医联体医护一体化在癌症患者居家镇痛中的应用
Application of Doctor-nurse Integrative Medical Care in Analgesia at Home for Cancer Patients
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摘要: 目的 探讨中晚期癌症患者居家镇痛中医联体医护一体化模式的构建及效果.方法 2016年9月至2017年2月收住都江堰市人民医院肿瘤科的癌性镇痛治疗出院患者120例, 随机分为实验组60例, 观察组60例, 观察组出院后常规门诊随访, 实验组予以医护一体化延伸居家镇痛干预, 镇痛方式包括心理支持、即时吗啡静脉滴定联合吗啡缓释片口服, 随访、干预由网络医院负责, 枢纽医院承担培训、指导, 干预时间和方式分别为出院后第1周家庭随访, 第4周电话随访, 第8周电话随访, 第12周家庭随访.比较2组患者分组时及干预12周时患者生命质量、抑郁程度和照护人焦虑程度.结果 实验组患者生活质量干预前是 (62.43±12.83) , 干预后 (50.33±9.04) ;抑郁程度干预前 (50.33±6.59) , 干预后 (47.37±4.97) ;癌症患者照护人焦虑程度干预前 (55.05±8.82) , 干预后 (52.22±5.37) , 差异均有统计学意义 (P<0.05) .结论 开展癌症患者居家医联体医护一体化, 能有效提高中晚期癌症患者生存质量, 明显降低患者抑郁程度, 降低患者照护者焦虑的程度, 值得推广.Abstract: Objecctive To explore the construction and effect of the Doctor-nurse integrative medical care mode for domestic analgesia in middle and late stage cancer patients.Me thods From september 2016 to February 2017, 120 Cancer patients in The People's hospitalof Du Jiang Yan were included, and randomly divided into experimental group (n=60) and observation group (n=60) . The observation group received routine outpatient follow-up after discharge.The experimental group was treated with the Doctor-nurse integrative medical care mode.The analgesic modes included psychological support, immediate morphine and morphine sustained release tablets for personalized home titration. The Net bottom-hospitals were responsible for the follow-up and intervention, the training and guidance were bore by Hub hospitals. The patients were followed up at the first and twelfth weeks, followed by telephone follow-up at fourth and eighthweek, after discharge. The quality of life, the degree of depression and the degree of anxiety of caregiver were compared between the two groups at the beginning of the study and the twelfth weeks after discharge. Re s ults In experimental group, the scores of in the life quality of patints before and after intervention were (62.43±12.83) and (50.33 ±9.04) , respectively, the scores of depression before and after intervention were (50.33± 6.59) and (47.37±4.97) , respectively, the scores of anxiety before and after intervention were (55.05 ±8.82) and (52.22 ±5.37) . There was statistically significant difference between the two groups (P<0.05) . Conclus ions Doctor-nurse integrative medical care mode can improve the quality of life of patients with advanced cancer, reduce the degree of depression, and reduce the degree of anxiety of patients.
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Key words:
- Cancer /
- Domestic analgesia /
- Doctor-nurse integrative medical care
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