患者参与式质量控制小组提高鼻咽癌放疗患者功能锻炼依从性的效果分析  

Effect of patients＇ participatory in quality control team on improving functional exercise adherence of patients with nasopharyngeal carcinoma undergoing radiotherapy

作　　者：马春艳[1] 刘雪融[1] 

机构地区：[1]哈尔滨医科大学附属第一医院肿瘤一病房,150001

出　　处：《中华现代护理杂志》2015年第11期1258-1260,共3页Chinese Journal of Modern Nursing

基　　金：国家临床重点专科建设项目（2012236）

摘　　要：目的探讨患者参与式质量控制小组在提高鼻咽癌放疗患者功能锻炼依从性中的作用。方法选取2013年10月-2014年4月实施放射治疗的鼻咽癌患者144例，成立包括患者质控员的质量控制小组，基线调查鼻咽癌化疗患者的功能锻炼依从性及不能按计划进行锻炼的原因，绘制鱼骨图，制订对策，包括将健康教育规范化、加强对患者家属的宣教、制订功能锻炼规范动作指引、为患者提供功能锻炼辅助用具以及患者质控员每天对全病房功能锻炼情况进行考核等措施。比较干预前后患者功能锻炼的依从性和口面部活动恢复情况。结果干预后患者功能锻炼的依从性良好121例，一般17例，差6例，依从性优于干预前，差异有统计学意义（Z=5．288，P〈0．05）。干预后张口困难与颈部活动受限发生率分别为3．47％与4．17％，优于干预前，差异有统计学意义（X^2值分别为7．087，12．818；P〈0．05）。结论患者参与式的质量控制小组活动可以提高鼻咽癌放疗患者功能锻炼的依从性，降低张口困难、颈部活动受限的发生率，值得在临床上推广。Objective To investigate the effect of patients＇ participatory in quality control team on improving functional exercise adherence of patients with nasopharyngeal carcinoma （NPC） undergoing radiotherapy. Methods Totals of 144 patients with NPC undergoing radiotherapy from October 2013 to April 2014 were selected. The quality control team was established including paitents quality controlers. We identified the reasons for no proceeding as planned exercise through survey, and drew fish bone diagram and developed countermeasures which including： the standardization of health education, strengthen the education to family members of patients, development of functional training standard action guidelines, provide patients with functional training aids and ask patients to responsible for the daily quality control of the wards＇ functional exercise. Results After the intervention, 121 patients had a great adherence, 17 patients had a moderate adherence and 6 patients had a bad adherence, which were significantly better than before （ Z = 5. 288, P 〈 O. 05）. The incidence of trismus and limited neck mobility were 3.47% and 4.17%, which were significantly better than those before the intervention （ X2 = 7. 087,12.818, respectively ;P 〈 0.05 ）. Conclusions Patients＇ participatory in the quality control group activities can improve their functional exercise adherence and reduce the incidence of trismus and limited neck mobility.

关 键 词：鼻咽癌 手术后并发症 质量控制 功能锻炼 依从性 

分 类 号：R473.73[医药卫生—护理学]