摘要
目的 探究快速康复外科理念(ERAS)理念联合赋能教育对老年胰腺癌患者术后心理状态、应对方式和生活质量的效果。方法 选取2020年1月—2021年10月于成都上锦南府医院/四川大学华西医院上锦医院收治的92例老年胰腺癌患者为研究对象,使用随机数字表法分为对照组(n=46)和观察组(n=46)。2组均进行腹腔镜手术,对照组进行常规护理,观察组在对照组护理方案的基础上实施ERAS理念联合赋能教育。比较2组术后康复相关指标差异,比较2组干预前和干预4周后心理状态[心理弹性量表(CD-RISC)]、应对方式[医学应对方式问卷(MCMQ)]、生活质量[胰腺癌患者生存质量特异量表(QLQ-PAN-26)]、自我效能感[中文版癌症自我管理效能感量表(SUPPH)]差异。结果 观察组术后首次进水时间、首次进食时间、首次肛门排气时间、首次下床活动时间均低于对照组(P<0.05);干预4周后,2组CD-RISC量表、 SUPPH量表各维度得分均较干预前上升,且观察组高于同期对照组(P均<0.05);干预4周后,2组MCMQ量表中回避、屈服维度得分均较干预前下降,且观察组低于同期对照组,面对维度得分均较干预前上升,且观察组高于同期对照组(P均<0.05);干预4周后,2组QLQ-PAN-26量表中癌性疼痛、饮食消化症状维度得分均较干预前下降,且观察组低于同期对照组,健康护理满意度维度得分均较干预前上升,且观察组高于同期对照组(P<0.05)。结论 ERAS理念联合赋能教育有利于患者早期康复,可调节老年胰腺癌患者术后心理状态,促使患者面对疾病,有利于患者生活质量及自我效能感提升。
Objective To explore the effects of concept of enhanced recovery after surgery(ERAS) combined with empowerment education on the psychological state,coping style and quality of life of elderly patients with pancreatic cancer after surgery.Methods 92 elderly patients with pancreatic cancer who were admitted to Chengdu Shangjin Nanfu Hospital/Shangjin Nanfu Hospital,West China Hospital Affiliated to Sichuan University from January 2020 to October 2021 were selected as the research subjects.They were divided into control group(n=46) and observation group(n=46) by the random number table method.Both groups underwent laparoscopic surgery.The control group received routine nursing,and the observation group implemented ERAS concept combined with empowerment education on the basis of the nursing plan of the control group.The differences in postoperative rehabilitation-related indexes between the two groups were compared.The differences in psychological status [Connor-Davidson Resilience Scale(CD-RISC)],coping style [Medical Coping Style Questionnaire(MCMQ)],quality of life [Quality of Life Scale for Patients with Pancreatic Cancer(QLQ-PAN-26)] and self-efficacy [Chinese version of Strategies Used by People to Promote Health(SUPPH)] before intervention and after 4 weeks of intervention were compared between the two groups.Results The first postoperative drinking water time,first eating time,first anal exhaust time and first ambulation time in the observation group were shorter than those in the control group(P<0.05).After 4 weeks of intervention,the scores of each dimension of CD-RISC scale and SUPPH scale of the two groups were higher than those of the same group before intervention,and the scores of the observation group was higher than those of the control group(all P<0.05).After 4 weeks of intervention,the scores of avoidance and yield dimensions in the MCMQ scale of the two groups were lower than those of the same group before intervention,and the scores of the observation group were lower than those of the control group,while the scores of face dimension were higher than those of the same group before intervention,and the score of the observation group was higher than that of the control group(P<0.05).After 4 weeks of intervention,the dimension scores of cancer pain and diet and digestive symptoms in the QLQ-PAN-26 scale of the two groups were lower than those of the same group before intervention,and the dimension scores of the observation group was lower than those of the control group,while the dimension scores of health care satisfaction were higher than those of the same group before intervention,and the dimension scores of observation group was higher than that of the control group(P<0.05).Conclusion ERAS concept combined with empowerment education is beneficial to the early rehabilitation of patients,and it can adjust the psychological state of elderly patients with pancreatic cancer after surgery,promote them to face the disease,and is conducive to the improvement of the quality of life and self-efficacy of patients.
作者
张建波
东爱华
Zhang Jianbo;Dong Aihua(Hepatobiliary and Pancreatic Minimally Invasive Center,Chengdu Shangjin Nanfu Hospital/Shangjin Hospital,West China Hospital of Sichuan University,Chengdu,Sichuan,610000,P.R.China)
出处
《老年医学与保健》
CAS
2022年第5期1130-1135,共6页
Geriatrics & Health Care
基金
四川省科技计划项目(2017KZ0019)。
关键词
老年
胰腺癌
快速康复外科理念
赋能教育
心理
应对方式
生活质量
elderly
pancreatic cancer
enhanced recovery after surgery
empowerment education
psychology
coping styles
quality of life
