卞伟峰

(安徽省滁州市第一人民医院，滁州 239000)

聚焦解决模式对膀胱肿瘤患者术后膀胱灌注依从性影响

卞伟峰

(安徽省滁州市第一人民医院，滁州 239000)

目的探讨聚焦解决模式对膀胱肿瘤患者术后行膀胱灌注治疗依从性的影响。方法选择2008年3月—2010年3月在安徽省滁州市第一人民医院施行浅表性膀胱肿瘤电切术的膀胱肿瘤患者50例，随机分为实验组25例和对照组25例，实验组在常规护理措施的基础上采用聚焦解决模式，观察两组患者在2年内对膀胱灌注治疗的依从性。结果实验组患者在按时灌注、配合灌注和定期复查方面与对照组比较，差异有统计学意义(P＜0.01);对照组中肿瘤复发6例，与实验组比较差异有统计学意义(P＜0.01)。结论采用聚焦解决模式实施护理干预及随访管理，能明显提高膀胱肿瘤患者手术后膀胱灌注依从性，减少肿瘤的复发，促进患者的康复。

膀胱肿瘤;膀胱灌注;聚焦解决模式;依从性

Abstract:ObjectiveTo explore the effect of solution focused approach on compliance of patients with bladder tumor to postoperative bladder perfusion.MethodsA total of 50patients undergoing transurethral resection of bladder tumor(TURBT)in our hospital were randomly and equally divided into the experimental group and control group from March 2008to March 2010.The patients in the control group received routine nursing，while the patients in the experimental group received routine nursing by implementing solution focused approach.The compliance of patients to postoperative bladder perfusion in the next 2years was compared.ResultsThe patients'compliance to perfusion on time，ration perfusion，and regular review in the experimental group was much better than that in the control group(P＜0.01).And the recurrence of tumor in the experimental group was lower than that in the control group(P＜0.01).ConclusionImplementation of solution focused approach in the nursing intervention and follow－up management can significantly improve the treatment compliance of patients，reduce tumor recurrence，and promote their recovery.

Key Words:Bladder tumor;Bladder perfusion;Solution focused approach;Compliance

膀胱肿瘤为泌尿生殖系统最常见的肿瘤，术后约有50%～70%患者肿瘤复发，其中10%～20%的肿瘤复发后恶性程度(病理分级和分期)增加［1］。故术后常采用膀胱内药物灌注治疗来预防肿瘤复发，其有效率达47%～75%［2］。由于膀胱灌注疗程长，需2年才能完成，因此患者对膀胱灌注的依从情况直接影响膀胱癌的疗效和转归。聚焦解决模式是目前广泛应用的一种心理干预模式，它把解决问题的关注点集中在寻求最大化地挖掘个体或团体的力量、优势和能力［3］。它的具体含义是与个体共同构建解决方案来达成个体自己期望的结果。……