摘要
目的:探讨叙事护理联合阶段性健康教育在非小细胞肺癌(non-small cell lung cancer,NSCLC)化疗患者护理中的应用效果。方法:通过前瞻性的研究方法,选择2021年3月至2023年8月山东省聊城市人民医院收治的90例NSCLC化疗患者,采用随机数字表法分为两组,每组各45例。对照组行常规护理,观察组行叙事护理联合阶段性健康教育护理。通过汉密顿焦虑量表(HAMA)和汉密顿抑郁量表(HAMD)比较两组患者的负性情绪,通过Piper疲乏调查量表(PFS)比较两组患者的癌性疲乏程度,通过肺癌患者生存质量测定量表(FACT-L)比较两组患者的生存质量情况。结果:干预前,观察组HAMA评分、HAMD评分,PFS的行为、情感、躯体、认知评分,以及FACT-L的生理状况、社会/家庭状况、情感状况、功能状况、肺癌特异模块评分分别为(22.84±2.35)(20.69±2.25)(6.62±1.63)(5.48±1.50)(6.69±1.62)(6.92±1.69)(17.67±2.43)(17.55±2.38)(13.71±1.94)(17.41±2.35)(18.88±2.36)分,与对照组的(22.98±2.43)(20.55±2.16)(6.54±1.56)(5.53±1.52)(6.62±1.58)(6.85±1.67)(17.54±2.36)(17.48±2.33)(13.65±1.85)(17.38±2.31)(18.98±2.42)分比较,差异均无统计学意义(t值分别为0.278、0.301、0.238、0.157、0.208、0.367、0.257、0.141、0.150、0.061、0.199,P值分别为0.782、0.764、0.813、0.876、0.836、0.715、0.797、0.888、0.881、0.951、0.843)。干预后,观察组HAMA评分、HAMD评分,PFS的行为、情感、躯体、认知评分分别为(8.56±1.34)(7.21±1.15)(3.15±1.06)(3.04±1.01)(3.62±1.12)(3.75±1.19)分,分别低于对照组的(12.13±1.75)(9.58±1.74)(4.87±1.27)(4.56±1.23)(5.01±1.34)(5.24±1.38)分,差异均有统计学意义(t值分别为10.856、7.623、6.975、6.407、5.339、5.485,P值均<0.001);FACT-L的生理状况、社会/家庭状况、情感状况、功能状况、肺癌特异模块评分分别为(27.92±2.76)(27.05±2.71)(20.24±2.50)(26.98±2.61)(28.93±2.98)分,均高于对照组的(22.69±2.54)(22.14±2.47)(17.69±2.31)(22.53±2.48)(24.56±2.64)分,差异均有统计学意义(t值分别为9.354、8.983、5.026、8.291、7.363,P值均<0.001)。结论:将叙事护理联合阶段性健康教育应用于NSCLC化疗患者中,更有利于缓解患者焦虑、抑郁、恐惧等消极情绪,减轻其癌性疲乏程度,提高患者生存质量。
Objective:Exploring the application effect of narrative nursing combined with phased health education in the nursing of patients with non-small cell lung cancer(NSCLC)undergoing chemotherapy.Methods:Convenience sampling method was used to select 90 patients with NSCLC treated with chemotherapy in Liaocheng People’s Hospital of Shandong Province from March 2021 to August 2023,and they were divided into two groups according to random number table,with 45 cases in each group.The control group received routine nursing,and the observation group received narrative nursing combined with phased health education nursing.The negative emotions,cancer fatigue and quality of life were compared between the two groups.Results:Before intervention,the HAMA score of the observation group was 22.84±2.35 and the HAMD score was 20.69±2.25.With the Piper fatigue survey scale(PFS),the behavioral score was 6.62±1.63,emotional score was 5.48±1.50,physical score was 6.69±1.62,and cognitive score was 6.92±1.69.The scores of physiological status,social/family status,emotional status,functional status and lung cancer specific module were 17.67±2.43,17.55±2.38,13.71±1.94,17.41±2.35 and 18.88±2.36,respectively with FACT-L Scale.For the control group,it were 22.98±2.43,20.55±2.16,6.54±1.56,5.53±1.52,6.62±1.58,6.85±1.67,17.54±2.36,17.48±2.33,13.65±1.85,17.38±2.31,18.98±2.42,there were no statistical significance(t=0.278,0.301,0.238,0.157,0.208,0.367,0.257,0.141,0.150,0.061,0.199,P=0.782,0.764,0.813,0.876,0.836,0.715,0.797,0.888,0.881,0.951,0.843).After intervention,the HAMA score and HAMD score of the observation group were 8.56±1.34 and 7.21±1.15 respectively.For PFS,the behavioral score was 3.15±1.06,the affective score was 3.04±1.01,the physical score was 3.62±1.12 and the cognitive score was 3.75±1.19.It was lower than that of the control group(12.13±1.75,9.58±1.74,4.87±1.27,4.56±1.23,5.01±1.34,5.24±1.38;t=10.856,7.623,6.975,6.407,5.339,5.485,all P<0.001).For FACT-L,physiological status score of the observation group was 27.92±2.76,social/family status score was 27.05±2.71,emotional status score was 20.24±2.50,functional status score was 26.98±2.61,lung cancer specific module score was 28.93±2.98,higher than the control group(22.69±2.54,22.14±2.47,17.69±2.31,22.53±2.48,24.56±2.64),the differences were all statistically significant(t=9.354,8.983,5.026,8.291,7.363;all P<0.001).Conclusion:The application of narrative nursing combined with phased health education in patients with NSCLC undergoing chemotherapy is good for relieving patients’negative emotions such as anxiety,depression and fear,reducing the degree of cancer-related fatigue,improving their quality of life.
作者
杭冲
房楠楠
刘晓
Hang Chong;Fang Nannan;Liu Xiao(Health Management Center,Dongchang Fuyuan District of Liaocheng People’s Hospital,Shandong Province,Liaocheng 252000,China;Department of Respiratory and Critical Care Medicine,Liaocheng People’s Hospital,Shandong Province,Liaocheng 252000,China)
出处
《结核与肺部疾病杂志》
2024年第4期339-344,共6页
Journal of Tuberculosis and Lung Disease
关键词
癌
非小细胞肺
病人医疗护理
健康教育
情绪
疲劳
Carcinoma,non-small-cell lung
Patient care
Health education
Emotions
Fatigue
