消化系统恶性肿瘤患者临终期医院-家庭-护理三位一体模式的研究  

Study on the hospital-home-nursing trinity model for patients with malignant tumor of digestive system in the advanced stage

作　　者：刘雪融[1] 张萍[2] 王艳[3] 张彩滨 赵晓琳[1] 张俊娟[1] Liu Xuerong Zhang Ping Wang Yah Zhang Caibin Zhao Xiaolin Zhang Junjuan(Tumor No.1 Ward, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China （Liu XR, Zhang CB, Zhao XL, Zhang JJ TCM Ward, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China （Zhang P Hematology Ward, the First Affiliated Hospital of Harbin Medical University, Harbin 150001, China （Wang Y)

机构地区：[1]哈尔滨医科大学附属第一医院肿瘤一病房,哈尔滨150001 [2]哈尔滨医科大学附属第一医院中医病房,哈尔滨150001 [3]哈尔滨医科大学附属第一医院血液病房,哈尔滨150001

出　　处：《中华现代护理杂志》2017年第21期2709-2713,共5页Chinese Journal of Modern Nursing

摘　　要：目的 探讨医院-家庭-护理（HHN）三位一体模式在肿瘤临终患者中的应用效果.方法 选取晚期肿瘤患者110例按住院日期分为观察组（2015年10月—2016年6月）与对照组（2015年1—9月）,各55例,对照组给予常规的肿瘤临终护理、心理护理,观察组在常规护理的基础上采取HHN三位一体模式进行护理,对两组患者心理痛苦、生命意义感进行比较.结果 出院1个月,观察组患者心理痛苦程度评分为（5.94±2.13）分,低于对照组的（7.03±2.27）分,差异有统计学意义（t=-2.296,P=0.020）;观察组家属心理痛苦程度评分为（5.22±1.83）分,低于对照组的（6.48±1.54）分,差异有统计学意义（t=-2.247,P=0.023）.观察组患者生命责任感、苦难承受、死亡接受维度得分明显高于对照组,差异具有统计学意义（t值分别为2.095、2.806、2.260;P〈0.05）.结论 HHN护理模式联合医、护、家三方对患者进行治疗、居家、心理护理,可以解决患者的实际问题,关注患者生活质量的提高,更好地实现肿瘤临终患者的护理目标.Objective To explore the effects of hospital-home-nursing（HHN） trinity model in the patients with malignant tumor of digestive system in the advanced stage.Methods Totally 110 patients with advanced tumor were selected and equally divided into an observation group （from October 2015 to June 2016） and a control group （from January 2015 to September 2015） based on the admission date. The patients in the control group received conventional terminal nursing and psychological nursing, while the patients in the observation group received nursing with the HHN trinity model on this basis. Then the psychological distress and meaning of life were compared between the patients in the two groups.Results One month after they were discharged from hospital, the patients in the observation group were scored （5.94±2.13） for psychological distress, lower than （7.03±2.27） of the patients in the control group （t=-2.296,P=0.020）. The family members of the patients in the observation group were scored （5.22±1.83） for psychological distress, lower than （6.48±1.54） of the patients in the control group （t=-2.247,P=0.023）. And the patients in the observation group were scored higher in the dimensions of meaning of life, misery bearing and death acceptance than the patients in the control group （t=2.095, 2.806, 2.260;P〈0.05）.Conclusions The HHN trinity model which integrates the forces of the hospital, nurses and family members for treatment, home and psychological nursing, can solve the real problems of patients, improve their quality of life, and better achieve the nursing objectives for patients with advanced tumor.

关 键 词：肿瘤 生活质量 医院-家庭-护理模式 生存时间 

分 类 号：R473.73[医药卫生—护理学]