作业疗法联合职业康复对结直肠癌患者术后重返工作岗位的效果研究

doi:10.3761/j.issn.0254-1769.2026.08.010

中华护理杂志 ›› 2026, Vol. 61 ›› Issue (8): 1080-1087.DOI: 10.3761/j.issn.0254-1769.2026.08.010

作业疗法联合职业康复对结直肠癌患者术后重返工作岗位的效果研究

杜倩¹(), 胡恒瑜², 李珍¹^,^*(), 曹静文³, 刘星歌⁴, 刘林莉¹

¹ 河南省人民医院肿瘤医学部郑州市 450003
² 河南省人民医院老年医学科郑州市 450003
³ 河南省人民医院神经内科ICU 郑州市 450003
⁴ 河南大学护理与健康学院开封市 475004

收稿日期:2025-04-25 出版日期:2026-04-20 发布日期:2026-04-22
*通讯作者: 李珍，E-mail：653852519@qq.com
作者简介:杜倩：女，本科，主管护师，E-mail：372345388@qq.com
第一联系人：作者贡献声明
杜倩：研究选题和设计、研究实施、论文撰写；胡恒瑜、曹静文：研究设计与实施、资料收集、统计学分析；李珍：研究设计与实施、论文审阅与修改；刘星歌、刘林莉：研究实施、数据收集与整理
基金资助:
2022年度河南省医学科技攻关省部共建重点项目(SBGJ202102002)

A study of the effect of occupational therapy combined with vocational rehabilitation on the return to work of postoperative colorectal cancer patients

DU Qian¹(), HU Hengyu², LI Zhen¹^,^*(), CAO Jingwen³, LIU Xingge⁴, LIU Linli¹

¹ Department of Oncology， Henan Provincial People’s Hospital， Zhengzhou 450003， China
² Geriatrics Department， Henan Provincial People’s Hospital， Zhengzhou 450003， China
³ Neurological ICU， Henan Provincial People’s Hospital， Zhengzhou 450003， China
⁴ School of Nursing and Health， Henan University， Kaifeng 475004， China.

Received:2025-04-25 Online:2026-04-20 Published:2026-04-22
* Corresponding author: LI Zhen，E-mail：653852519@qq.com
Funding program:
Key Project of Henan Provincial Medical Science and Technology Research for Provincial-Ministerial Coconstruction in 2022(SBGJ202102002)

摘要/Abstract

摘要：

目的探讨作业疗法联合职业康复对结直肠癌患者术后重返工作岗位的影响，旨在为临床护理实践中支持患者顺利重返工作提供参考依据。方法采用便利抽样法，选取2024年4月—2025年2月在郑州市某三级甲等医院肿瘤中心及胃肠外科门诊收治的60例结直肠癌患者作为研究对象，采用随机数字表法，将其分为试验组和对照组，每组各30例，试验组在常规健康宣教的基础上予以作业疗法联合职业康复干预，对照组实施常规健康宣教。干预12周后，比较两组干预前后在重返工作率、重返工作自我效能、疲乏程度、生活质量的差异。结果共有55例结直肠癌患者完成该研究，试验组27例，对照组28例。干预后，试验组的重返工作率、重返工作自我效能、生活质量均优于对照组，疲乏水平低于对照组，两组比较，差异有统计学意义（P<0.05）。结论作业疗法联合职业康复可对结直肠癌患者术后的重返工作率、重返工作自我效能、生活质量产生积极影响，并能降低患者的疲乏水平。

关键词: 结直肠癌, 作业疗法, 职业康复, 重返工作岗位, 生活质量, 护理

Abstract:

