六步标准沟通结合疼痛管理对非小细胞肺癌胸腔镜术后患者康复的影响  

Effects of CICARE standard communication combined with pain management measures on the rapid recovery of NSCLC patients undergoing VATS

作　　者：廖萌露 陈微微 丁小荣 Liao Menglu;Chen Weiei;Ding Xiaorong(Department of thoracic surgery,Nantong Sixth People's Hospital,Nantong 226001,China)

机构地区：[1]江苏省南通市第六人民医院胸外科,226001

出　　处：《中国实用护理杂志》2020年第35期2747-2753,共7页Chinese Journal of Practical Nursing

摘　　要：目的探讨六步标准沟通结合多学科合作疼痛管理措施,对非小细胞肺癌(NSCLC)胸腔镜术后患者快速康复情况及疼痛数字评价量表(NRS)评分和日常生活活动能力(ADL)Barthel评分(BI指数)的影响。方法选取2016年2月至2019年12月在南通市第六人民医院接受VATS辅助手术治疗的86例NSCLC患者作为研究对象,所有患者按照随机数字表法分为对照组和研究组各43例。对照组患者围手术期给予传统管理方式,护患沟通应用常规方案,研究组患者给予基于六步标准沟通流程的护患沟通方案和以护士为主体的多学科合作疼痛管理模式。比较2组患者术后快速康复情况和干预前后NRS评分、BI指数变化情况。结果研究组患者术后24hNRS评分为(3.18±1.04)分,对照组为(4.61±1.27)分,差异有统计学意义(t值为5.713,P<0.001),其术后24h内中重度疼痛发生率研究组为4.65%(2/43),对照组为18.60%(8/43),差异有统计学意义(χ^2值为4.074,P<0.05)。研究组患者术后首次下床时间、住院时间分别为(19.06±7.52)h、(9.42±2.83)d,对照组分别为(27.83±12.01)h,(11.05±2.97)d,差异有统计学意义(t值为4.058、4.044,P<0.01);干预后研究组患者的简明心境问卷(POMS)各维度愤怒-敌意、疲乏-迟钝、精力-活力、紧张-焦虑、抑郁-沮丧、迷惑-混乱评分分别为(3.43±1.21)、(6.16±1.63)、(7.62±2.43)、(3.43±1.04)、(4.26±1.59)、(4.48±1.58)分,对照组分别为(5.26±1.46)、(7.20±1.65)、(8.89±1.80)、(5.37±1.58)、(5.49±1.27)、(6.70±2.21)分,差异有统计学意义(t值为2.754~6.725,P<0.01);研究组干预前后BI指数分别为(55.02±11.07)、(75.44±14.51)分,对照组干预前后分别为(54.48±10.24)、(63.38±14.10)分,2组干预后比较差异有统计学意义(t值为3.909,P<0.01);研究组满意度为95.35%(41/43),对照组满意度72.09%(31/43),差异有统计学意义(χ^2值为8.532,P<0.01)。结论六步标准沟通模式联合以护士为主体的多学科合作疼痛管�Objective To explore the effect of CICARE standard communication combined with multidisciplinary cooperative pain management measures on the rapid recovery of patients with non-small cell lung cancer(NSCLC)undergoing video-assisted thoracoscopic surgery(VATS)and the NRS score and the Barthel score(Bl index)of patients.Methods 86 NSCLC patients who received VATS assisted surgery were randomly divided into control group(43 cases)and study group(43 cases).The patients in the control group were given the traditional management mode and the routine scheme of nurse patient communication The patients in the study group were given the traditional management mode and the routine scheme based on the six-step standard communication process and the multidisciplinary cooperative pain management mode based on nurses.The rapid postoperative rehabilitation,changes of NRs score and Bi index were compared between the two groups.Results The NRS score of the patients in the studly group was(3.18±1.04)and that in the control group was(4.61l±1.27).The difference was statistically significant(t value was 5.713.P<0.001).The incidence of moderate and severe pain in the study group was significantly lower than that in the control group(4.65%(2/43),and that in the controlgroup was 18.60%(8/43).The difference was statistically significant(value was 4.074,P<0.05)The first time for patients to get out of bed and stay in hospital were(19.06±7.52)h and(9.42±2.83)d,respectively,and those in the control group were(27.83±12.01)H and(11.05±2.97)d,respectively,with statistically significant differences(1-values of 4.058 and 4.044,P<0.001).The simple mood questionnaire(POMS)of patients in the intervention studly group included anger hostility,fatigue relardation,energy vitality,tension anxiety and depression The scores of depression,confusion and confusion were(3.43±1.21),(6.16±1.63),(7.62±2.43),(3.43±1.04),(4.26±1.59),(4.48±1.58)in thecontrol group,and(5.26±1.46),(7.20±1.65),(7.62±2.43),(5.37±1.58),(5.49±1.27),(6.70±2.21)in the con

关 键 词：非小细胞肺肿瘤 电视辅助胸腔镜手术 六步标准沟通流程 疼痛管理 

分 类 号：R473.73[医药卫生—护理学]