综合护理对肺癌化疗患者情绪及应对方式和生活质量的影响
发布时间：2018-08-12 07:26
【摘要】：目的从情绪、应对方式和生活质量三个方面对肺癌患者进行评估,阐述在肺癌患者化疗过程中应用综合护理模式后其情绪、应对方式和生活质量等方面的变化,根据临床护理反馈来评估综合护理干预的实际疗效和临床价值。方法收集河南省某三级甲等医院2014年12月至2015年2月肺癌化疗4个病区首次确诊为肺癌的患者132例,对这132例患者的临床资料进行回归性分析,以1、3病区为对照组,2、4病区作干预组。每组患者均为66例。对照组给予呼吸内科常规护理,包括:(1)基础护理(2)健康教育(3)心理护理(4)预防感染(5)饮食指导。干预组分为6个小组,每小组8-12人。干预组的研究对象需要在临床常规护理的基础上进行综合护理干预措施,详细的护理干预措施为:(1)患者入院确诊后拟行化疗时开始进行认知干预、渐进式肌肉放松训练、团体心理干预的综合护理干预。每次干预时间30~60min,每周给予干预1次,共计6次,同时结合患者实际情况随时调整。(2)患者化疗间歇期出院后,电话跟踪随访,每1周一次。主要以解决患者的实际问题为目的,继续向患者提供心理学相关知识,巩固治疗效果。(3)应用调查问卷收集研究对象的一般基线资料。应用简式心境量表(POMS-SF)、医学应对量表(MCMQ)、生活质量调查表(QLQ-C30)分别在化疗前调查研究开始时、接受综合护理干预后化疗结束一月内,评估两组患者的情绪、应对方式和生活质量状况。资料收集整理后录入数据库,采用SPSSl6.0进行统计分析。通过对比两组研究对象在进行护理干预前后的情绪、应对方式和生活质量三个方面的变化进行分析讨论,从而评价综合护理干预的效果。结果1、简式心境量表是测量患者的心境状态,主要得分经t检验。干预前,干预组和对照组简式心境量表调查表各分值经t检验,得分差异不具有统计学意义(P㧐0.05);干预后,干预组和对照组相比,研究对象紧张-焦虑、抑郁-沮丧、疲乏-迟钝、愤怒-敌意、迷惑-混乱,精力-活力的变化有统计学意义(P㩳0.05)。2、医学应对方式调查表主要测量患者的应对方式,主要得分经t检验。干预前,干预组合对照组医学应对方式调查表各分值经t检验,两组患者在面对、回避和屈服方面的得分差异不具有统计学意义(P㧐0.05),具有可比性;干预后,干预组与对照组相比,各项评估指标均有统计学意义(P0.05)。3、生活质量调查表主要是调查患者的生活质量,主要得分经t检验。干预前,干预组和对照组生活质量调查表各分值经t检验,两组患者在躯体、角色、情绪、认知、社会、疲劳、疼痛、恶心呕吐以及总健康状况等方面的得分不具有统计学意义(P㧐0.05);干预后,干预组患者在躯体功能、情绪功能、认知功能和总健康这四项出现了明显的改善结果,而社会功能和角色功能与对照组相比并无明显差异。干预组经综合护理后,干预组患者疲乏、疼痛、恶心呕吐、呼吸困难、睡眠障碍、食欲障碍、腹泻等症状得到了明显的改善(P0.05)。而便秘和经济困难这两个方面并无明显差异。结论1、综合护理干预可以改善患者的心理问题。2、综合护理干预能够帮助患者积极主动地面对疾病,使患者较多运用积极的应对方式。3、综合护理干预能部分改善患者的不良症状,提高患者的生活质量。
[Abstract]:Objective To evaluate the patients with lung cancer from three aspects: emotion, coping style and quality of life, to expound the changes of emotion, coping style and quality of life after applying comprehensive nursing mode in the course of chemotherapy for lung cancer patients, and to evaluate the actual curative effect and clinical value of comprehensive nursing intervention according to clinical nursing feedback. From December 2014 to February 2015, 132 patients with lung cancer were diagnosed as lung cancer for the first time in four wards of lung cancer chemotherapy in a tertiary hospital of Nan Province. The clinical data of 132 patients were analyzed retrospectively. The control group was divided into 1,3 wards as control group and 2,4 wards as intervention group. (2) Health education (3) Psychological nursing (4) Prevention of infection (5) Dietary guidance. The intervention group was divided into six groups, each group of 8-12 people. The intervention group needs to carry out comprehensive nursing intervention measures on the basis of clinical routine nursing. Detailed nursing intervention measures are: (1) After the patients were admitted to hospital, they began to carry out cognitive intervention, gradually. The intervening time was 30-60 minutes, once a week, totally 6 times, and adjusted according to the actual situation of the patients. (2) After discharging from the hospital during the chemotherapy interval, the patients were followed up by telephone every week, mainly to solve the actual problems of the patients. (3) General baseline data were collected by questionnaires. Simple Mood State Scale (POMS-SF), Medical Coping Scale (MCMQ) and Quality of Life Questionnaire (QLQ-C30) were used to evaluate the two groups at the beginning of the pre-chemotherapy investigation and one month after the end of chemotherapy after comprehensive nursing intervention. After collecting and sorting out the data, the patients'mood, coping style and quality of life were recorded in the database and analyzed by SPSSl6.0. The effects of comprehensive nursing intervention were evaluated by comparing the changes of mood, coping style and quality of life before and after nursing intervention between the two groups. Results 1. Simple mood scale was used to measure patients'mood state, and the main score was tested by t test. Before intervention, the scores of the intervention group and the control group were not statistically significant (P? 0.05). After intervention, compared with the control group, the subjects in the intervention group were nervous-anxiety, depression-depression, fatigue-retardation, anger-anger. Hostility, confusion-confusion, energy-vitality changes were statistically significant (P?0.05). 2. Medical Coping Style Questionnaire mainly measured the coping style of patients, the main score was tested by t test. Before intervention, the intervention group control group medical coping style questionnaire scores by t test, two groups of patients in the face, avoidance and surrender score differences were not significant. There was statistical significance (P? 0.05), comparable; after intervention, the intervention group compared with the control group, the evaluation indicators were statistically significant (P 0.05). 3, the quality of life questionnaire is mainly to investigate the quality of life of patients, the main score by t test. The scores of body, role, emotion, cognition, society, fatigue, pain, nausea and vomiting, and general health status were not statistically significant (P?0.05). After intervention, the intervention group showed significant improvement in physical function, emotional function, cognitive function and general health, while the social function and role function were compared with the control group. After comprehensive nursing, the symptoms of fatigue, pain, nausea and vomiting, dyspnea, sleep disorders, appetite disorders, diarrhea and other symptoms were significantly improved in the intervention group (P Combined nursing intervention can help patients to actively face the disease, so that patients more use positive coping style. 3, comprehensive nursing intervention can partly improve the adverse symptoms of patients, improve the quality of life of patients.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R473.73