Objective To evaluate the effects of occupational therapy combined with vocational rehabilitation on return-to-work rate，return-to-work self-efficacy，fatigue，and quality of life in postoperative colorectal cancer patients，with the aim of providing evidence-based guidance for clinical nursing practice in facilitating patients’ return to work. Methods 60 postoperative colorectal cancer patients admitted to the Oncology Center and Gastrointestinal Surgery Outpatient Department of a tertiary hospital in Zhengzhou between April 2024 and February 2025 were selected using convenience sampling. Participants were randomly assigned to an experimental group or a control group （n=30 each） using a random number table. The control group received routine health education，while the experimental group received additional occupational therapy combined with vocational rehabilitation. After a 12-week intervention，outcomes were assessed and compared between groups，including return-to-work rate，return-to-work self-efficacy，fatigue level，and quality of life. Results Post-intervention，the experimental group showed significantly higher return-to-work rates，greater self-efficacy，improved quality of life，and lower fatigue levels compared to the control group（P<0.05）. Conclusion Occupational therapy combined with vocational rehabilitation significantly enhances return-to-work outcomes，self-efficacy，and quality of life，while effectively reducing fatigue in postoperative colorectal cancer patients.

Key words: Colorectal Cancer, Occupational Therapy, Vocational Rehabilitation, Return to Work, Quality of Life, Nursing Care

杜倩, 胡恒瑜, 李珍, 曹静文, 刘星歌, 刘林莉. 作业疗法联合职业康复对结直肠癌患者术后重返工作岗位的效果研究[J]. 中华护理杂志, 2026, 61(8): 1080-1087.

DU Qian, HU Hengyu, LI Zhen, CAO Jingwen, LIU Xingge, LIU Linli. A study of the effect of occupational therapy combined with vocational rehabilitation on the return to work of postoperative colorectal cancer patients[J]. Chinese Journal of Nursing, 2026, 61(8): 1080-1087.

图/表 4

表1 作业疗法联合职业康复干预方案

Table 1 Occupational therapy combined with vocational rehabilitation intervention programme

表2 两组一般资料的比较[例（百分比，%）]

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

表3 两组干预前后重返工作自我效能得分和疲乏得分比较（分，$\bar{x}\pm s$）

Table 3 Comparison of RTW-SE and RPFS scores before and afterintervention between 2 groups（score，$\bar{x}\pm s$）

表4 两组干预前后功能领域和症状领域得分的比较（分，$\bar{x}\pm s$）

Table 4 Comparison of EORTC QLQ-C30 score before and after intervention between 2 groups（score，$\bar{x}\pm s$）

