after discharge from hospital. Methods: a randomized controlled trial was used. The period from March 1st 2015 to March 25th 2016 was selected. 132 patients who received concurrent radiotherapy and chemotherapy in the radiotherapy department of our hospital were randomly divided into the control group (65 cases) and the control group (65 cases). 67 patients in the intervention group were treated with traditional health guidance and follow-up methods after discharge. The patients in the intervention group were instructed to download and use self-designed smartphone software when discharged from the hospital. The software included personal information, follow-up reminder, and evaluation of complications. Knowledge base, interactive 5 modules, specific contents include the patient with nasopharyngeal carcinoma after the concurrent radiotherapy and chemotherapy of acute and chronic side effects and complications of observation and treatment of diseases related knowledge, rehabilitation exercise, Operation video of nasal lavage etc. General data of patients were collected when discharged from the two groups; The complications of radiotherapy and chemotherapy and QLQ-C30 were collected at the time of discharge and 6 months after discharge, and the compliance of nasal irrigation and open mouth exercise were collected at 3 months after discharge and 6 months after discharge. After 6 months of discharge, the patients in the intervention group were collected the use of smart phone software. Results: 1.The side effects and complications of radiotherapy and chemotherapy were compared between the two groups when they were discharged from the hospital, the patients had oral mucositis, difficulty opening mouth, dry mouth, and hearing loss. There was no significant difference in the incidence of nasal congestion (P 0.05), which was comparable. Six months after discharge, the two groups were compared in four aspects: oral mucositis, difficult mouth opening, dry mouth, and nasal congestion. The difference was statistically significant (P 0.05). There was no significant difference in hearing loss between the two groups. The scores of quality of life (QOL) were compared between the two groups at the time of discharge. There was no statistical significance in symptom and total quality of life score (P 0.05). At discharge and 6 months after discharge, the total quality of life of intervention group was 42.14 卤10.64 卤10.07, and that of control group was 44.15 卤13.31 卤60.15 卤12.17.The total quality of life in intervention group was 42.14 卤10.64 卤10.07, respectively. 6 months after discharge, the total quality of life in intervention group was 44.15 卤13.31 卤60.15 卤12.17 respectively. The intervention group was superior to the control group in terms of cognitive function, symptoms of shortness of breath and economic difficulties, and the difference was statistically significant (p 0.05). The compliance of rehabilitation exercise between the two groups was compared at 3 months and 6 months after discharge. The compliance of the intervention group in open mouth exercise was significantly higher than that in the control group, and the difference was statistically significant (P 0.05). At 3 months after discharge, there was no significant difference in the compliance of nasal irrigation in the intervention group. At 6 months after discharge, there was no significant difference in the compliance of the patients with nasal irrigation. The nasal cavity flushing compliance of the intervention group was higher than that of the control group, and the difference was statistically significant (p 0.05). 4. The use of smart phone software in the intervention group was 6 months after the use of smart phone application software. 96% of patients are reminded to receive regular visits after discharge via smartphone software push message. 89% of the patients think the content settings of smartphone software can meet the health knowledge needs after discharge from the hospital, and 89% of the patients think that the content settings of the smartphone software can meet the needs of health knowledge after discharge. An average of 87% of the patients can use the smartphone software once a week. 82% of the patients think that it is most appropriate to choose the night time to push the news. Conclusion 1. After receiving radiotherapy and chemotherapy, patients with nasopharyngeal carcinoma have more complications and side effects. The use of smart phone applications can improve the exercise compliance of patients with radiotherapy and chemotherapy nasopharyngeal carcinoma after discharge. Reduce side effects and complications of radiotherapy and chemotherapy. 3. The use of smart phone applications can improve patients' quality of life and patient satisfaction, which is feasible.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：TP311.56;R739.63

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