本文编号：2178326
[Abstract]:Objective To evaluate the patients with lung cancer from three aspects: emotion, coping style and quality of life, to expound the changes of emotion, coping style and quality of life after applying comprehensive nursing mode in the course of chemotherapy for lung cancer patients, and to evaluate the actual curative effect and clinical value of comprehensive nursing intervention according to clinical nursing feedback. From December 2014 to February 2015, 132 patients with lung cancer were diagnosed as lung cancer for the first time in four wards of lung cancer chemotherapy in a tertiary hospital of Nan Province. The clinical data of 132 patients were analyzed retrospectively. The control group was divided into 1,3 wards as control group and 2,4 wards as intervention group. (2) Health education (3) Psychological nursing (4) Prevention of infection (5) Dietary guidance. The intervention group was divided into six groups, each group of 8-12 people. The intervention group needs to carry out comprehensive nursing intervention measures on the basis of clinical routine nursing. Detailed nursing intervention measures are: (1) After the patients were admitted to hospital, they began to carry out cognitive intervention, gradually. The intervening time was 30-60 minutes, once a week, totally 6 times, and adjusted according to the actual situation of the patients. (2) After discharging from the hospital during the chemotherapy interval, the patients were followed up by telephone every week, mainly to solve the actual problems of the patients. (3) General baseline data were collected by questionnaires. Simple Mood State Scale (POMS-SF), Medical Coping Scale (MCMQ) and Quality of Life Questionnaire (QLQ-C30) were used to evaluate the two groups at the beginning of the pre-chemotherapy investigation and one month after the end of chemotherapy after comprehensive nursing intervention. After collecting and sorting out the data, the patients'mood, coping style and quality of life were recorded in the database and analyzed by SPSSl6.0. The effects of comprehensive nursing intervention were evaluated by comparing the changes of mood, coping style and quality of life before and after nursing intervention between the two groups. Results 1. Simple mood scale was used to measure patients'mood state, and the main score was tested by t test. Before intervention, the scores of the intervention group and the control group were not statistically significant (P? 0.05). After intervention, compared with the control group, the subjects in the intervention group were nervous-anxiety, depression-depression, fatigue-retardation, anger-anger. Hostility, confusion-confusion, energy-vitality changes were statistically significant (P?0.05). 2. Medical Coping Style Questionnaire mainly measured the coping style of patients, the main score was tested by t test. Before intervention, the intervention group control group medical coping style questionnaire scores by t test, two groups of patients in the face, avoidance and surrender score differences were not significant. There was statistical significance (P? 0.05), comparable; after intervention, the intervention group compared with the control group, the evaluation indicators were statistically significant (P 0.05). 3, the quality of life questionnaire is mainly to investigate the quality of life of patients, the main score by t test. The scores of body, role, emotion, cognition, society, fatigue, pain, nausea and vomiting, and general health status were not statistically significant (P?0.05). After intervention, the intervention group showed significant improvement in physical function, emotional function, cognitive function and general health, while the social function and role function were compared with the control group. After comprehensive nursing, the symptoms of fatigue, pain, nausea and vomiting, dyspnea, sleep disorders, appetite disorders, diarrhea and other symptoms were significantly improved in the intervention group (P Combined nursing intervention can help patients to actively face the disease, so that patients more use positive coping style. 3, comprehensive nursing intervention can partly improve the adverse symptoms of patients, improve the quality of life of patients.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R473.73
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