联合家庭随访的预立性医疗照护计划在终末期肺癌患者中的应用  

Application of advance care planning with family follow-up in end-stage lung cancer patients

作　　者：蒋颖新 邱娟[1] 温蓉 杨路 罗淑兰[1] 李俊玉[1] 宗静 罗赞 JIANG Yingxin;QIU Juan;WEN Rong;YANG Lu;LUO Shulan;LI Junyu;ZONG Jing;LUO Zan(The Second Ward of Thoracic Surgery,Jiangxi Cancer Hospital,Jiangxi Province,Nanchang330029,China)

机构地区：[1]江西省肿瘤医院胸放二病区,江西南昌330029

出　　处：《中国当代医药》2024年第16期155-158,163,共5页China Modern Medicine

基　　金：江西省卫生健康委科技计划项目(202210976)。

摘　　要：目的观察联合家庭随访的预立性医疗照护计划(ACP)在终末期肺癌患者中的应用效果。方法选取2022年1月至12月江西省肿瘤医院收治的110例终末期肺癌患者为研究对象,通过抽签法分为对照组(55例)和试验组(55例),对照组患者实施肿瘤常规护理,试验组患者实施联合家庭随访的ACP干预。比较两组患者的尊严水平、生命质量、死亡质量。结果两组干预前心理状况分数、症状困扰分数、依赖性分数、精神安宁分数、社会支持分数比较,差异无统计学意义(P>0.05);试验组干预后的心理状况分数、症状困扰分数、依赖性分数、精神安宁分数、社会支持分数低于对照组,差异有统计学意义(P<0.05)。两组干预前癌症患者生命质量测定量表(EORTC QLQ-C30)的角色功能分数、躯体功能分数、认知功能分数、社会功能分数、情绪功能分数比较,差异无统计学意义(P>0.05);两组干预后的EORTC QLQ-C30的各项评分高于对照组,差异有统计学意义(P<0.05)。两组干预前的优逝量表(GDI)评分比较,差异无统计学意义(P>0.05);试验组干预后的GDI分数高于对照组,差异有统计学意义(P<0.05)。结论终末期肺癌患者使用联合家庭随访的ACP干预模式,让患者充分表达护理意愿、临终治疗意愿,舒适地走完生命旅程。Objective To observe the effect of advance care planning(ACP)with family follow-up in patients with end-stage lung cancer.Methods A total of 110 patients with end-stage lung cancer admitted to Jiangxi Cancer Hospital from January to December 2022 were selected as the study objects and divided into control group(55 cases)and experimental group(55 cases)by drawing lots.Patients in the control group received routine cancer nursing,and patients in the experimental group received ACP intervention with joint family follow-up.The dignity level,life quality and death quality of the two groups were compared.Results There was no significant difference in scores of psychological status,symptom distress,dependence,mental peace and social support between the two groups before intervention(P>0.05).The scores of psychological status,symptom disturbance,dependence,mental peace and social support of experimental group were lower than those of control group after intervention,and the differences were statistically significant(P<0.05).There were no significant differences in the role function scores,physical function scores,cognitive function scores,social function scores and emotional function scores of European Organization for Research and Treatment of Cancer quality of life questionnaire(EORTC QLQ-C30)between the two groups before intervention(P>0.05).The EORTC QLQ-C30 scores of the two groups after intervention were higher than those of the control group,and the difference was statistically significant(P<0.05).There was no significant difference in good death inventory(GDI)scores between the two groups before intervention(P>0.05).The GDI score of experimental group was higher than that of control group after intervention,and the difference was statistically significant(P<0.05).Conclusion Patients with end-stage lung cancer use the ACP intervention model of combined family follow-up,allowing patients to fully express their willingness to care and end-of-life treatment willingness,and walk through their life journey comfortably.

关 键 词：家庭随访 预立性医疗照护计划 终末期肺癌 尊严 生命质量 

分 类 号：R734.2[医药卫生—肿瘤]