摘要
目的探索闭环式管理模式对门诊癌痛患者的镇痛效果及可行性。方法收集2019年12月—2020年6月在江苏省肿瘤医院镇痛门诊首诊并使用阿片类药物(羟考酮缓释片)进行镇痛治疗的癌痛患者112例为研究对象。按照组间基本特征具有可比性的原则将患者分为对照组和观察组,每组56例,对照组给予常规管理;观察组接受闭环式管理模式,包括对患者首诊、复诊、定期随访、宣教、用药记录、指导等,同期疼痛门诊专科医师、药师、护士对患者制订个体化规范、合理、有效的镇痛方案及随诊计划,重点解决患者镇痛用药依从性,随诊反馈中存在的问题。两组患者均接受持续1个月的管理,记录并比较两组患者管理前后的服药依从率、数字评分量表(NRS)、爆发痛次数、疼痛控制满意程度,外周血β-内啡肽(β-EP)、前列腺素E-2(PGE-2)、内皮素-1(ET-1)、体质状况(KPS)评分,记录两组患者管理后对护理满意程度及管理期间发生的不良反应。结果管理前,两组患者的服药依从率、NRS、爆发痛次数、β-EP、PGE-2、ET-1、KPS评分比较差异均无统计学意义(P>0.05);管理后,观察组患者的服药依从率、镇痛满意程度、β-EP、护理满意程度和KPS评分高于对照组,差异均有统计学意义(P<0.05)。观察组患者的NRS、PGE-2、ET-1和不良反应发生程度均低于对照组,爆发痛次数少于对照组,差异均有统计学意义(P<0.05)。结论闭环式管理模式可有效提升门诊癌痛患者服药依从,有效控制疼痛,改善患者体质。
Objective To explore the analgesic effect and feasibility of the closed-loop management model for outpatient cancer pain patients.Methods A total of 112 patients with cancer pain who were first diagnosed at the analgesic clinic of Jiangsu Cancer Hospital from December 2019 to June 2020 and were treated with opioids(oxycodone sustained-release tablets)for analgesia were collected as research subjects.According to the principle of comparability of basic characteristics between groups,the patients were divided into a control group and an observation group,with 56 cases in each group.The control group received routine management;the observation group received a closed-loop management model,including first consultation,follow-up consultation,regular follow-up,education,medication records,guidance,etc.During the same period,pain clinic specialists,pharmacists,and nurses formulated individualized and reasonable standards for patients,effective analgesic programs and follow-up plans,focusing on solving problems in patients'analgesic medication compliance and follow-up feedback.Both groups of patients received continuous management for one month.The medication compliance rate,number rating scale(NRS),number of burst pains,pain control satisfaction,peripheral bloodβ-endorphin(β-EP),prostaglandin E-2(PGE-2),endothelin-1(ET-1)and physical status(KPS)scores were used to record the satisfaction of the two groups of patients with care after management and the adverse reactions that occurred during management.Results There was no statistically significant difference in the medication compliance rate,NRS,number of burst pains,β-EP,PGE-2,ET-1 and KPS scores between the two groups before management(P>0.05).After management,the medication compliance rate,analgesia satisfaction,β-EP,nursing satisfaction and KPS scores of patients in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).The NRS,PGE-2,ET-1 and degree of adverse reactions of patients in the observation group were lower than those in the control group,the number of burst pains was less than that in the control group,and the differences were statistically significant(P<0.05).Conclusion The closed-loop management model can effectively improve the medication compliance of outpatient cancer pain patients,effectively control pain,and improve patients'physical condition.
作者
王敏
周学健
吉爱军
单靖眙
张赟
刘德林
金陶
WANG Min;ZHOU Xuejian;JI Aijun;SHAN Jingyi;ZHANG Yun;LIU Delin;JIN Tao(Jiangsu Cancer Hospital,Nanjing 210009,China)
出处
《护理实践与研究》
2024年第1期138-145,共8页
Nursing Practice and Research
基金
江苏省科技计划项目(编号:BK20201496)。
