肿瘤患者临终等级需求护理的临床研究  

Level nursing in terminal cancer patients

作　　者：李玉芹[1] 付丽[1] 刘媛[1] 田丽梅[1] 张莉[1] 刘柏琳 德艳艳[1] LI Yu-qin FULi LIU Yuan TIAN Li-mei ZHANG Li LIU Bo-lin DE Yan-yan(Department of Science Education, Huanghua People＇s Hospital, Huanghua 061100, China)

机构地区：[1]河北省黄骅市人民医院科教科,黄骅061100

出　　处：《中国肿瘤临床与康复》2017年第5期613-616,共4页Chinese Journal of Clinical Oncology and Rehabilitation

摘　　要：目的探讨临终肿瘤患者生存时间预估及构建等级需求临终护理模式。方法选取2014年1月至2015年6月间黄骅市人民医院收治的110例晚期肿瘤患者,采用随机数字表法分为观察组与对照组,每组55例。对照组患者给予常规疾病临床护理和心理护理,观察组患者在常规护理基础上依据临终患者病情评估结果实施等级需求护理,对两组患者心理痛苦、生命意义感和护理质量进行比较。结果两组患者入院时心理痛苦程度比较,差异无统计学意义(P>0.05)。护理21天,观察组患者较入院时和较对照组,心理痛苦程度减轻,差异均有统计学意义(均P<0.05);对照组护理前后差异无统计学意义(P>0.05)。两组患者护理21天生命意义感总分及观察组患者护理前后生命意义感总分比较,差异均有统计学意义(均P<0.05)。护理21天,两组患者间及观察组患者较入院时生命责任感、苦难承受和死亡接受比较,差异均有统计学意义(均P<0.05)。观察组患者对护理工作到位率、需求处理率和心理教育覆盖率均高于对照组患者,不良反应发生率低于对照组,组间比较,差异均有统计学意义(均P<0.05)。结论使用临终肿瘤患者病情评估表预估其生存时间,构建等级需求临终护理模式,能有效提高肿瘤晚期患者生存质量,更好地实现肿瘤临终患者的护理目标。Objective To estimate the survival time according to disease assessment form and to establish a model for end-of-life care according to the level of patients＇ requirements. Methods From Janu- ary 2014 to June 2015, 110 patients with advanced cancer were selected at Huaughua Peopleg Hospital. Pa- tients were divided into an observation group and a control group with 55 patients in each group using a ran- dom number table. Patients in the observation group were given nursing according to the assessment resuhs of the survival time apart from routine nursing. Patients in the control group were given routine clinical and psychological nursing. Psychological distress, meaning of life and quality of care were compared between the two groups. Results There was no significant difference in the degree of psychological distress between the two groups （P 〉 0. 05）. At 21 days, psychological distress was lessened in the observation group compared with the control group （ P 〈 0. 05 ）. At 21 days, there was significant difference in the overall score of meaning of life between the two groups （ P 〈 0. 05 ）. At 21 days, there was significant difference in life re- sponsibility, pain tolerance and death acceptance between the two groups （P 〈 0.05 ）. The performance of nursing, requirements processing rate and psychological education coverage were higher and the incidence of adverse events was lower in the observation group than in the control group （ all P 〉 0.05 ）. Conclusion The use of disease assessment form to predict the survival time and constructe hospice care based on the re- quirements level can effectively improve the quality of life and better achieve nursing goal in patients with advanced cancer.

关 键 词：恶性肿瘤 临终关怀 生存时间 生存质量 

分 类 号：R473.73[医药卫生—护理学]