居家安宁疗护团队服务模式在终末期恶性肿瘤患者及主要照顾者中应用的效果分析  

Effects of home hospice care team service model on fall risk in patients with end-stage malignant tumors and main caregivers

作　　者：周方平 何玉珍[1] 胡明彩 邹丽霞[3] 肖日霞[4] 黄雪君[5] 周俊 Zhou Fangping;He Yuzhen;Hu Mingcai;Zou Lixia;Xiao Rixia;Huang Xuejun;Zhou Jun(Department of Nursing,Yuebei People′s Hospital,Shaoguan 512026,China;Department of Hospice,Yuebei People′s Hospital,Shaoguan 512026,China;Department of Medical Oncology,Yuebei People′s Hospital,Shaoguan 512026,China;Department of General Medicine,Yuebei People′s Hospital,Shaoguan 512026,China;Department of Thyroid and Breast Head and Neck Surgery,Yuebei People′s Hospital,Shaoguan 512026,China;Department of Traumatic Orthopedics,Yuebei People′s Hospital,Shaoguan 512026,China)

机构地区：[1]粤北人民医院护理部,韶关512026 [2]粤北人民医院宁养院,韶关512026 [3]粤北人民医院肿瘤内科,韶关512026 [4]粤北人民医院全科医学科,韶关512026 [5]粤北人民医院甲状腺、乳腺头颈外科,韶关512026 [6]粤北人民医院创伤骨科,韶关512026

出　　处：《中国实用护理杂志》2024年第28期2165-2172,共8页Chinese Journal of Practical Nursing

基　　金：广东省医学科研基金立项项目(B2020097)。

摘　　要：目的探究居家安宁疗护团队服务模式在终末期恶性肿瘤患者及主要照顾者中的应用效果,为改善终末期恶性肿瘤患者生命质量提供干预方案。方法采用前瞻性、对照研究设计方案,以便利抽样法选取2021年5—7月在粤北人民医院接受终末期疗护的106对恶性肿瘤患者及主要照顾者,按照随机数字表法将其分成试验组和对照组,每组53对。对照组采用常规安宁护理干预,试验组在对照组基础上采用居家安宁疗护团队服务模式干预。观察干预后跌倒发生情况,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、亲属应激量表(RSS)及癌症患者生命质量测定量表(EORTC QLQ-C30)评估2组干预前后患者负性情绪、生命质量及主要照顾者心理应激变化情况。结果最终103对完成本研究,对照组52对,试验组51对。对照组患者男29例,女23例,年龄(54.33±12.24)岁,主要照顾者男22名,女30名,年龄(41.67±8.14)岁;试验组患者男27例,女24例,年龄(55.17±10.56)岁,主要照顾者男24名,女27名,年龄(43.62±7.39)岁。干预后,试验组患者跌倒总发生率及跌倒并发症总发生率分别为7.84%(4/51)、1.96%(1/51),均低于对照组的25.00%(13/52)、11.54%(7/52),差异均有统计学意义(χ^(2)=5.50、4.75,均P<0.05)。2组患者及主要照顾者干预前的SAS、SDS、RSS、EORTC QLQ-C30评分比较差异均无统计学意义(均P>0.05)。干预后,试验组患者SAS、SDS评分分别为(32.66±3.18)、(31.19±4.50)分,均低于对照组的(34.54±3.91)、(34.31±4.03)分,差异均有统计学意义(t=2.67、2.51,均P<0.05)。干预后,试验组主要照顾者心理痛苦、生活扰乱、负性情绪维度评分及RSS总分分别为(3.52±0.48)、(3.66±0.56)、(3.47±0.82)、(10.65±0.67)分,均低于对照组的(4.74±2.75)、(4.67±2.64)、(4.12±2.13)、(13.53±2.26)分,差异有统计学意义(t值为2.04~8.73,均P<0.05)。干预后,试验组患者EORTC QLQ-C30评分为(74.14±5.64)分,高于对照组的(70.54±ObjectiveTo explore the effects of home hospice care team service model in patients with end-stage malignant tumors and main caregivers,so as to provide intervention programs for improving the quality of life of patients with end-stage malignant tumors.MethodsIn the prospective and controlled study,106 patients with malignant tumors who received end-stage hospice care in Yuebei People′s Hospital and main caregivers from May 2021 to July 2021 were selected by convenience sampling method,and divided into trial group(53 pairs)and control group(53 pairs)according to the random number table method.The control group was treated with routine nursing intervention,and the trial group was given home hospice care team service model intervention based on the control group.The occurrence of falls and negative emotions and quality of life of patients,psychological stress of primary caregivers before and after intervention were observed by using Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS),Relative Stress Scale(RSS)and European Organization for Research and Treatment of Cancer Quality of Life Scale(EORTC QLQ-C30).ResultsFinally,103 patients and main caregivers completed the study,with 52 pairs in the control group and 51 pairs in the trial group.In the control group,the patients were 29 males and 23 females,aged(54.33±12.24)years old,and the main caregivers were 22 males and 30 females,aged(41.67±8.14)years old.In the trial group,the patients were 27 males and 24 females,aged(55.17±10.56)years old,and the main caregivers were 24 males and 27 females,aged(43.62±7.39)years old.After intervention,the total incidence of falls and the total incidence of fall complications in the trial group were 7.84%(4/51)and 1.96%(1/51),respectively,which were lower than 25.00%(13/52)and 11.54%(7/52)in the control group,the differences were statistically significant(χ^(2)=5.50,4.75,both P<0.05).There was no significant difference in the score of SAS,SDS,RSS,EORTC QLQ-C30 before intervention between the two groups(all P>0

关 键 词：意外跌倒 居家安宁疗护 恶性肿瘤 癌因性症状 终末期 

分 类 号：R473.73[医药卫生—护理学]