参考文献 33

[1]	El Din KS, Loree JM, Sayre EC, et al. Trends in the epidemiology of young-onset colorectal cancer:a worldwide systematic review[J]. BMC Cancer, 2020, 20(1):288. DOI
[2]	Li JM, Su XQ, Xu XP, et al. Influencing factors analysis of adaptability of cancer patients to return-to-work[J]. Support Care Cancer, 2023, 31(5):302.
[3]	Ren YL, Zhou Y, Zhang LL, et al. Readiness for return-to-work model-based analysis of return-to-work perception of young and middle-aged colorectal cancer patients with stoma in the early postoperative period:a descriptive qualitative study[J]. Support Care Cancer, 2023, 31(7):411.
[4]	den Bakker CM, Anema JR, Huirne JF, et al. Predicting return to work among patients with colorectal cancer[J]. Br J Surg, 2020, 107(1):140-148. DOI PMID
[5]	Liu JL, Ye H, Tian JY, et al. Construction and validation of a predictive model for the return to work of patients with permanent colorectal stoma:a cross-sectional study[J]. BMC Gastroenterol, 2024, 24(1):352. DOI
[6]	Kovacevic N, Žagar T, Homar V, et al. Benefits of early integrated and vocational rehabilitation in breast cancer on work ability,sick leave duration,and disability rates[J]. Healthcare, 2024, 12(23):2433. DOI URL
[7]	McNichols CC, Peterson AK, Reynolds S. The effect of occupational therapy services on hospital readmission for patients with cancer in acute care settings:a retrospective data analysis[J]. J Cancer Surviv, 2025, 19(6):2091-2100. DOI
[8]	He K, Jiang JJ, Chen MM, et al. Effects of occupational therapy on quality of life in breast cancer patients:a systematic review and meta-analysis[J]. Medicine, 2023, 102(31):e34484. DOI URL
[9]	Udovicich A, Foley KR, Bull D, et al. Occupational therapy group interventions in oncology:a scoping review[J]. Am J Occup Ther, 2020, 74(4):7404205010p1-7404205010p13.
[10]	Hoving JL, Broekhuizen MLA, Frings-Dresen MHW. Return to work of breast cancer survivors:a systematic review of inter-vention studies[J]. BMC Cancer, 2009, 9(1):117. DOI URL
[11]	倪平, 陈京立, 刘娜. 护理研究中量性研究的样本量估计[J]. 中华护理杂志, 2010, 45(4):378-380.
	Ni P, Chen JL, Liu N. The sample size estimation in quantitative nursing research[J]. Chin J Nurs, 2010, 45(4):378-380.
[12]	万崇华, 陈明清, 张灿珍, 等. 癌症患者生命质量测定量表EORTC QLQ-C30中文版评介[J]. 实用肿瘤杂志, 2005, 20(4):353-355.
	Wan CH, Chen MQ, Zhang CZ, et al. Evaluation of Chinese version of EORTC QLQ-C30,a quality of life scale for cancer patients[J]. J Pract Oncol, 2005, 20(4):353-355.
[13]	孟琼, 万崇华, 罗家洪. 癌症患者生命质量测定量表EORT CQLQ-C30的应用[J]. 中国行为医学科学, 2005, 14(3):273-274.
	Meng Q, Wan CH, Luo JH. Application of EORT CQLQ-C30,a quality of life scale for cancer patients[J]. Chin J Behav Med Sci, 2005, 14(3):273-274.
[14]	Lagerveld SE, Blonk RWB, Brenninkmeijer V, et al. Return to work among employees with mental health problems:development and validation of a Self-Efficacy Questionnaire[J]. Work Stress, 2010, 24(4):359-375. DOI URL
[15]	高娅鑫, 屈清荣, 王碧轩, 等. 重返工作自我效能问卷的汉化及其在癌症患者中的信效度检验[J]. 解放军护理杂志, 2021, 38(7):52-55.
	Gao YX, Qu QR, Wang BX, et al. Chinese translation of the Return-to-Work Self-Efficacy Questionnaire in cancer patients and its reliability and validity test[J]. Nurs J Chin PLA, 2021, 38(7):52-55.
[16]	So WKW, Dodgson J, Tai JWM. Fatigue and quality of life among Chinese patients with hematologic malignancy after bone marrow transplantation[J]. Cancer Nurs, 2003, 26(3):211-221. PMID
[17]	吴晓琴, 夏海鸥, 孔振芳, 等. 结直肠癌患者癌因性疲乏的多维度纵向研究[J]. 护理学杂志, 2015, 30(4):21-25.
