症状管理动态模型在鼻咽癌同步放化疗病人口咽部症状群管理中的应用研究

马倩倩; 王国栋; 李淑华

doi:10.13898/j.cnki.issn.1000-2200.2023.04.030

症状管理动态模型在鼻咽癌同步放化疗病人口咽部症状群管理中的应用研究

Application of symptom management dynamic model in the oropharyngeal symptom cluster management of nasopharyngeal carcinoma patients during concurrent chemo-radiotherapy

摘要

摘要:
目的探讨症状管理动态模型对鼻咽癌同步放化疗病人口咽部症状群中的干预效果。
方法将104例鼻咽癌同步放化疗病人随机分为干预组(53例)和对照组(51例)。对照组给予常规护理及症状管理日志, 干预组在对照组基础上采用症状管理动态模型进行干预。干预从病人放疗第1天开始, 至病人出院后2周结束, 共8周。比较2组病人在干预实施后第2、4、6周末及出院后第2周末4个时间点, 各种口咽部症状严重程度的差异, 以及2组病人在干预实施前、干预结束后生活质量的差异。
结果2组病人的疼痛、味觉异常、吞咽困难、唾液黏稠及口干症状得分均存在时间、组间效应, 疼痛、味觉异常症状得分同时有交互效应(P < 0.05~P < 0.01)。干预后干预组病人生活质量在躯体、认知、情绪等领域均高于对照组(P < 0.05~P < 0.01)。干预后病人生活质量在社会、躯体、角色功能等领域高于干预前(P < 0.05)。
结论症状管理动态模型能够显著降低鼻咽癌同步放化疗病人口咽部症状群的严重程度, 提高病人的生活质量。

Abstract:
ObjectiveTo investigate the intervention effect of symptom management dynamic model on oropharyngeal symptom cluster in nasopharyngeal carcinoma (NPC) patients undergoing concurrent chemo-radiotherapy.
MethodsOne hundred and four patients with NPC undergoing concurrent chemo-radiotherapy were randomly divided into intervention group (53 cases) and control group (51 cases).The control group was given routine nursing and symptom management log, while the intervention group was given symptom management dynamic model on the basis of control group.The intervention began on day 1 of radiotherapy and ended 2 weeks after discharge, a total of 8 weeks.The severity of oropharyngeal symptoms was compared between the two groups at the end of the second week, the fourth week and the sixth week after the intervention and at the end of the second week after discharge.The quality of life between the two groups was compared before and after the intervention.
ResultsThe symptom scores of pain, abnormal taste, dysphagia, sticky saliva and dry mouth showed time effects and inter-group effects both in the two groups, and positive interaction effects were found for pain and abnormal taste symptoms (P < 0.05 to P < 0.01).After intervention, The physical, cognitive and emotional domains of quality of life in the intervention group was higher than those of the control group (P < 0.05 to P < 0.01).After intervention, the quality of life of patients in social, physical, role and function domain were higher than before (P < 0.05).
ConclusionsThe symptom management dynamic model can significantly reduce the severity of oropharyngeal symptom cluster and improve the quality of life of patients with NPC with concurrent chemo-radiotherapy.

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