个案护理模式在乳腺癌切除术后乳房重建患者中的应用价值分析(1)
[摘要]目的：探讨个案护理模式对乳房重建患者术后恢复效果的应用价值。方法：选取笔者医院2016年1月-2019年1月就诊的72例乳房重建女性患者，按照随机数字表随机分为观察组和对照组，每组36例。对照组采取常规护理，观察组采取个案护理。比较两组的术后恢复效果。结果：术后6个月，两组患者的生理状况、情感状况、社会/家庭状况、功能状况评分均高于术前，且观察组高于对照组，差异具有统计学意义(P<0.05);两组患者的自评、外貌、社交、学习评分均低于术前，且观察组低于对照组(P<0.05)。两组患者的人际关系、新可能性、个人力量、精神改变、欣赏生活、总分均高于术前，且观察组高于对照组(P<0.05)。观察组患者的满意度明显高于对照组，差异具有统计学意义(P<0.05)。结论：个案护理模式提高了乳房重建患者生存质量，对患者的术后恢复有更好的效果。
[关键词]个案护理模式;乳腺癌;乳房重建;生活质量
[中图分类号]R473.6 [文献标志码]B [文章编号]1008-6455(2019)11-0143-04
Abstract： Objective To explore the application value of case nursing model in the treatment of breast cancer patients underwent breast reconstruction. Methods 72 cases underwent breast reconstruction patients admitted to our hospital between January 2016 and January 2019 were randomly divided into the observation group and the control group， 36 cases in each group according to the random number table. The routine nursing was used in the control group and the case nursing was used in the observation group. The effect of postoperative recovery was compared between the two groups. Results Six months after operation， the scores of physiological status， emotional status， social/family status and functional status of the patients in the two groups were higher than those before operation， and the differences were statistically significant(P<0.05). The scores of self-evaluation， appearance， social interaction and learning of the two groups were lower than those before operation， and the observation group was lower than the control group(P<0.05). The scores of interpersonal relationship， new possibility， personal strength， mental change， appreciation of life and total score in the two groups were higher than those before operation， and those in the observation group were higher than those in the control group(P<0.05). The satisfaction of patients in the observation group was significantly higher than that in the control group(P<0.05). Conclusion The case nursing mode improves the quality of life of patients with breast reconstruction and has better effect on postoperative recovery.
Key words： case nursing model; breast cancer; breast reconstruction; quality of life
乳腺肿瘤已位居城市女性恶性肿瘤发病率的首位[1]。目前针对乳腺肿瘤无特效药物，主要依靠手术切除治疗[2]。随着医学技术的发展和临床医生的医学技术不断提高，乳腺肿瘤病死率呈下降趋势[3]，但由于肿瘤本身的治疗给患者带来的生理痛苦和身体外形上的改变，患者的心理状态会因此受到影响[4]。如今，更多的女性患者在乳腺癌切除术后选择乳房重建进行修复[5]，重塑体形并重新拥有女性的第二性征[6]。但乳腺癌术后需长期接受放化疗，产生了身体和精神上的压力，常规护理对患者的术后生命质量和心理适应能力并不能起到明显作用[7]。个案护理模式是针对个体患者的疾病特性及个性化的需求，为患者提供系统性照护服务的工作模式[8-9]，随着患者基数的增大，急需要连续的、能有效整合协调各种医疗资源、监测医疗质量的个案管理模式[10]。目前国内乳房重建患者个案管理尚无成熟的标准化模式，也存在承担者专业知识不丰富、专职岗位缺失的问题。因此，本研究成立个案管理小组，根据乳腺癌术后乳房重建患者的满意度、生活质量以及术后恢复情况，讨论个案护理模式的臨床意义，现报道如下。, http://www.100md.com(黄霞 孙少甫 程朝霞)
[关键词]个案护理模式;乳腺癌;乳房重建;生活质量
[中图分类号]R473.6 [文献标志码]B [文章编号]1008-6455(2019)11-0143-04
Abstract： Objective To explore the application value of case nursing model in the treatment of breast cancer patients underwent breast reconstruction. Methods 72 cases underwent breast reconstruction patients admitted to our hospital between January 2016 and January 2019 were randomly divided into the observation group and the control group， 36 cases in each group according to the random number table. The routine nursing was used in the control group and the case nursing was used in the observation group. The effect of postoperative recovery was compared between the two groups. Results Six months after operation， the scores of physiological status， emotional status， social/family status and functional status of the patients in the two groups were higher than those before operation， and the differences were statistically significant(P<0.05). The scores of self-evaluation， appearance， social interaction and learning of the two groups were lower than those before operation， and the observation group was lower than the control group(P<0.05). The scores of interpersonal relationship， new possibility， personal strength， mental change， appreciation of life and total score in the two groups were higher than those before operation， and those in the observation group were higher than those in the control group(P<0.05). The satisfaction of patients in the observation group was significantly higher than that in the control group(P<0.05). Conclusion The case nursing mode improves the quality of life of patients with breast reconstruction and has better effect on postoperative recovery.
Key words： case nursing model; breast cancer; breast reconstruction; quality of life
乳腺肿瘤已位居城市女性恶性肿瘤发病率的首位[1]。目前针对乳腺肿瘤无特效药物，主要依靠手术切除治疗[2]。随着医学技术的发展和临床医生的医学技术不断提高，乳腺肿瘤病死率呈下降趋势[3]，但由于肿瘤本身的治疗给患者带来的生理痛苦和身体外形上的改变，患者的心理状态会因此受到影响[4]。如今，更多的女性患者在乳腺癌切除术后选择乳房重建进行修复[5]，重塑体形并重新拥有女性的第二性征[6]。但乳腺癌术后需长期接受放化疗，产生了身体和精神上的压力，常规护理对患者的术后生命质量和心理适应能力并不能起到明显作用[7]。个案护理模式是针对个体患者的疾病特性及个性化的需求，为患者提供系统性照护服务的工作模式[8-9]，随着患者基数的增大，急需要连续的、能有效整合协调各种医疗资源、监测医疗质量的个案管理模式[10]。目前国内乳房重建患者个案管理尚无成熟的标准化模式，也存在承担者专业知识不丰富、专职岗位缺失的问题。因此，本研究成立个案管理小组，根据乳腺癌术后乳房重建患者的满意度、生活质量以及术后恢复情况，讨论个案护理模式的臨床意义，现报道如下。, http://www.100md.com(黄霞 孙少甫 程朝霞)