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.
护理研究

基于微视频的护理干预对急性胰腺炎患者疾病知晓、自我管理和遵医行为的影响

The impact of micro video based nursing interventions on disease awareness,self-management and compliance behavior in patients with acute pancreatitis

:125-130
 
       目的   探讨基于微视频的护理干预对急性胰腺炎患者疾病知晓、自我管理和遵医行为的影响。方法   根据中心随机法将郑州大学第二附属医院2021年1月—2023年1月收治的88例急性胰腺炎患者作为研究对象,其中传统组44例给予常规干预,微视频组44例在传统组的基础上结合微视频的护理干预,比较两组患者疾病知晓情况、自我管理能力和遵医行为情况。结果   干预2个月后,微视频组病例脱落3例,传统组病例脱落4例,两组疾病知晓各维度高于干预前,且微视频组高于传统组,其中疾病病因(t=3.151,P=0.003)、临床症状(t=7.165,P<0.001)、并发症(t=5.497,P<0.001)、如何预防疾病复发(t=8.195,P<0.001);两组自我护理能力量表(ESCA)各维度评分高于干预前,且微视频组高于传统组,其中各维度评分结果为自我护理技能(t=2.787,P=0.007)、自我概念(t=2.272,P=0.026)、自护责任感(t=2.644,P=0.011)、健康知识水平(t=3.321,P=0.001);两组遵医行为各维度评分高于干预前,且微视频组高于传统组,其中各维度评分结果为饮食依从性(t=6.271,P<0.001)、用药依从性(t=3.539,P=0.001)、锻炼依从性(t=4.469,P<0.001)、定期复查(t=2.764,P=0.007)。结论   通过运用微视频的护理干预能够提高急性胰腺炎患者疾病知识的掌握,促进机体自我管理水平的恢复,进而提高遵医行为。
       Objective  To explore the impact of micro video based nursing interventions on disease awareness,self-management and compliance behavior in patients with acute pancreatitis.Methods  According to the central randomization method,88 patients with acute pancreatitis admitted to the Second Affiliated Hospital of Zhengzhou University from January 2021 to January 2023 were selected as the research subjects.Among them,44 patients in the traditional group received routine intervention,and 44 patients in the micro video group received nursing intervention combined with micro video on the basis of the traditional group.The disease awareness,self-management ability and compliance behavior of the two groups of patients were compared.Results  After two months of intervention,three cases were dropped out in the micro video group and four cases were dropped out in the traditional group.The disease awareness in both groups was higher than that before intervention,and the micro video group was higher than the traditional group,including disease etiology(t=3.151,P=0.003),clinical symptoms(t=7.165,P<0.001),complicationst=5.497,P<0.001) and how to prevent disease recurrence(t=8.195,P<0.001).The scores of ESCA in both groups were significantly higher than those before intervention,and the micro video group was higher than the traditional group in terms of self-care skills(t=2.787,P=0.007),self-concept(t=2.272,P=0.026),self-care responsibility(t=2.644,P=0.011) and health knowledge level(t=3.321,P=0.001).The scores of all dimensions of compliance behavior in both groups were significantly higher than those before intervention,and the micro video group had higher scores than the traditional group in terms of dietary compliancet=6.271,P<0.001),medication compliance(t=3.539,P=0.001),exercise compliance(t=4.469,P<0.001) and  regular follow-up(t=2.764,P=0.001).Conclusions  The use of micro video nursing interventions can improve the mastery of disease knowledge in patients with acute pancreatitis,promote the recovery of the body’s self-management level,and thereby improvemedical compliance behavior.
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