作者：戴芬，巫荷英，陈伟

单位：安徽医科大学第一附属医院 普外科，安徽 合肥 230022

Authors: Dai Fen, Wu Heying, Chen Wei

Unit:  Department of General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230022, Anhui, China

摘要：

目的 评估支持性护理干预在结直肠癌患者术后的实施效果。方法 选取安徽医科大学第一附属医院确诊为结直肠癌并接受手术治疗的患者130例,随机分为对照组(72例)和干预组(58例),两组术后均给予常规护理,干预组在常规护理的基础上增加支持性护理。采用护理协调和连续性问卷(Continuity and Coordination of Care Questionnaire,CCCQ)、支持性护理需求调查简表(34-item short form Supportive Care Needs Survey,SCNS-SF34)和疾病不确定感量表(Mishel Uncertainty in Illness Scale-Community Form,MUIS-C)在3个时段进行评分,对两组的评分结果进行比较分析。结果 与对照组相比,干预组在术后第3周时的CCCQ评分有所提升(t=0.316,P=0.038)。干预组患者的心理需求、卫生服务和信息需求、生理和日常生活需求均显著高于对照组(P<0.05)。在术后10周内,干预组患者寻求护士帮助(<2 d/次)的比例显著高于对照组(63.7%比45.5%,P=0.002);干预组患者寻求精神支持(心理咨询、聊天、信仰宗教等)的比例均高于对照组(40.0%比23.5%,P=0.002)。此外,干预组患者寻求肿瘤学家、营养师帮助的比例显著高于对照组(P<0.05),寻求药剂师的比例低于对照组(P<0.05),差异均有统计学意义。结论 支持性护理干预可以在结直肠癌手术后补充常规护理,更好地改善患者的生活质量。

关键词：  癌症护理；支持性护理需求；评价

Abstract：

Objective To evaluate the effect of supportive nursing intervention on postoperative patients with colorectal cancer. Methods This study included 130 patients diagnosed of colorectal cancer and underwent surgery in the First Affiliated Hospital of Anhui medical university. They were randomly divided into the control group （72 cases）and the intervention group （58 cases）. Both groups received routine nursing after operation, and the intervention group received extra supportive nursing on the basis of routine nursing. Continuity and Coordination of Care Questionnaire （CCCQ）. The 34-item short form Supportive Care Needs Survey, and Mishel Uncertainty in Illness Scale-Community Form （MUIS-C）were used to collect patient information through three periods. The scoring results and resource utilization of the two groups were compared. Results Compared with the control group, the information continuity （CCCQ）of the intervention group at three weeks after surgery was improved （t=0.316, P=0.038）. The psychological needs, health services and information needs, physiological and daily life needs of the intervention group were higher than those of the control group （P<0.05）. Within 10 weeks after operation, the proportion of patients seeking nurse assistance （<2 hours / time）in the intervention group was significantly higher than those in the control group （63.7 % vs 45.5%, P=0.002）. The proportion of patients in the intervention group seeking spiritual support （psychological counseling, chat, religion, etc.）was slightly higher than those in the control group （40.0 % vs 23.5 %）, and the difference was statistically significant （P=0.002）. In addition, the proportion of patients in the intervention group seeking help from oncologists and nutritionists was significantly higher than that in the control group （P<0.05）, and the proportion of demand pharmacists was lower than that in the control group （P<0.05）. Conclusion The results of this study suggested that supportive care interventions can complement routine care after colorectal cancer surgery and better improve patients' quality of life.

Key Words:  Cancer care; Supportive care needs; Assessment