摘要
目的 探究医共体模式下延伸护理在出院后晚期癌痛患者中的应用及效果。方法 选取2020年8月至2020年12月晚期癌痛住院患者160名研究对象，分为对照组（n=80）和观察组（n=80），出院后对照组给予传统出院护理，观察组加以医共体模式下延伸护理。统计对比两组出院3个月后的生存质量、疼痛程度、服药依从性、疼痛护理满意度指标。结果 两组临床特征无差异，和对照组相比，观察组更提高癌痛患者出院3个月后的生存质量QLQ-C30量表评分（躯体功能、角色功能、情绪功能、认知功能、社会功能），NRS评分疼痛控制有效率，服药依从性问卷评分（服药种类、服药剂量、服药次数、服药时间、长期坚持服药），具有统计学差异（P＜0.05）。结论 医共体模式下延伸护理可以改善晚期癌痛患者生存质量，有效控制疼痛，提高服药依从性，值得推广。
关键词： 医共体模式；延伸护理；癌痛
Abstract
Objective To explore the application and effect of extended care in patients with advanced cancer pain after discharge under the medical community model. Methods A total of 160 inpatients with advanced cancer pain from August 2020 to December 2020 were selected and divided into control group (n=80) and observation group (n=80). After discharge, the control group was given traditional discharge nursing, and the observation group was given extended nursing under the medical community mode. The quality of life, pain degree, medication compliance and pain nursing satisfaction indexes of the two groups were statistically compared 3 months after discharge. Results There was no difference in clinical characteristics between the two groups. Compared with the control group, the QOL-C30 score (somatic function, role function, emotional function, cognitive function and social function) of cancer pain patients 3 months after discharge was improved in the observation group, and the efficiency of pain control by NRS score was improved. The questionnaire scores of medication compliance (type of medication, dose, times of medication, duration of medication, long-term adherence to medication) had statistical differences (P < 0.05). Conclusion Extended nursing under the medical community model can improve the quality of life of patients with advanced cancer pain, effectively control pain and improve medication compliance, which is worthy of promotion.
Key words： medical community model; Extended care; pain
参考文献 References
[1] Maunsell E, Allard P, Dorval M, et al. A brief pain diary for ambulatory patients with advanced cancer[J]. Cancer, 2015,88(10):2387-2397.
[2] Antonio Viganó, Bruera E, Suarez-Almazor M E. Age, pain intensity, and opioid dose in patients with advanced cancer[J]. Cancer, 2015,83(6):1244-1250.
[3] 周静,王永才,汪鑫.基于微信平台对癌痛患者出院后延续护理效果的分析[J].中国卫生信息管理杂志,2018,15(4):457-460.
[4] 胡成文,张晓明,唐世芳,等.癌症患者护理随访系统的构建与应用[J].中国护理管理,2019,19(6):938-941.
[5] 中华人民共和国国家卫生健康委员会(国卫办医函号).癌症疼痛诊疗规范(2018年版)[J].临床肿瘤学杂志,2018,23(10):937-944.
[6] 水小芳,陈文宇,吕晓东,等.微信教育模式对癌痛患者家属心理健康的影响[J].中华全科医学,2019,17(8):118-122.
[7] 陈萍,褚玲玲,冯丹,等.肿瘤患者癌痛规范化管理的策略研究及应用[J].中国护理管理,2019,19(S1):36-38.
[8] 董明芬,林爱宝,周红波.疼痛护理小组的培训管理与质量效果评价[J].中华全科医学,2016,14(6):1034-1036.