	Wu XQ, Xia HO, Kong ZF, et al. The multidimensional and longitudinal study on cancer related fatigue of patients with colorectal cancer[J]. J Nurs Sci, 2015, 30(4):21-25.
[18]	Guo YJ, Tang J, Li JM, et al. Exploration of interventions to enhance return-to-work for cancer patients:a scoping review[J]. Clin Rehabil, 2021, 35(12):1674-1693. DOI URL
[19]	杨晓霞, 于子夫, 王芳, 等. 结直肠癌患者社会疏离的潜在剖面分析及护理启示[J]. 中华护理杂志, 2025, 60(20):2499-2506. DOI URL
	Yang XX, Yu ZF, Wang F, et al. Latent profile analysis and nursing implications of social alienation in colorectal cancer patients[J]. Chin J Nurs, 2025, 60(20):2499-2506. DOI URL
[20]	郑存风, 王峥, 刘海静, 等. 结直肠癌术后化疗患者核心症状的纵向研究及护理对策[J]. 中华护理杂志, 2025, 60(11):1309-1315. DOI URL
	Zheng CF, Wang Z, Liu HJ, et al. Longitudinal study on core symptoms and nursing strategies for patients with colorectal cancer undergoing postoperative chemotherapy[J]. Chin J Nurs, 2025, 60(11):1309-1315. DOI URL
[21]	Zhang N, Yang F, Di WL, et al. Predictors of return to work among postoperative patients with colorectal cancer[J]. Clin Rehabil, 2024, 38(11):1559-1568. DOI PMID
[22]	李梦洁, 苟晓瑜, 卢楠, 等. 结直肠癌病人重返工作岗位的研究进展[J]. 护理研究, 2024, 38(10):1804-1808.
	Li MJ, Gou XY, Lu N, et al. Research progress of return to work of patients with colorectal cancer[J]. Chin Nurs Res, 2024, 38(10):1804-1808.
[23]	Silver JK, Gilchrist LS. Cancer rehabilitation with a focus on evidence-based outpatient physical and occupational therapy interventions[J]. Am J Phys Med Rehabil, 2011, 90(5Suppl 1): S5-15.
[24]	Bandura A. Self-efficacy:toward a unifying theory of behavioral change[J]. Adv Behav Res Ther, 1978, 1(4):139-161. DOI URL
[25]	Zaman AM, Tytgat KJ, Klinkenbijl JG, et al. Effectiveness of a tailored work-related support intervention for patients diagnosed with gastrointestinal cancer:a multicenter randomized controlled trial[J]. J Occup Rehabil, 2021, 31(2):323-338. DOI
[26]	Barsevick A, Frost M, Zwinderman A, et al. I’m so tired:biological and genetic mechanisms of cancer-related fatigue[J]. Qual Life Res, 2010, 19(10):1419-1427. DOI PMID
[27]	Bower JE. Cancer-related fatigue:mechanisms,risk factors,and treatments[J]. Nat Rev Clin Oncol, 2014, 11(10):597-609. DOI
[28]	Bower JE, Greendale G, Crosswell AD, et al. Yoga reduces inflammatory signaling in fatigued breast cancer survivors:a randomized controlled trial[J]. Psychoneuroendocrinology, 2014, 43:20-29. DOI URL
[29]	David Creswell J, Irwin MR, Burklund LJ, et al. Mindfulness-based stress reduction training reduces loneliness and pro-inflammatory gene expression in older adults:a small randomized controlled trial[J]. Brain Behav Immun, 2012, 26(7):1095-1101. DOI PMID
[30]	Huri M, Huri E, Kayihan H, et al. Effects of occupational therapy on quality of life of patients with metastatic prostate cancer. A randomized controlled study[J]. Saudi Med J, 2015, 36(8):954-961. DOI PMID
[31]	宋鹏娟, 刘均娥, 陈少华, 等. 回归家庭干预对乳腺癌术后患者康复效果的影响[J]. 中华护理杂志, 2022, 57(2):133-139. DOI URL
	Song PJ, Liu JE, Chen SH, et al. Effect of Return-to-Family intervention on rehabilitation efficacy of breast cancer patients[J]. Chin J Nurs, 2022, 57(2):133-139. DOI URL
[32]	Yang SY, Wang JD, Chang JH. Occupational therapy to improve quality of life for colorectal cancer survivors:a randomized clinical trial[J]. Support Care Cancer, 2020, 28(3):1503-1511.
[33]	Hu YR, Wang LJ, Su GQ, et al. The relationship between physical activity,self-efficacy and quality of life in colorectal cancer survivors:a multicenter cross-sectional study[J]. Discov Oncol, 2024, 15(1):4.

