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食管癌放化疗患者中实施自我护理干预的临床效果

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   【摘要】 目的:探讨食管癌放化疗患者中自我护理干预的应用效果。方法:在医院2016年9月-2018年9月诊治的食管癌放化疗患者中选取110例,根据干预模式不同分组,将采取常规护理模式干预者设为对照组(n=55),将加用自我护理干预者设为研究组(n=55),就两组患者自我护理能力变化及主观护理体验优良率进行对比分析。结果:治疗后,两组的自我护理能力评分均高于护理前(P<0.05),而研究组自我护理能力评分高于对照组(P<0.05);研究组主观护理体验优良率(100%)高于对照组(89.09%),差异有统计学意义(P<0.05)。结论:食管癌放化疗患者中自我护理干预的应用效果肯定,可增强患者自我护理能力,改善其主观护理体验,值得借鉴。
   【关键词】 食管癌 放化疗 自我护理干预 主观护理体验 自我护理能力
   doi:10.14033/j.cnki.cfmr.2020.02.032 文献标识码 B 文章编号 1674-6805(2020)02-00-02
   [Abstract] Objective: To investigate the application effect of self-care intervention in patients with esophageal cancer undergoing radiotherapy and chemotherapy. Method: A total of 110 patients with esophageal cancer from September 2016 to September 2018 were enrolled. The patients were divided according to the intervention mode, the routine nursing mode intervention was used as the control group (n=55). The self-care intervention were added to the study group (n=55), and the self-care ability changes and the subjective nursing experience rate of the two groups were compared and analyzed. Result: After treatment, the self-care ability scores of the two groups were higher than those before the nursing (P<0.05), while the self-care ability scores of the study group were higher than the control group (P<0.05). The excellent rate of subjective nursing experience in the study group (100%) was higher than the control group (89.09%), and the difference was significant (P<0.05). Conclusion: The application of self-care intervention in patients with esophageal cancer radiotherapy and chemotherapy is positive, which can enhance the self-care ability of patients and improve their subjective nursing experience. It is worth learning.
   [Key words] Esophageal cancer Radiotherapy and chemotherapy Self-care intervention Subjective nursing experience Self-care ability
   First-author’s address: Zhongshan Hospital Affiliated to Xiamen University, Xiamen 361000, China
   食管癌在國内的发生率、死亡率均位居世界首位,多数食管癌患者确诊时已经丧失了手术治疗机会,已有调查研究发现,大约有80%患者难以耐受手术治疗,而仅能通过放射治疗、化学治疗等方式控制病情、延续寿命[1-2]。然而,放射疗法可引起急性放射性反应,化疗药物也可引起脱发、恶心等不良反应,均可加重患者躯体不适感,从而影响其遵医行为,这对改善患者主观护理体验而言十分不利[3]。因此,有必要加强对食管癌放化疗患者的护理干预,常规护理干预效果有限,建议应用其他护理模式。近期,笔者所在医院在食管癌放化疗患者常规护理基础上加用自我护理干预,在提高患者自我护理能力、改善主观护理体验方面取得良好效果[4]。为此,笔者特开展本次分组对照,对应用不同护理方案的一组食管癌放化疗患者临床资料进行回顾性分析,现报道如下。
  1 资料与方法
  1.1 一般资料
   纳入2016年9月-2018年9月笔者所在医院食管癌放化疗患者110例,纳入标准:(1)经病理学检查明确诊断为食管癌,且丧失了手术时机,均选择放化疗方案;(2)神志清醒、语言沟通能力正常;(3)卡氏评分在70分以上,可耐受放化疗。排除标准:(1)合并器质性疾病、严重精神类疾病;(2)存在出血、穿孔情况。将上述样本按护理方案不同分成研究组、对照组,均55例。其中,对照组男28例,女27例;年龄40~83岁,平均(63.63±3.69)岁;病理学类型:鳞癌30例,腺癌25例。研究组男27例,女28例;年龄40~81岁,平均(63.99±3.28)岁;病理学类型:鳞癌29例,腺癌26例;两组年龄、病理学类型等资料差异无统计学意义(P>0.05),有可比性。
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