基于二元应对理论的老年肺癌患者及照顾者出院准备服务方案的构建与初步验证  

Construction and preliminary validation of discharge preparation service for elderly lung neoplasms patientsand caregivers based on dualistic coping theory

作　　者：聂奕轩 宋娟[2] 谢砚辞 金学勤[4] Nie Yixuan;Song Juan;Xie Yanci;Jin Xueqin(School of Medicine,Jiangsu University,Zhenjiang 212013,China;Department of Oncology,Kunshan Hospital Affiliated to Jiangsu University,Suzhou 215399,China;Hospital Infection Management Department,the Affiliated Suzhou Hospital of Nanjing Medical University,Suzhou 215001,China;Department of Nursing,Kunshan Hospital Affiliated to Jiangsu University,Suzhou 215399,China)

机构地区：[1]江苏大学医学院,镇江212013 [2]江苏大学附属昆山医院肿瘤科,苏州215399 [3]南京医科大学附属苏州医院医院感染管理处,苏州215001 [4]江苏大学附属昆山医院护理部,苏州215399

出　　处：《中国实用护理杂志》2022年第26期2019-2027,共9页Chinese Journal of Practical Nursing

基　　金：昆山市一院新冠肺炎科技专题项目(XGF202010)。

摘　　要：目的构建基于二元应对理论的老年肺癌患者及照顾者出院准备服务方案并评价其临床可行性。方法采用文献检索、专家函询、理论研究等方法开发老年肺癌患者及照顾者出院准备服务方案。该方案包含二元评价、二元管理行为和二元健康3个主题及评价患者和照顾者对症状、照护目标和意愿等评价、决策制定、情感沟通支持、管理身体功能变化及一般性的健康行为6项干预策略。招募到2021年7—9月收治于江苏大学附属昆山医院肿瘤科的30对老年肺癌患者及其照顾者,根据计算机产生的随机数字分配对照组和试验组各15对。通过可行性评价指标、出院准备度、二元应对及照顾者综合需求量表评价方案的可行性及临床效果。结果本次研究招募率为76%(32/42),留存率为94%(30/32),试验组干预方案可接受率为100%。干预后试验组患者出院准备度总分为(83.00±2.59)分、患者二元应对总分(136.80±4.54)分;照顾者二元应对总分(136.33±3.56)分、照顾者综合需求总分(124.37±11.69)分,明显优于对照组的(74.40±4.17)、(129.07±4.83)、(120.33±9.17)、(206.57±9.14)分,差异有统计学意义(t值为-6.78~5.54,均P<0.05)。结论基于二元应对理论的老年肺癌患者及照顾者出院准备服务方案具有科学性及可行性,但方案仍需进一步的优化、改善和大样本的随机对照试验加以验证。Objective To construct a discharge preparation service program for elderly lung cancer patients and their caregivers based on binary coping theory,evaluate its clinical feasibility.Methods To develop discharge preparation service for elderly lung cancer patients and their caregivers by literature retrieval,expert correspondence consultation and theoretical research.The program included three themes:binary evaluation,binary management behaviorand binary health,and six intervention strategies:evaluation of symptoms,care goals and intentions,decision making,emotional communication support,management of physical function changes and general health behavior.From July to September 2021,30 pairs of elderly lung cancer patients and their caregivers were recruited and assigned into the control group and the experimental group with 15 pairs in each group according to random numbers generated by computer.The feasibility and clinical effect of the program were evaluated by feasibility evaluation index,discharge readiness,dual coping and comprehensive needs scale of caregivers.Results In this study,the recruitment rate was 76%(32/42),the retention rate was 94%(30/32),and the acceptance rate of the intervention plan in the experimental group was 100%.After intervention,the total scores of discharge readiness was(83.00±2.59),the patient dyadic coping was(136.80±4.54),caregiver dyadic coping was(136.33±3.56)and caregiver comprehensive needs was(124.37±11.69)in the experimental group,which were better than those of in the control group,(74.40±4.17),(129.07±4.83),(120.33±9.17)and(206.57±9.14),the differences were statistically significant(t values were-6.78-5.54,all P<0.05).Conclusion The discharge preparation service plan for elderly lung cancer patients and caregivers based on dyadic coping theory is scientific and feasible,but the plan still needs further optimization,improvement and large sample randomized controlled trial to verify.

关 键 词：肺肿瘤 化疗 二元应对 出院准备度 

分 类 号：R473.73[医药卫生—护理学]