基于共享决策的医护-家属联动干预对胃癌患者的影响  

Effect of Medical Staff-Family Members Combined Intervention Based on Shared Decision on Gastric Cancer Patients

作　　者：刘楠[1] 李琴[1] 季苗苗 汪刘华[1] Liu Nan;Li Qin;Ji Miaomiao(Subei People′s Hospital of Jiangsu Province,Yangzhou Jiangsu 225000,China)

机构地区：[1]江苏省苏北人民医院,江苏扬州225000

出　　处：《齐鲁护理杂志》2021年第8期1-3,共3页Journal of Qilu Nursing

基　　金：国家自然科学基金面上项目(编号:8197102014)。

摘　　要：目的:探讨基于共享决策的医护-家属联动干预对胃癌患者的影响。方法:选择2017年1月1日~2020年1月31日在胃肠外科治疗的胃癌患者106例,采用随机信封法分为观察组58例和对照组48例;对照组实施常规营养支持与护理,观察组在对照组基础上实施基于共享决策的医护-家属联动干预模式;比较两组干预前后治疗依从性,心理状态[采用焦虑自评量表(SAS)和抑郁自评量表(SDS)],恢复时间,各项营养指标变化[包括人血白蛋白(ALB)、前白蛋白(PRE)、转铁蛋白(TRF)]及并发症发生情况。结果:干预后,两组治疗依从性均高于干预前(P<0.05),且观察组高于对照组(P<0.05);干预后,两组SAS、SDS评分均低于干预前(P<0.05),且观察组低于对照组(P<0.05);观察组肛门排气时间、胃肠道功能恢复时间、下床活动时间及住院时间均短于对照组(P<0.01,P<0.05);出院后,两组ALB、PRE、TRF水平均高于干预前(P<0.05),且观察组高于对照组(P<0.05);观察组并发症发生率低于对照组(P<0.05)。结论:将基于共享决策的医护-家属联动干预模式应用于胃癌患者的护理中,能提高患者治疗依从性,缓解焦虑、抑郁情绪,改善营养指标水平,降低并发症发生率,对促进患者恢复具有重要意义。Objective:To explore the effect of medical staff-family members combined intervention based on shared decision on gastric cancer patients.Methods:From January 1,2017 to January 31,2020,106 patients with gastric cancer for gastrointestinal surgery were selected and randomly divided into the observation group with 58 cases and the control group with 48 cases.The control group received routine nutritional support and nursing.On this basis,the observation group received medical staff-family members combined intervention based on shared decision.Comparison was made on the treatment compliance between the two groups before and after intervention,and the psychological state[by the self-assessment on anxiety scale(SAS)and depression self-rating scale(SDS)],recovery time and the nutrition indicators change[including human blood albumin(ALB),prealbumin(PRE),transferrin(TRF)]and its complications.Results:After intervention,the treatment compliance was higher in the two groups than that before intervention(P<0.05),and higher in the observation group than that in the control group(P<0.05).SAS scores and SDS scores were lower in the two groups than thosebefore intervention(P<0.05),and lower in the observation group than those in the control group(P<0.05).The anal exhaust time,gastrointestinal function recovery time,time to get out of bed and length of hospital stay in the observation group were shorter than those of the control group(P<0.01,P<0.05).After discharge,the levels of ALB,PRE and TRF were all higher in the two groups than those before intervention(P<0.05),and higher in the observation group than those in the control group(P<0.05).And the incidence of complications in the observation group was lower than that in the control group(P<0.05).Conclusion:The application of medical staff-family members combined intervention based on shared decision in the nursing of patients with gastric cancer can improve the patients'treatment compliance,relieve their anxiety and depression,improve the levels of nutritional indicators,redu

关 键 词：共享决策 医护-家属联动 胃癌 心理状态 营养状况 护理 

分 类 号：R473.73[医药卫生—护理学]