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目的探讨循证护理在原发性肝癌晚期患者临终关怀中的应用效果。方法选取2013年2月至2015年2月间秦皇岛市第一医院收治的126例原发性肝癌晚期患者,依据入院顺序随机分为观察组和对照组,每组63例。观察组患者接受循证护理,对照组患者接受常规护理,观察两组患者护理不同时间点的镇痛效果、不良情绪和生活质量改变情况,同时对其营养学指标进行观察。结果与对照组比较,观察组患者在护理后2和3个月时间点的疼痛视觉评分(VAS)、抑郁自评量表(SDS)、焦虑自评量表(SAS)和数字评价量表(NRS)评分均明显降低,癌症治疗功能评价系统评分(FACT)中生理维度(PWB)、社会/家庭维度(SWB)、情感维度(EWB)、功能维度(FWB)评分、总蛋白、清蛋白、前清蛋白、转铁蛋白和血红蛋白均明显增加,差异均有统计学意义(均P<0.05)。结论循证护理有助于提高原发性肝癌晚期患者的镇痛效果,降低其抑郁、焦虑情绪的发生,改善其营养状况,提高生活质量。
Objective To explore the application of evidence-based nursing in hospice care of patients with advanced primary liver cancer. Methods A total of 126 patients with advanced primary hepatocellular carcinoma who were admitted to the First Hospital of Qinhuangdao from February 2013 to February 2015 were randomly divided into observation group and control group according to the order of admission, with 63 cases in each group. The patients in the observation group received evidence-based nursing. The patients in the control group received routine nursing care. The analgesic effect, bad mood and quality of life at different time points of the two groups were observed. At the same time, their nutritional indexes were observed. Results Compared with the control group, pain visual score (VAS), depression self-rating scale (SDS), self-rating anxiety scale (SAS) and numerical rating scale (VAS) in the observation group at the time points of 2 and 3 months (NRS) were significantly lower than those in the control group (P <0.05). The scores of PWB, SWB, FWW, total protein, albumin, Prealbumin, transferrin and hemoglobin were significantly increased, the differences were statistically significant (P <0.05). Conclusion Evidence-based nursing can help to improve the analgesic effect of patients with advanced liver cancer, reduce the occurrence of depression and anxiety, improve their nutritional status and improve their quality of life.