目的 探讨院外跟踪护理对提高慢性阻塞性肺疾病(COPD)合并肺结核(PTB)患者医疗依从性及生活质量的应用价值。方法 选择2016年1月至2017年12月门诊收治的COPD合并PTB患者90例随机分为观察组和对照组,每组45例。在院外康复期间,对照组仅...目的 探讨院外跟踪护理对提高慢性阻塞性肺疾病(COPD)合并肺结核(PTB)患者医疗依从性及生活质量的应用价值。方法 选择2016年1月至2017年12月门诊收治的COPD合并PTB患者90例随机分为观察组和对照组,每组45例。在院外康复期间,对照组仅接受常规护理,观察组患者根据奥瑞姆(Orem)理论给予院外跟踪护理管理。分别采用圣·乔治医院呼吸问题调查问卷(SGRQ)评估患者生活质量情况,采用慢性病患者健康素养与医疗依从性调查问卷评估患者对医嘱的依从性,并比较两组患者临床症状显著改善时间和出院后6个月的痰菌转阴率。结果 与出院时比较,对照组患者在出院1个月后和出院6个月后的SGRQ总评分及各维度评分显著升高,且出院6个月后的总评分及各维度评分显著高于出院1个月后,差异均有统计学意义( P <0.05);观察组患者的总评分和各维度评分与出院时比较差异无统计学意义( P > 0.05 ),且在出院1个月后和出院6个月后的评分均显著低于对照组评分,差异均有统计学意义( P <0.05)。在医疗依从性方面,与出院1个月时比较,对照组在出院后6个月时的各项依从性评分显著下降( P <0.05);而观察组患者的各项评分虽略有下降,但差异无统计学意义( P >0.05)。与对照组比较,观察组患者在出院1个月后和6个月后的各项依从性评分明显更高,差异均有统计学意义( P <0.05)。观察组患者的临床症状改善时间显著短于对照组[(26.7±5.6)d vs.(43.5±6.8)d, P <0.05],痰菌转阴率显著高于对照组(87.1% vs. 62.5%, P < 0.05 )。结论 院外跟踪护理干预有助于COPD合并PTB患者提高对医嘱的依从性,提高痰菌转阴率,巩固临床治疗效果,从而提高患者的生活质量,值得推广应用。展开更多
Objective:To standardize the distress management of gastric cancer patients receiving chemotherapy,the adapted Cancer-related Distress Management Guidelines were implemented in nursing practice among gastric cancer pa...Objective:To standardize the distress management of gastric cancer patients receiving chemotherapy,the adapted Cancer-related Distress Management Guidelines were implemented in nursing practice among gastric cancer patients receiving chemotherapy based on A Guideline Adaptation and Implementation Planning Resource(CAN-IMPLEMENT).Methods:Based on the theoretical framework of CAN-IMPLEMENT,A multidisciplinary team was established,barriers and facilitators obstacles of guidelines implementation in medical oncology units were assessed,corresponding solutions were formulated,the guidelines implementation process was monitored,and implementation results were evaluated.Results:The multidisciplinary team developed review criteria,standardized work paths,assessment tools,training manuals for healthcare professionals,education manuals for patients and their caregivers.After guidelines implementation,the completion rate of the distress management record came up to 97.9%(189/193).From September 2017 to December 2018,the compliance of medical staff on most items in the audit checklist was improved,ranging from 57.1%(100/175)to 100.0%(193/193).The positive distress rate of gastric cancer patients receiving chemotherapy was decreased from 22.7%(32/141)to 9.3%(18/193)(P<0.05),and the Median(range)of the distress score declined from 2(0e9)to 0(0e7)(P<0.001).Conclusions:The implementation of guidelines based on CAN-IMPLEMENT promotes the establishment of a distress management system in the medical oncology units.The review standards,standardized work paths,and evaluation tools for distress in cancer patients formulated by the multidisciplinary team had clinical applicability and effectiveness.Quality control in the practice of distress management was effective.The compliance of healthcare professionals with distress management was improved.The distress of gastric cancer patients receiving chemotherapy was alleviated effectively.展开更多
