结直肠癌个案管理模式的实践及效果  

Practice and effect of case management model in colorectal cancer patients

作　　者：吴晓丹[1] 张丽娟[2] 覃惠英[3] 张美芬[4] 郑美春[1] 王霞[4] WU Xiaodan;ZHANG Lijuan;QIN Huiying;ZHANG Meifen;ZHENG Meichun;WANG Xia(Department of Colorectum,Sun Yat-sen University Cancer Center,Guangzhou 510060,China;Department of Galactophore,Sun Yat-sen University Cancer Center,Guangzhou 510060,China;Nursing Department,Sun Yat-sen University CancerCenter,Guangzhou 510060,China;School of Nursing,Sun Yat-sen University,Guangzhou 510080,China)

机构地区：[1]中山大学肿瘤防治中心结直肠科,广州市510060 [2]中山大学肿瘤防治中心乳腺科,广州市510060 [3]中山大学肿瘤防治中心护理部,广州市510060 [4]中山大学护理学院,广州市510080

出　　处：《护理管理杂志》2018年第9期661-665,共5页Journal of Nursing Administration

基　　金：2015年广东省科技计划项目(2014A020212105);2016年广东省科技计划项目(2016A020215091)

摘　　要：目的探讨符合中国国情的结直肠癌患者个案管理模式,并在直肠癌患者中进行临床实践以探讨其对直肠癌患者进行全程管理的效果。方法对结直肠癌个案管理师的角色定位、考评标准、岗位职责、全程管理的工作模式进行全面构建,结直肠癌个案管理师依托"多专科肿瘤团队",对结直肠癌患者实行从诊断至生命终点的全程整体管理。结果肿瘤个案管理组患者实现了直肠癌患者的无缝隙全程管理,与对照组比提高了患者的留治率、治疗后服药及复诊依从性、患者满意度等(P<0.01或P<0.05)。结论结直肠癌个案管理模式实现了直肠癌患者无缝隙全程管理,是改善患者需求的有效方法,为临床实践提供了借鉴依据。Objective To explore the case management model and its effect of colorectal cancer patients in China during clinical practice.Methods To establish the role localization,evaluation criterial positing statement and overall management of the case managers.The casemanagers who relied on the ＂ multi disciplinary cancer team＂ carried out overall management from diagnosis to the end of life for patients.Results The case managers achieved overall management about colorectal cancer patients,and improved retention rate,treatment compliance,patient satisfaction and utilization of hospital resources （P〈0.01 or P〈0.05）.Conclusion The case management model of colorectalcancer patients was an effective method which realized the overall management and meet patients＇ demands,and can provide reference for other diseases＇ case management.

关 键 词：结直肠癌 肿瘤个案管理 个案管理师 多专科团队 

分 类 号：R473.73[医药卫生—护理学]