肝癌患者围手术期疾病不确定感的影响因素及护理对策  

Perioperative uncertainty in illness in patients with liver cancer:Influencing factors and nursing measures

作　　者：郑馨梅 武守国[1] 魏玲玲[1] 

机构地区：[1]宁波开发区中心医院消化内科,浙江省宁波市315800

出　　处：《世界华人消化杂志》2016年第34期4615-4620,共6页World Chinese Journal of Digestology

摘　　要：目的通过Mishel量表及生活质量核心量表QLQ-C30对系统性护理干预前后的效果进行比较,讨论护理干预对肝癌手术患者前后疾病的不确定感及生活质量的影响,为系统性护理干预措施的临床应用提供理论依据.方法选取2012-01/2016-01宁波开发区中心医院收治的200例肝癌手术治疗的患者,以随机实验参照原则分为实验组(100例)和对照组(100例),实验组在常规护理基础上对患者进行系统性护理干预,对照组在常规护理干预.患者入院第2天进行第1次问卷调查,出院前1 d进行第2次问卷调查.采用Mishel疾病不确定感量表、癌症患者生活质量核心量表QLQ-C30中文版作为测定疾病不确定感和生活质量的评价标准.结果通过对实验组和对照组的问卷调查,肝癌患者疾病不确定感得分和不明确性维度得分、复杂性维度得分与不同文化程度、家庭收入、医疗费用来源、手术方法有关(P<0.05),而与年龄、性别、婚姻状况、居住地无关(P>0.05).经过系统性护理干预后,实验组患者疾病不确定感得分、不明确性维度得分与对照组比较,得分明显下降,差异有统计学意义(P<0.05),实验组患者总体健康状况、情绪功能、角色功能和认知功能与对照组比较,得分明显提高,差异有统计学意义(P<0.05).结论系统性护理干预可以改善肝癌手术患者的疾病不确定感得分,提高患者的生活质量.AIM To identify factors influencing perioperative uncertainty in illness in patients with liver cancer and evaluate the impact of systemic nursing intervention on quality of life and uncertainty in illness in patients with liver diseases before and after surgery.METHODS Two hundred patients with hepato cellular carcinoma undergoing surgical treatment at our hospital between January 2012 and January 2016 were reviewed retrospectively.They were divided into either an experimental group or a control group.The experimental group received systemic nursing intervention on the basis of routine care,and the control group received routine care only.Patients were administered the first questionnaire in the second day after admission,and the second questionnaire in the day before discharge.Mishel＇s Uncertainty in Illness Scale and the Chinese version of EORTC QLQ-C3 form were used to assess uncertainty in illness and quality of life,respectively.RESULTS The score of uncertainty in illness and scores of ＂ambiguity＂ and ＂complexity＂ were significantly influenced by education level,household income,source of medical expenses,and surgical method（P〈0.05）,but were unrelated to age,sex,marital status,or place of residence（P〈0.05）.After systematic nursing intervention,the score of uncertainty in illness and ＂ambiguity＂ score were decreased significantly compared with the control group（P〈0.05）.After systematic nursing intervention,scores of general health situation,emotional function,role function and cognitive function in the experimental group were significantly increased compared with the control group（P〈0.05）.CONCLUSION Systematic nursing intervention can improve uncertainty in illness and dimension scores and increase the quality of life of patients with liver cancer undergoing operation.

关 键 词：肝癌 疾病不确定感 系统性护理 生活质量 

分 类 号：R473.73[医药卫生—护理学]