摘要
目的探讨多维度支持性照护对结直肠癌造口患者生存扩展期的负性情绪、自护能力、症状困扰及生活质量的影响。方法选取2021年1月至2024年6月于河南大学第一附属医院就诊的结直肠癌造口生存扩展期患者94例,采用随机数表法分为对照组和支持性照护组,每组47例。对照组患者给予常规护理干预,支持性照护组患者在对照组的基础上给予多维度支持性照护,两组均干预3个月。比较两组患者干预前、干预3个月后(干预后)的负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、自护能力[自我护理能力测定表(ESCA)]、症状困扰[安德森症状评估量表胃肠道肿瘤特异性模块(MDASI-GI)]、生活质量[结直肠癌患者生命质量测定量表(FACT-C)],同时比较两组患者干预期间的并发症发生率。结果干预后支持性照护组患者的SAS评分、SDS评分分别为(46.58±3.58)分、(42.97±5.19)分,明显低于对照组的(53.14±5.36)分、(55.58±4.73)分,ESCA为(138.72±8.63)分,明显高于对照组的(105.36±10.45)分,差异均有统计学意义(P<0.05);干预后支持性照护组患者MDASI-GI中的症状严重程度、症状困扰程度及总分分别为(42.68±8.31)分、(17.23±3.57)分、(59.91±4.25)分,明显低于对照组的(65.39±9.07)分、(28.36±5.81)分、(93.75±10.65)分,差异均有统计学意义(P<0.05);干预后支持性照护组患者FACT-C中的生理状况、情感状况、社会/家庭状况、功能状况、结直肠癌附加关注评分及总分明显高于对照组,差异均有统计学意义(P<0.05);干预期间支持性照护组患者的并发症发生率为4.26%,明显低于对照组的17.02%,差异有统计学意义(P<0.05)。结论多维度支持性照护可改善结直肠癌造口生存扩展期患者负性情绪,提升其自护能力,减轻其症状困扰,提升其生活质量,并降低并发症发生率。
Objective To explore the effects of multi-dimensional supportive care on negative emotions,self-care ability,symptom distress,and quality of life in colorectal cancer patients with colostomy during extended survival period.Methods A total of 94 colorectal cancer patients with colostomy during extended survival period,who were admitted to the First Affiliated Hospital of Henan University from January 2021 to June 2024,were selected and randomly divided into a control group and a supportive care group by the random number table method,with 47 cases in each group.Patients in the control group were given routine nursing intervention,and those in the supportive care group were given multi-dimensional supportive care on the basis of the control group.Both groups were intervened for 3 months.Comparison were conducted between the two groups on negative emotions(Self-rating Anxiety Scale[SAS],Self-rating Depression Scale[SDS]),self-care ability(Exercise of Self-Care Agency Measure[ESCA]),symptom distress(MD Anderson Symptom Inventory for gastrointestinal cancer[MDASI-GI]),and quality of life(Functional Assessment of Cancer Therapy-Colorectal[FACT-C])before intervention and after 3 months of intervention(post-intervention).At the same time,the incidence of complications during the intervention period was compared between the two groups.Results After the intervention,the SAS scores and SDS scores for the supportive care group were(46.58±3.58)points and(42.97±5.19)points,respectively,which were significantly lower than(53.14±5.36)points and(55.58±4.73)points of the control group(P<0.05);the ESCA score for the supportive care group was(138.72±8.63)points,significantly higher than(105.36±10.45)points of control group(P<0.05).After the intervention,the severity of symptom,the degree of symptom distress,and total scores on the MDASI-GI for the supportive care group were(42.68±8.31)points,(17.23±3.57)points,and(59.91±4.25)points,respectively,which were significantly lower than(65.39±9.07)points,(28.36±5.81)points,and(93.75±10.65)points of the control group(all P<0.05).After the intervention,the physiological status score,emotional status score,social/family status score,functional status score,colorectal cancer additional attention score,and the total score on the FACT-C for the supportive care group were significantly higher than those of the control group(P<0.05).During the intervention period,the incidence of complications in the supportive care group was 4.26%,which was significantly lower than 17.02%in the control group(P<0.05).Conclusion Multi-dimensional supportive care can improve negative emotions,improve self-care ability,reduce symptom distress,improve quality of life,and reduce the incidence of complications in colorectal cancer patients with colostomy during extended survival period.
作者
许艳华
刘菁菁
崔堂文
潘威婕
XU Yan-hua;LIU Jing-jing;CUI Tang-wen;PAN Wei-jie(Gastroenterology Ward,Department of General Surgery,the First Affiliated Hospital of Henan University,Kaifeng 475004,Henan,CHINA)
出处
《海南医学》
2026年第5期735-740,共6页
Hainan Medical Journal
基金
2024年度河南省医学科技攻关计划联合共建项目(编号:LHGJ20240385)。
关键词
结直肠癌
造口
生存扩展期
多维度支持性照护
症状困扰
生活质量
Colorectal cancer
Colostomy
Extended survival period
Multi-dimensional supportive care
Symptom distress
Quality of life
