肿瘤化疗患儿急性恶心呕吐非药物干预方案的构建及应用研究

doi:10.3761/j.issn.0254-1769.2024.18.001

摘要/Abstract

摘要：

目的构建肿瘤化疗患儿急性恶心呕吐非药物干预方案，并评价其应用效果。方法通过文献检索和专家函询，构建肿瘤化疗患儿急性恶心呕吐非药物干预方案。采用方便抽样法，选取2023年7月1日—10月31日在浙江省某三级甲等儿童医院神经外科接受化疗的100例患儿作为试验组，将2023年2月1日—5月30日在同病房接受化疗的100例患儿作为对照组。试验组应用肿瘤化疗患儿急性恶心呕吐非药物干预方案进行护理，对照组应用常规非药物干预措施。比较住院期间两组恶心发生率、呕吐发生率、呕吐严重程度、睡眠时间达标率和负性情绪发生率。结果 2轮专家函询有效问卷回收率均为100%，专家的权威系数为0.836，肯德尔和谐系数分别为0.471和0.820（均P<0.001），最终形成的肿瘤化疗患儿急性恶心呕吐非药物干预方案包括5项一级条目、14项二级条目和18项三级条目。方案应用结果显示，试验组恶心发生率、呕吐发生率及负性情绪发生率均低于对照组，呕吐严重程度轻于对照组，睡眠时间达标率高于对照组，差异具有统计学意义（均P<0.05）。结论该研究构建的肿瘤化疗患儿急性恶心呕吐非药物干预方案具有科学性和全面性，实施该方案可以降低患儿恶心、呕吐及负性情绪的发生率，减轻呕吐严重程度，提高睡眠时间达标率。

关键词: 肿瘤, 化疗, 恶心, 呕吐, 德尔菲技术, 儿科护理学

Abstract:

Objective To construct a non-drug intervention program for acute chemotherapy-related nausea and vomiting in children with cancer and to evaluate its efficacy. Methods Through literature review and Delphi expert correspondence，a non-drug intervention program for acute chemotherapy-related nausea and vomiting in children with cancer was constructed. By the convenience sampling method，200 consecutive children who received chemotherapy in the neurosurgery department of a tertiary children’s hospital in Zhejiang province from February 1 to October 31，2023 were included as the application subjects，with 100 cases in an experimental group and 100 cases in a control group. The experimental group applied the non-drug intervention program of acute chemotherapy-related nausea and vomiting in children with cancer，and the routine measures were applied in the control group. The incidence of nausea and vomiting，severity of vomiting，compliance rate of normal sleep duration and incidence of negative emotions were compared between the 2 groups. Results The recovery rate of the valid questionnaire in 2 rounds of expert letter inquiry was 100%，and the expert authority coefficient was 0.836. The Kendall harmony coefficients were 0.471 and 0.820（P<0.001），and the final non-drug intervention program for pediatric acute chemotherapy-related nausea and vomiting included 5 primary，14 secondary and 18 tertiary items. The results showed that the incidence of nausea，vomiting and negative emotions in the experimental group were lower than that in the control group，with statistically significant differences（P<0.05）. The severity of vomiting was less than it in the control group，with statistically significant difference（P<0.05）. The standard rate of normal sleep time was higher than that of the control group，and the difference was statistically significant（all P<0.05）. Conclusion The non-drug intervention program of chemotherapy-related nausea and vomiting in children is scientific and feasible，and the implementation of the program can reduce the incidence of nausea，vomiting and negative emotions，reduce the severity of vomiting，and improve the standard rate of normal bedtime in children.

Key words: Neoplasms, Chemotherapy, Nausea, Vomiting, Delphi Technique, Pediatric Nursing

虞露艳, 周莹, 范佳杰, 吴倩, 褚小艺, 盛土君, 张稀, 白冠男, 林楠, 诸纪华. 肿瘤化疗患儿急性恶心呕吐非药物干预方案的构建及应用研究[J]. 中华护理杂志, 2024, 59(18): 2181-2188.

YU Luyan, ZHOU Ying, FAN Jiajie, WU Qian, CHU Xiaoyi, SHENG Tujun, ZHANG Xi, BAI Guannan, LIN Nan, ZHU Jihua. Construction and application of a non-drug intervention program for acute chemotherapy-related nausea and vomiting in children with cancer[J]. Chinese Journal of Nursing, 2024, 59(18): 2181-2188.

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