原发性肝癌患者肝动脉化疗栓塞术后自我管理效能干预的效果观察  

Effect of Self-care and Self-efficacy for Patients with Primary Hepatic Carcinoma after Transcatheter Arterial Chemoembolization

作　　者：钱多[1] 徐旭娟[2] 李智[1] 沈静慧[1] QIAN Duo XU Xu-juan LI Zhi SHEN Jing-hui(Dept. of lnterventional Radiology, the First Affiliated Hospital of Soochow University, Suzhou 215006, China Dept. of Nursing Administration, Affiliated Hospital of Nantong University, Nantong 226001, China)

机构地区：[1]苏州大学附属第一医院介入科,江苏苏州215006 [2]南通大学附属医院护理部,江苏南通226001

出　　处：《护理学报》2016年第22期44-49,共6页Journal of Nursing（China）

基　　金：国家自然科学基金资助项目(81501563)

摘　　要：目的探讨自我管理效能干预在首次经导管肝动脉化疗栓塞术后原发性肝癌患者中的应用效果。方法选取肝动脉化疗栓塞术后原发性肝癌患者85例,根据入院时间段进行分组,将2014年1—6月42例患者为对照组,2014年7—12月43例患者为观察组。对照组给予常规护理及出院后随访,观察组在常规护理和出院后随访基础上实施自我管理效能干预。观察比较2组患者术后第1天及出院后第4周末的自我管理效能水平、生活质量、症状困扰、肝癌患者介入治疗间歇期非计划性再入院发生率、血清白细胞计数和血清丙氨酸转氨酶。结果出院后第4周末观察组自我管理效能水平、生活质量得分均高于对照组(P<0.05),症状困扰条目均分、非计划性再入院发生率均低于对照组(P<0.05)。术后第1天和出院后第4周末2组患者血清白细胞计数及血清丙氨酸转氨酶比较差异无统计学意义(P>0.05)。结论应用自我管理效能干预,可提高肝动脉化疗栓塞术后原发性肝癌患者自我管理效能水平,减轻其症状困扰,减少患者治疗间歇期非计划性再入院次数,改善患者的生活质量。Objective To discuss the impact of self-efficacy on primary hepatic carcinoma（PHC） patients after surgery with transcatheter arterial chemoembolization（TACE） for the first time. Methods 85 PHC patients were selected after the first surgery with TACE according to the admission time. The 42 cases of PHC patients from January to June 2014 were selected as control group,and another 43 cases of PHC patients from July to December 2014 as observation group. Control group was treated by general health guidance and regular follow-up after discharge and observation group by the intervention of self-care self-efficacy. The data were compared in both groups of self-care self-efficacy states, quality of life, symptom burden and unscheduled readmission, the values of white blood cell and serum levels of alanine aminotransferase on the first day after TACE and in the fourth weekend after discharge.Results Patients＇ self-care and self-efficacy and the score of quality of life in observation group were higher than those of control group（P〈0.05）; patients＇ symptom burden and unscheduled readmission in observation group were lower than those in control group in the fourth weekend after discharge（P〈0.05）. There was no statistical significance between two groups in terms of values of white blood cell and serum levels of alanine aminotransferase on the first day after TACE and in the fourth weekend after discharge（ P〈0.05）.Conclusion Interventional strategy of self-care and self-efficiency can enhance self-management self-efficacy, reduce the burden of the patient＇s symptoms and the unscheduled readmission in intermittent period after surgery with TACE for PHC patients. It can eventually promote patients＇ quality of life.

关 键 词：肝动脉化疗栓塞术 原发性肝癌 自我效能 自我管理 生活质量 

分 类 号：R473.6[医药卫生—护理学]