个案管理结合聚焦心理模式对胃癌根治术患者胃肠功能、希望水平的影响  

Effect of case management combined with focused psychological model on gastrointestinal function and hope level of patients undergoing radical gastrectomy for gastric cancer

作　　者：陈韦 万丽丽 施莉 刘国印 黄玉萍 CHEN Wei;WAN Lili;SHI Li(Department of General Surgery,Qinhuai Medical District of General Hospital of Eastern Theater Command,Jiangsu,Nanjing 210002,China)

机构地区：[1]中国人民解放军东部战区总医院秦淮医疗区普外科,南京市210002

出　　处：《河北医药》2024年第1期87-90,94,共5页Hebei Medical Journal

基　　金：国家自然科学基金资助项目(编号:82102547)。

摘　　要：目的探讨个案管理结合聚焦心理模式对胃癌根治术患者胃肠功能、希望水平的影响。方法选择2019年1月至2021年6月,收治的80例胃癌根治术患者,将随机分为2组,每组40例,对照组给予常规护理,观察组采用个案管理结合聚焦心理模式进行干预,比较2组患者的干预效果、胃肠功能恢复情况和希望水平。结果2组干预后的自我护理能力实施量表(ESCA)评分高于干预前,观察组高于对照组,差异有统计学意义(P<0.05)。2组干预后的HAMD评分和HAMA评分低于干预前,观察组低于对照组,差异有统计学意义(P<0.05)。观察组的首次排气时间、首次排便时间、肠鸣音恢复时间、进食时间和胃管留置时间等短于对照组,差异有统计学意义(P<0.05)。2组干预后的Herth总分高于干预前,观察组高于对照组;2组干预后的Herth分级分布优于干预前,观察组优于对照组,差异有统计学意义(P<0.05)。观察组的角色功能、社会功能、躯体功能、情绪功能、认知功能等的评分均高于对照组,差异有统计学意义(P<0.05)。观察组的术后并发症(肺部感染、吻合口瘘、粘连性肠梗阻、切口感染)发生率为7.50%低于对照组的30.00%,差异有统计学意义(P<0.05)。结论胃癌根治术患者应用个案管理结合聚焦心理模式进行干预,效果显著。Objective To explore the effect of case management combined with focused psychological model on gastrointestinal function and hope level of patients undergoing radical gastrectomy for gastric cancer.Methods A total of 80 gastric cancer patients undergoing radical gastrectomy in our hospital from January 2019 to June 2021 were recruited.They were randomly divided into the observation group(routine nursing) and control group(nursing with the case management combined with focused psychological model),with 40 cases in each group.The intervention effect,gastrointestinal function recovery and hope level of the two groups were compared.Results After the intervention,the Self-Care Ability Scale(ESCA) scores in both groups were significantly higher than those before the intervention,which were significantly higher in the observation group than those of the control group(P<0.05).After the intervention,the Hamilton Depression Rating Scale(HAMD) and the Hamilton Anxiety Rating Scale(HAMA) scores in the both groups were significantly lower than those before the intervention,which were significantly lower in the observation group than those of the control group(P<0.05).The time of first exhaust,time of first defecation,time of bowel sound recovery,time of first eating and indwelling time of gastric tube in the observation group were significantly shorter than those of the control group(P<0.05).The total score of the Herth Hope Index(HHP) after the intervention in the both groups was significantly higher than that before the intervention,which was significantly higher in the observation group than that of the control group(P<0.05).The grading distribution of the HHI in the both groups after intervention was significantly better than that before intervention,which was significantly superior in the observation group than that of the control group(P<0.05).The scores of role function,social function,physical function,emotional function and cognitive function in the observation group were significantly higher than those of the contr

关 键 词：个案管理 聚焦心理模式 胃癌根治术 希望水平 

分 类 号：R473.73[医药卫生—护理学]