共享门诊管理模式对肝移植术后患者生活质量和睡眠质量的影响  

Influence of shared medical appointments on health-related quality of life and quality of sleep in patients after liver transplantation

作　　者：王迪[1] 王曼曼[1] 苗莹[1] 叶青敏 李爱改 万英英 郭文治[1] Wang Di;Wang Manman;Miao Ying;Ye Qingmin;Li Aigai;Wan Yingying;Guo Wenzhi(Department of Hepatobiliary and Pancreatic Surgery 3,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,China)

机构地区：[1]郑州大学第一附属医院肝胆胰外三科,郑州450052

出　　处：《中华健康管理学杂志》2023年第6期455-460,共6页Chinese Journal of Health Management

基　　金：2016年度河南省科技攻关项目(162102310168)。

摘　　要：目的观察共享门诊管理模式对肝移植术后患者生活质量和睡眠质量的影响。方法采用随机对照研究法,选取2018年1月至2019年1月于郑州大学第一附属医院肝移植术后患者124例,采用抓阄法随机将患者分为常规管理组(64例)和共享门诊管理组(60例),分别接受常规门诊干预和共享门诊管理模式进行干预。采用肝移植后生活质量调查问卷(pLTQ)和匹兹堡睡眠质量指数(PSQI)于干预前(出院当日)和干预后(最后一次共享门诊结束)评价两组患者的生活质量和睡眠质量。结果干预后常规护理组和共享门诊管理组pLTQ的担忧、经济、身体功能、情感功能、健康服务、并发症各维度评分和总分均显著高于干预前[常规管理组:(41.90±7.61)、(18.13±4.22)、(22.22±5.10)、(14.92±3.28)、(20.39±4.87)、(14.63±3.99)和(132.19±37.09)比(32.25±5.55)、(12.77±3.47)、(17.58±4.72)、(9.23±1.38)、(15.17±4.81)、(10.89±1.51)和(98.00±29.03)分;t=8.20、7.85、3.58、12.79、6.10、7.01、5.81,均P<0.001;共享门诊管理组:(46.12±7.92)、(24.16±5.34)、(25.55±5.42)、(17.90±3.60)、(24.81±5.12)、(17.93±3.60)和(155.47±41.00)比(32.57±5.69)、(12.81±3.82)、(17.00±4.70)、(9.60±1.39)、(15.39±4.84)、(11.00±3.52)和(98.37±28.96)分;t=10.76、13.39、9.23、16.66、10.36、10.66、8.81,均P<0.001],且共享门诊管理组均显著高于常规护理组(t=3.03、6.95、3.53、4.82、4.93、4.83、3.32,均P<0.05)。干预后,常规护理组仅PSQI总分显著低于干预前[(10.48±2.14)比(11.89±2.45)分;t=3.47,P=0.001],而共享门诊管理组PSQI的睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能、催眠药物各维度评分和总分均显著低于干预前[(1.41±0.32)、(0.54±0.13)、(1.17±0.26)、(1.11±0.35)、(1.21±0.27)、(1.30±0.33)、(1.08±0.21)和(8.05±1.75)比(1.88±0.53)、(0.86±0.37)、(1.84±0.41)、(2.05±0.56)、(1.39±0.33)、(1.47±0.43)、(1.22±0.32)和(11.71±2.43)分;t=-5.Objective To observe the influence of shared medical appointments on health-related quality of life and quality of sleep in patients after liver transplantation.Methods By randomized controlled study,a total of 124 patients after liver transplantation were included from our hospital from January 2018 to January 2019,and according to the lottery method,all subjects were divided into the routine management group(n=64)who received routine outpatient intervention and the shared medical management group(n=60)who received shared medical appointments management.The health-related quality of life and quality of sleep were investigated and compared by post-liver transplant quality of life questionnaire(pLTQ)and Pittsburgh sleep quality index(PSQI)before intervention(the day of discharge)and after intervention(the end of the last shared outpatient service).Results After intervention,the dimension scores of worry,economics,body function,emotional function,health service,complication and total score of pLTQ were improved in tow groups than before intervention[the routine management group:(41.90±7.61),(18.13±4.22),(22.22±5.10),(14.92±3.28),(20.39±4.87),(14.63±3.99),and(132.19±37.09)vs(32.25±5.55),(12.77±3.47),(17.58±4.72),(9.23±1.38),(15.17±4.81),(10.89±1.51)and(98.00±29.03)score,t=8.20,7.85,3.58,12.79,6.10,7.01,5.81,all P<0.001;shared medical management group:(46.12±7.92),(24.16±5.34),(25.55±5.42),(17.90±3.60),(24.81±5.12),(17.93±3.60)and(155.47±41.00)vs(32.57±5.69),(12.81±3.82),(17.00±4.70),(9.60±1.39),(15.39±4.84),(11.00±3.52)and(98.37±28.96)score,t=10.76,13.39,9.23,16.66,10.36,10.66,8.81,all P<0.001],and those in the shared medical management group were higher than those in routine management group(t=3.03,6.95,3.53,4.82,4.93,4.83,3.32,all P<0.05).After intervention,the total score of PSQI scale were lower than before intervention in the routine management group[(10.48±2.14)vs(11.89±2.45)score,t=3.47,P=0.001],and the dimensions score of sleep quality,full-sleep time,sleep time,sleep efficiency

关 键 词：肝移植 病人医护管理 共享门诊 生活质量 睡眠质量 

分 类 号：R657.3[医药卫生—外科学]