基于行为改变模式理论的健康教育联合临床药师参与下的多学科协作团队模式对服用阿片类药物的癌痛患者的管理效果  

Management effect of health education based on behavioral change wheel theory combined with clinical pharmacists-participated multidisciplinary team model on cancerous pain patients administrating opioid drugs

作　　者：凌国珍[1] 李妹英 韦汝琼[1] 黄金玲 LING Guo-zhen;LI Mei-ying;WEI Ru-qiong;HUANG Jin-ling(Department of Respiratory Oncology,Guangxi Medical University Affiliated Tumor Hospital,Nanning 530021,Guangxi,China)

机构地区：[1]广西医科大学附属肿瘤医院呼吸肿瘤内科,广西南宁市530021

出　　处：《广西医学》2022年第23期2744-2748,共5页Guangxi Medical Journal

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190593)。

摘　　要：目的探讨基于行为改变模式(BCW)理论的健康教育联合临床药师参与下的多学科协作团队(MDT)模式对服用阿片类药物的癌痛患者的管理效果。方法将100例癌痛患者随机分为观察组和对照组,各50例。给予两组患者阿片类镇痛药物治疗及常规干预,在此基础上给予观察组基于BCW理论的健康教育联合临床药师参与的MDT模式管理,两组均干预4周。比较两组患者干预前后疼痛数字评价量表(NRS)评分、8条目Morisky服药依从性问卷(MMAS-8)评分、世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评分,治疗过程中不良反应发生率,以及干预后美国疼痛协会疼痛控制满意度问卷(APS-POQ)评分。结果干预后,两组患者疼痛NRS评分均低于干预前,MMAS-8评分和WHOQOL-BREF评分均高于干预前,且观察组患者的疼痛NRS评分低于对照组,MMAS-8评分和WHOQOL-BREF评分均高于对照组(均P<0.05)。在用药期间,观察组患者总不良反应发生率低于对照组(P<0.05)。观察组对疼痛控制效果的满意度、对医师处理方法的满意度、对疼痛教育的满意度、对临床药师随访的满意度评分及APS-POQ总分均高于对照组(均P<0.05)。结论基于BCW理论的健康教育联合临床药师参与下的MDT模式管理,可有效缓解服用阿片类药物的癌痛患者的疼痛症状,提高其用药依从性,改善其生存质量,同时降低不良反应发生率,提高患者对癌痛控制的满意度,增加患者的癌痛耐受力。Objective To explore the management effect of health education based on behavior change wheel(BCW)theory combined with clinical pharmacists-participated multidisciplinary team(MDT)model on cancerous pain patients administrating opioid drugs.Methods A total of 100 patients with cancerous pain were randomly divided into observation group or control group,with 50 cases in each group.Both groups were treated with opioid analgesic drugs and received routine intervention,based on which the observation group was managed by health education based on BCW theory combined with clinical pharmacists-participated MDT model,and both groups received a 4-week intervention.The pre-and post-intervention Numerical Rating Scale(NRS)score for pain,Eight-Item Morisky Medication Adherence Scale(MMAS-8)score,World Health Organization Quality of Life-BREF(WHOQOL-BREF)score,and incidence rate of adverse reactions during treatment,as well as post-intervention American Pain Society Patient Outcome Questionnaire(APS-POQ)score were compared between the two groups.Results After intervention,the NRS score for pain of both groups was lower than that before intervention,whereas the MMAS-8 and WHOQOL-BREF scores of both groups were higher than those before intervention,and the NRS score for pain in the observation group was lower than that in the control group,as well as the scores of MMAS-8 and WHOQOL-BREF were higher than those in the control group(all P<0.05).During medication,the incidence rate of total adverse reactions in the observation group was lower than that in the control group(P<0.05).The observation group yielded higher satisfactions with pain control effect,with physician′s treatment methods,with pain education,and with clinical pharmacists follow-up score,as well as a higher total score of APS-POQ as compared with the control group(all P<0.05).Conclusion The management of health education based on BCW theory combined with clinical pharmacists-participated MDT model can effectively relieve pain symptoms in cancerous pain patients a

关 键 词：癌痛 行为改变模式 健康教育 多学科协作团队模式 药师 阿片类药物 管理效果 

分 类 号：R473.73[医药卫生—护理学]