作业疗法联合职业康复对结直肠癌患者术后重返工作岗位的效果研究

A study of the effect of occupational therapy combined with vocational rehabilitation on the return to work of postoperative colorectal cancer patients

RichHTML

PDF

可视化

摘要/Abstract

引用本文

使用本文

图/表 4

参考文献 33

相关文章 15

编辑推荐

Metrics

[1]	中华护理学会静脉输液治疗专业委员会, 北京护理学会, （执笔：李佳, 李旭英, 覃惠英, 陈利芬, 吴珍明, 胡泽吟, 罗梦娜, 范育英, 吴嘉慧, 林宇萍, 王蕾, 孙文彦, 冯毕龙, 高伟, 李亚南, 侯罗娅, 李春燕. 中心静脉通路装置拔除护理专家共识[J]. 中华护理杂志, 2026, 61(9): 1157-1162.
[2]	周霞, 马艳艳, 师正坤, 于海霞, 周艳, 胡红玲, 李莜, 陈思思, 张京慧. 隧道式经股静脉PICC置入术在困难静脉通路婴幼儿中的应用研究[J]. 中华护理杂志, 2026, 61(9): 1163-1170.
[3]	黄萍, 李黎, 郭骊莉, 徐莹, 叶赟, 江淑芳. 与无针输液接头相关的导管相关性血流感染风险评估工具的构建与初步应用[J]. 中华护理杂志, 2026, 61(9): 1171-1179.
[4]	李佳, 张玉玲, 邢乐, 张利峰, 牛秀峰, 许莉. 早产儿经上肢置入PICC尖端继发性异位风险预测模型的建立与验证[J]. 中华护理杂志, 2026, 61(9): 1180-1186.
[5]	何娟, 赵蕾蕾, 叶冠军, 余艳芬, 傅晓君, 周琴. 1例双侧无名静脉及上腔静脉人工血管置换术后患者经上肢置入PICC的护理[J]. 中华护理杂志, 2026, 61(9): 1187-1191.
[6]	梁江淑渊, 曾妃, 何鹏, 谢梦珊, 江悦, 蒋宗恒, 王建茗. 静脉-静脉体外膜肺氧合患者早期活动风险等级评估系统的构建及应用研究[J]. 中华护理杂志, 2026, 61(9): 1192-1199.
[7]	陈晨, 顾肖, 郭凡, 王敏, 倪兴梅, 黄琴, 程念开. 3种衰弱评估工具对急诊老年创伤患者不良结局的预测价值[J]. 中华护理杂志, 2026, 61(9): 1200-1207.
[8]	郑煜琳, 刘晋宁, 张静, 郭会敏, 谷艳梅, 张莉莉. 酒精性肝病患者肝移植术后再饮酒现状及其影响因素分析[J]. 中华护理杂志, 2026, 61(9): 1208-1214.
[9]	叶俊霜, 沈丽佳, 孟霞靓, 张玉姣, 蔡根莲, 邵碧云, 周亚辉, 张柳倩, 应金萍. 维持性血液透析患者对口腔衰弱认知和体验的质性研究[J]. 中华护理杂志, 2026, 61(9): 1215-1220.
[10]	王芸姣, 杨玉金, 郑春艳, 彭菲津, 王淑贞, 蒋喜露, 周为民, 王薇, 张娜. 糖尿病下肢动脉硬化闭塞症患者介入术后康复护理方案的构建及应用研究[J]. 中华护理杂志, 2026, 61(9): 1221-1229.
[11]	杨明霞, 安冉, 臧金凤, 李春梅. 老年慢性病共病患者及照护者老老照护能力与自我忽视的相关性分析[J]. 中华护理杂志, 2026, 61(9): 1230-1236.
[12]	梁和静, 许鹊, 史云霞, 祖金美, 黄文静, 杨春旭, 郭明华, 王磊. 颈动脉内膜剥脱术围手术期护理质量评价指标的构建[J]. 中华护理杂志, 2026, 61(9): 1237-1244.
[13]	韩媛媛, 石玉竹, 尚文涵, 么莉. 870所三级甲等医院老年住院患者跌倒伤害发生现状与影响因素分析[J]. 中华护理杂志, 2026, 61(9): 1245-1252.
[14]	夏云芳, 王洪, 崔岱, 付真真, 朱敏. 1例弥漫性毒性甲状腺肿合并超敏反应综合征青少年患者的护理[J]. 中华护理杂志, 2026, 61(9): 1253-1256.
[15]	周益飞, 王海苹, 胡益环, 应莉, 罗松娜. 1例氢氟酸中毒并发呼吸心搏骤停患者的急救护理[J]. 中华护理杂志, 2026, 61(9): 1257-1260.