文摘目的 探讨院外跟踪护理对提高慢性阻塞性肺疾病(COPD)合并肺结核(PTB)患者医疗依从性及生活质量的应用价值。方法 选择2016年1月至2017年12月门诊收治的COPD合并PTB患者90例随机分为观察组和对照组,每组45例。在院外康复期间,对照组仅接受常规护理,观察组患者根据奥瑞姆(Orem)理论给予院外跟踪护理管理。分别采用圣·乔治医院呼吸问题调查问卷(SGRQ)评估患者生活质量情况,采用慢性病患者健康素养与医疗依从性调查问卷评估患者对医嘱的依从性,并比较两组患者临床症状显著改善时间和出院后6个月的痰菌转阴率。结果 与出院时比较,对照组患者在出院1个月后和出院6个月后的SGRQ总评分及各维度评分显著升高,且出院6个月后的总评分及各维度评分显著高于出院1个月后,差异均有统计学意义( P <0.05);观察组患者的总评分和各维度评分与出院时比较差异无统计学意义( P > 0.05 ),且在出院1个月后和出院6个月后的评分均显著低于对照组评分,差异均有统计学意义( P <0.05)。在医疗依从性方面,与出院1个月时比较,对照组在出院后6个月时的各项依从性评分显著下降( P <0.05);而观察组患者的各项评分虽略有下降,但差异无统计学意义( P >0.05)。与对照组比较,观察组患者在出院1个月后和6个月后的各项依从性评分明显更高,差异均有统计学意义( P <0.05)。观察组患者的临床症状改善时间显著短于对照组[(26.7±5.6)d vs.(43.5±6.8)d, P <0.05],痰菌转阴率显著高于对照组(87.1% vs. 62.5%, P < 0.05 )。结论 院外跟踪护理干预有助于COPD合并PTB患者提高对医嘱的依从性,提高痰菌转阴率,巩固临床治疗效果,从而提高患者的生活质量,值得推广应用。
基金funded by Fudan-Fuxing Nursing Research Funds(No.FNF201701)JBI Evidence Based Clinical Fellowship Pro-gram Funds(No.FNF201861)from Fudan University,China.
文摘Objective:To standardize the distress management of gastric cancer patients receiving chemotherapy,the adapted Cancer-related Distress Management Guidelines were implemented in nursing practice among gastric cancer patients receiving chemotherapy based on A Guideline Adaptation and Implementation Planning Resource(CAN-IMPLEMENT).Methods:Based on the theoretical framework of CAN-IMPLEMENT,A multidisciplinary team was established,barriers and facilitators obstacles of guidelines implementation in medical oncology units were assessed,corresponding solutions were formulated,the guidelines implementation process was monitored,and implementation results were evaluated.Results:The multidisciplinary team developed review criteria,standardized work paths,assessment tools,training manuals for healthcare professionals,education manuals for patients and their caregivers.After guidelines implementation,the completion rate of the distress management record came up to 97.9%(189/193).From September 2017 to December 2018,the compliance of medical staff on most items in the audit checklist was improved,ranging from 57.1%(100/175)to 100.0%(193/193).The positive distress rate of gastric cancer patients receiving chemotherapy was decreased from 22.7%(32/141)to 9.3%(18/193)(P<0.05),and the Median(range)of the distress score declined from 2(0e9)to 0(0e7)(P<0.001).Conclusions:The implementation of guidelines based on CAN-IMPLEMENT promotes the establishment of a distress management system in the medical oncology units.The review standards,standardized work paths,and evaluation tools for distress in cancer patients formulated by the multidisciplinary team had clinical applicability and effectiveness.Quality control in the practice of distress management was effective.The compliance of healthcare professionals with distress management was improved.The distress of gastric cancer patients receiving chemotherapy was alleviated effectively.
