疼痛护理对直肠癌癌痛患者不良情绪及爆发性疼痛的影响

doi:10.3969/j.issn.1000-8535.2022.02.016

摘要/Abstract

摘要： 目的分析疼痛护理对直肠癌癌痛患者不良情绪及爆发性疼痛的影响。方法选取2020年4月—2020年6月我院收治的68例直肠癌癌痛患者作为研究对象,通过随机分组的方式将患者分为2组,对照组使用常规临床护理模式,观察组使用疼痛护理模式,对比2组患者的癌痛程度、不良情绪及爆发性疼痛的发生率。结果 2组患者在接受不同护理模式后,SF-MPQ评分相较于护理前出现了下降(P＜0.05),其中观察组的评分与对照组比较下降(P＜0.05),但护理前2组比较并无差异(P＞0.05);2组患者在接受不同护理模式后,功能维度评分和总体健康评分相较于护理前出现了上升(P＜0.05),且与对照组比较观察组得分升高(P＜0.05),2组患者在接受不同护理模式后,症状维度评分相较于护理前降低(P＜0.05),且与对照组比较观察组的评分下降(P＜0.05);服药依从率对比结果显示,观察组(94.12%)的依从性优于对照组(61.76%),组间比较有差异(P＜0.05);爆发性疼痛对比结果显示,观察组(8.82%)低于对照组(47.06%),组间比较有差异(P＜0.05)。结论疼痛护理可以有效应用于直肠癌癌痛患者的护理中,其不仅可以减轻患者的癌痛程度,还有利于调节患者的不良情绪,降低患者的爆发性疼痛发生率,宜广泛应用及推广。

关键词: 疼痛护理, 直肠癌, 癌痛, 不良情绪, 爆发性疼痛

Abstract: Objective To analyze the influence of pain nursing on the negative mood and explosive pain of patients with rectal cancer pain. Methods A total of 68 patients with colorectal cancer pain in June 2020 were included as research objects, and divided into two groups by randomized grouping.Routine clinical care was applied on the control group, pain nursing was applied on the observation group.The incidence of cancer pain, negative emotions and explosive pain in both groups of patients were compared. Results After applying different care plans, two groups of patients had a significant decrease in the SF-MPQ score (P<0.05), in which the score of the observation group was significantly lower than the control group (P<0.05), however, there were no significant differences before nursing (P>0.05). Two groups of patients were significantly improving in function scoring and the overall health scoring after receiving different care modes (P<0.05), and the observation group was significantly higher than the control group (P<0.05). The symptom dimension scores were significantly lower than before accepting different care modes (P<0.05), and the control group was significantly higher (P<0.05). The comparative results of the medicinal compliance of observation group (94.12%) were better than the control group (61.76%,P<0.05); outbreak pain comparative results showed the observation group (8.82%) was significantly lower than that of the control group (47.06%,P<0.05). Conclusion Pain nursing can be effectively used in the nursing of patients with rectal cancer pain.It can not only reduce the degree of cancer pain, but also help regulate the patient's negative mood and reduce the incidence of explosive pain.It should be widely used and promoted.

Key words: pain care, rectal cancer, cancer pain, negative mood, explosive pain

傅华容, 黄妙芳, 辜赛花, 黄玉如, 张利东. 疼痛护理对直肠癌癌痛患者不良情绪及爆发性疼痛的影响[J]. 广州医药, 2022, 53(2): 77-81.

FU Huarong, HUANG Miaofang, GU Saihua, HUANG Yuru, ZHANG Lidong. The effect of pain nursing on the negative mood and explosive pain of patients with rectal cancer pain[J]. Guangzhou Medical Journal, 2022, 53(2): 77-81.

参考文献

[1] 陈苏萍.自我管理教育对直肠癌保肛术后患者胃肠功能恢复情况、情绪及生活质量的影响研究[J].护士进修杂志,2018,33(23):2130-2133.
[2] SUNG H, FERLAY J, SIEGEL R L,et al. Global Cancer Statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J].CA Cancer J Clin,2021,71(3):209-249.
[3] 黄喆,赵文娟,张晓菊,等.住院患者癌痛护理质量评价指标体系的构建[J].护士进修杂志,2021,36(1):17-21.
[4] 许丽媛,魏梦娅,覃旺军,等.北京市67家医院癌痛管理相关护理质量水平分析[J].中国疼痛医学杂志,2021,27(5):362-366.
[5] 中华人民共和国国家卫生健康委员会.中国结直肠癌诊疗规范(2020年版)[J].中华外科杂志,2020,58(8):561-585.
[6] 国家卫生健康委办公厅,国家中医药局办公室.癌症疼痛诊疗规范(2018年版)[J].全科医学临床与教育,2019,17(1):4-8.
[7] AARONSON N K, AHMEDZAI S, BERGMAN B, et al.The European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology[J].J Natl Cancer Inst,1993,85(5):365-76.
[8] 中国抗癌协会癌症康复与姑息治疗专业委员会难治性癌痛学组,中华医学会疼痛学分会癌痛学组.癌性爆发痛专家共识(2019年版)[J].中国肿瘤临床,2019,46(6):267-271.
[9] 王云,陈蕾.癌症疼痛护理策略团队在癌痛管理中应用[J].国际护理学杂志,2020,39(22):4185-4187.
[10] NEUFELD N J, ELNAHAL S M, ALVAREZ R H.Cancer pain: a review of epidemiology, clinical quality and value impact[J].Future Oncol, 2017,13(9):833-841.
[11] 亢本荣.中西医结合护理品质管理对晚期肿瘤患者癌痛、生活质量的影响[J].国际护理学杂志,2021,40(7):1276-1279.
[12] 李娟娟,张丽霞,赵丹凤,等.多维度疼痛护理干预在晚期癌症患者中的应用[J].齐鲁护理杂志,2021,27(11):148-150.
[13] 王玲,邱志敏,陈婧.疼痛治疗仪联合综合护理干预对晚期中重度癌痛患者的疗效研究[J].中国医药导报,2021,18(7):169-172.
[14] 刘茜,张梅.自拟止痛中药外敷联合热疗对中重度癌性疼痛患者疼痛、不良情绪及生活质量的影响[J].现代中西医结合杂志,2017,26(27):3034-3036.
[15] 翁霞玲,杨玲,李凡.PDCA循环护理对癌痛患者疼痛及自我效能感的影响[J].护理实践与研究,2020,17(13):102-104.
[16] SWARM R A, PAICE J A, ANGHELESCU D L, et al. Adult Cancer Pain, Version 3.2019, NCCN clinical practice guidelines in oncology[J].J Natl Compr Canc Netw, 2019,17(8):977-1007.
[17] 甄斯杰,崔花顺,秦金.针灸配合放松训练对晚期癌性疼痛患者镇痛效果和生活质量的影响[J].中国肿瘤临床与康复,2021,28(6):730-732.
[18] 梁裕,杨永英,卢彩慧.综合性护理干预对癌痛患者阿片类镇痛药致药源性便秘的影响[J].齐鲁护理杂志,2020,26(3):78-80.
[19] 郑江平,冯莉霞,宋秀英,等.品管圈活动在降低癌症患者爆发痛发生次数中的应用[J].护士进修杂志,2020,35(13):1209-1211.
[20] 刘萍,刘利,郑炜.全程疼痛护理干预对直肠癌癌痛患者负性情绪和服药依从性及爆发性疼痛的影响[J].中国肿瘤临床与康复,2018,25(2):202-205.