论著

预防性风险管理对肌层浸润性膀胱癌根治术后的应用效果及术后生活质量影响

Effect of preventive risk management after surgery and quality of life of myometrial invasive bladder cancer patients

:494-499
 
       目的   探讨预防性风险管理在肌层浸润性膀胱癌根治术后的应用效果及对术后生活质量影响。方法   选取2020年6月—2023年10月安阳市肿瘤医院收治的66例肌层浸润性膀胱癌患者,应用抽签法分为观察组(n=33)与对照组n=33)。所有患者均采取根治性全膀胱切除术与淋巴清扫术治疗,对照组患者术后实施常规护理,观察组在对照组基础上增加预防性风险管理。对比两组术后尿量、胃肠功能恢复时间、术后住院时间,干预前后病耻感及负面情绪、术后并发症发生率,最后对比两组干预前后生活质量变化。结果   两组患者术后尿量对比差异无统计学意义(P>0.05),观察组术后胃肠功能恢复时间为(5.27±0.82)d,术后住院时间为(18.31±3.27)d,短于对照组的(7.25±1.12)(23.27±4.18)d,对比差异有统计学意义(t分别为8.194、5.369,P<0.05);干预后两组患者病耻感量表(SSCI)、抑郁自评量表(SDS)和焦虑自评量表(SAS)评分均降低,观察组分别为(35.67±7.45)(40.02±2.43)(45.36±4.17)分,低于对照组的(48.27±10.69)(54.54±3.54)(51.37±4.38)分,对比差异有统计学意义(t分别为5.555、19.426、5.709,P<0.05);观察组术后并发症发生率为9.09%,低于对照组的30.30%(χ 2 =4.690,P=0.030);干预后两组膀胱癌特异性模块、功能状况、精神状况、家庭/社会状况及躯体状况相关维度膀胱癌患者生活质量量表(FACT-BL)评分均升高,观察组分别为(34.27±3.26)(25.11±4.23)(21.51±4.23)(25.02±4.43)(20.56±3.11)分,高于对照组的(27.00±4.34)(21.11±3.24)(16.12±2.12)(21.54±5.54)(15.87±4.13)分,对比差异有统计学意义(t分别为7.694、4.313、6.544、2.818、5.211,P<0.05)。结论   预防性风险管理在肌层浸润性膀胱癌根治术后的应用效果显著,可缩短患者术后胃肠功能恢复时间及住院时间,改善患者负面情绪,有助减少术后并发症,提升患者生活质量。
       Objective  To explore the effect of preventive risk management on postoperative application and quality of life of myometrial invasive bladder cancer patients after radical surgery.Methods  A total of 66 patients with myometrial invasive bladder cancer admitted to Anyang Cancer Hospital from June 2020 to October 2023 were selected as research objects,and were divided into observation group(n=33)and control group(n=33)by lot drawing.All patients were treated with  radical total cystectomy and lymph node dissection.The control group received routine nursing care after surgery,while the observation group received preventive risk management in addition to the control group.The postoperative urine output,recovery time of gastrointestinal function,and hospitalization time between two groups were compared,as well as the shame and negative emotions before and after intervention,the incidence of postoperative complications,and the changes in quality of life between the two groups before and after intervention.Results  There was no significant difference in postoperative urine volume between the two groups of patients(P>0.05),and the postoperative gastrointestinal function recovery time(5.27±0.82)d,postoperative hospitalization time(18.31±3.27)d were shorter than the control group[(7.25±1.12)d,(23.27±4.18)d],with statistical significantce(t=8.194,5.369,P<0.05).After intervention,the Stigma Scale of Chronic Illness(SSCI),Self Rating Depression Scale(SDS),and Self-Rating Anxiety Scale(SAS)in both groups of patients decreased,and the observation group[(35.67±7.45),(40.02±2.43),(45.36±4.17)]scored lower than the control group[(48.27±10.69),(54.54±3.54),(51.37±4.38)],statistically significantt=5.555,19.426,5.709,P<0.05).The incidence of postoperative complications in the observation group was significantly lower at 9.09% compared to the control group at 30.30%(χ 2 =4.690,P=0.030,P<0.05).After intervention,the scores of bladder cancer specific module,functional status,mental status,family/social status and physical status  related dimensions of bladder cancer patients’ quality of life scale for bladder cancer patients(FACT-BL)in both groups increased,and the observation group[(34.27±3.26),(25.11±4.23),(21.51±4.23),(25.02±4.43),(20.56±3.11)] scored higher than the control group[(27.00±4.34),(21.11±3.24),(16.12±2.12),(21.54±5.54),(15.87±4.13)],the comparison was statistically significant(t=7.694,4.313,6.544,2.818,5.211,P<0.05).Conclusions  Preventive  risk management has a significant effect on the application of myometrial invasive bladder cancer after radical surgery,which can shorten the recovery time of gastrointestinal function and hospital stay,improve patients’ negative emotions,assist in preventing postoperative complications,and improve patients’ quality of life.
论著

癌症患者生命质量测定量表体系之肾癌量表(QLICP-REV2.0)的条目筛选

Items selection on the Specific Module of Quality of Life Instruments for patients with renal cancer (QLICP-REV2.0)

:77-81
 
       目的   开发适合中国肾癌患者的生命质量测定量表的特异模块。   采用议题小组和核心小组的程序化决策方式,提出条目池,形成初步量表,采用医生及患者重要性评分法、相关系数法、变异度法、因子分析法和克朗巴赫系数α对20例肾癌患者和20名医护人员进行的数据进行统计分析。结果   经过上述方法进行筛检,结合专家小组的建议,最终得到含有11个条目的肾癌生命质量测定量表的特异模块。结论 肾癌的生命质量测定量表特异模块严格按照程序执行,具有较好的内容效度。
      Objective  To develop the specific module of the quality of life instruments for patients with renal cancer(QLICP-RE).Methods  With the structured group(nominal group and focus group)methods,the item pool was put forward and a preliminary instrument was formed.The data from 20 renal cancer patients and 20 doctors/nurses were analyzed by statistical procedures.Doctors and patients’ importance rating procedure,correlation analysis,method of coefficient of variation,factor analysis,and Cronbach’s α.Results  By above statistical procedures and advises of expert panel,11-items of the specific module were formed finally.Conclusions  The specific module of QLICP-RE developed on the strict procedures has good content validity and representativeness.
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