基于前哨症状的肺癌术后化疗患者护理干预方案的构建及应用

doi:10.3761/j.issn.0254-1769.2024.02.001

摘要/Abstract

摘要：

目的基于前哨症状构建肺癌术后化疗患者消化道症状群护理干预方案并评价其应用效果。方法在参照指南、质性访谈和专家咨询的基础上，构建消化道症状群护理干预方案。2021年1月—2022年1月，选取沈阳市某三级甲等医院肺癌术后化疗患者330例作为应用对象。试验组在常规护理的基础上接受消化道症状群护理干预方案，对照组接受常规护理。采取安德森症状评估量表、健康状况调查简表分别于第1次化疗前（T1）、第3次化疗前（T2）和第5次化疗前（T3）对患者进行评估。结果干预后，两组症状群总分、各症状得分及健康状况调查简表的生理职能、躯体疼痛、总体健康、活力、情感职能、精神健康维度得分存在组间和时间的交互效应（P<0.05）。简单效应分析结果显示，两组症状群总分、各症状得分及健康状况调查简表的生理职能、躯体疼痛、总体健康、活力、情感职能、精神健康维度得分在T2、T3时间比较，差异具有统计学意义（P<0.05）。结论基于前哨症状的消化道症状群护理干预方案，有利于减轻肺癌术后化疗患者消化道症状群的严重程度，并提高生活质量。

关键词: 肺癌, 症状群, 前哨症状, 恶心, 生活质量, 护理

Abstract:

Objective Based on sentinel symptoms，a nursing intervention program for gastrointestinal symptom group of postoperative chemotherapy for lung cancer was constructed and its application effect was evaluated. Methods The nursing intervention program of gastrointestinal symptom group was constructed on the basis of reference guidelines，qualitative interview and expert consultation. From January 2021 to January 2022，a total of 330 patients with postoperative chemotherapy for lung cancer in a tertiary hospital in Shenyang were selected as research subjects. The experimental group received the gastrointestinal symptoms group nursing intervention program on the basis of routine nursing，and the control group received routine care. Patients were investigated with the M.D. Anderson Symptom Inventory and the MOS 36-Item Short-Form Health Survey before 1st chemotherapy（T1），3rd chemotherapy（T2） and 5th chemotherapy（T3）. Results After the intervention，the total scores of the 2 groups and the total scores of each symptom in T2 and T3 were statistically significant（P<0.05），and the score of the experimental group was lower than that of the control group. For the scores of 6 dimensions of physiological function，physical pain，overall health，vitality，emotional function，mental health in 2 groups between different time points，the differences are statistically significant（P<0.05）. Conclusion The nursing intervention program of the gastrointestinal symptom group based on sentinel symptoms is beneficial to reduce the severity of the gastrointestinal symptom group and improve the quality of life for postoperative chemotherapy for lung cancer patients.

Key words: Lung Cancer, Symptom Cluster, Sentinel Symptoms, Nausea, Quality of Life, Nursing Care

马景双, 王爱平, 王艳杰, 李魏, 刘艳霞. 基于前哨症状的肺癌术后化疗患者护理干预方案的构建及应用[J]. 中华护理杂志, 2024, 59(2): 133-141.

MA Jingshuang, WANG Aiping, WANG Yanjie, LI Wei, LIU Yanxia. Intervention study of lung cancer patients undergoing postoperative chemotherapy based on sentinel symptoms[J]. Chinese Journal of Nursing, 2024, 59(2): 133-141.

图/表 4

表1 肺癌术后化疗患者消化道症状群护理干预方案

Table 1 Nursing intervention program of gastrointestinal symptom group for postoperative chemotherapy for lung cancer patients

表2 两组一般资料的比较[例（百分比，%）]

Table 2 Comparison of general data between 2 groups[case（percentage，%）]

表3 两组消化道症状群评分比较（分，$\bar{x}±s$）

Table 3 Comparison of gastrointestinal symptom clusters between the 2 groups（scores，$\bar{x}±s$）

表4 两组健康状况调查简表得分比较（分，$\bar{x}±s$）

Table 4 Comparison of scores of SF-36 in the 2 groups（scores，$\bar{x}±s$）

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