阮淑芳 袁兰 熊秋萍

【摘要】 目的：探讨胃癌化疗患者的医护一体化干预方法及其干预效果。方法：选取本院2018年1-8月收治的胃癌化疗患者42例作为研究对象，按照随机数字表法将其分为对照组和观察组，各21例。对照组按照常规护理模式干预，观察组则采取医护一体化干预模式干预，比较两组护理前后焦虑自評量表（SAS）、抑郁自评量表（SDS）、癌症疲乏量表（CFS）评分，同时记录化疗副反应发生情况和住院时间，护理质量和患者对护理的满意度评分。结果：护理前两组SAS、SDS、CFS评分比较，差异均无统计学意义（P>0.05）；护理后，两组SAS、SDS、CFS评分与治疗前比较均明显降低，且观察组均明显低于对照组，差异均有统计学意义（P<0.05）。观察组化疗副反应发生率明显低于对照组，住院时间明显短于对照组，差异均有统计学意义（P<0.05）。观察组护理质量和患者对护理的满意度评分均明显高于对照组，差异均有统计学意义（P<0.05）。结论：医护一体化护理干预应用在胃癌患者中不仅可以明显改善患者的焦虑、抑郁症状，而且还能更好地改善癌性疲乏症状，提高护士护理水平，减少化疗副反应，缩短住院时间，使得患者对护理更满意，值得借鉴。

【关键词】 胃癌； 医护一体化干预； 化疗； 负性情绪； 癌性疲乏症状； 化疗副反应

【Abstract】 Objective：To explore the intervention method and intervention effect of health care integration intervention for gastric cancer patients with chemotherapy.Method：A total of 42 patients with gastric cancer admitted in our hospital from January to August 2018 were selected as the research objects.According to the random number table method，they were divided into control group and observation group，21 cases in each group.The control group was intervened by routine nursing mode，the observation group was intervened by health care integration intervention mode.The scores of self-rating anxiety scale （SAS），self-rating depression scale （SDS） and cancer fatigue scale （CFS） before and after nursing，the side effects of chemotherapy and hospitalization time，nursing quality and patients satisfaction with nursing scores between the two groups were compared.Result：There were no significant differences in SAS，SDS and CFS scores between two groups before nursing（P>0.05）；after nursing，SAS，SDS and CFS scores of two groups were significantly lower than those before treatment，and the observation group were significantly lower than those of the control group，the differences were statistically significant （P<0.05）.The incidence of side effects of chemotherapy in the observation group was significantly lower than that in the control group，the hospitalization time was significantly shorter than that in the control group，the differences were statistically significant （P<0.05）.The nursing quality and the patients satisfaction with nursing scores of the observation group were significantly higher than those of the control group，the differences were statistically significant （P<0.05）.Conclusion：The application of health care integration intervention in patients with gastric cancer can not only significantly improve the anxiety and depressive symptoms，but also better improve the symptoms of cancer fatigue，improve the nursing level of nurses，reduce side effects of chemotherapy，shorten hospitalization time，make patients more satisfied with nursing，which is worth learning.

【Key words】 Gastric cancer； Health care integration intervention； Chemotherapy； Negative emotion； Cancerous fatigue symptoms； Chemotherapy side effects

First-authors address：Jiangxi Cancer Hospital，Nanchang 330029，China

doi：10.3969/j.issn.1674-4985.2018.33.024

胃癌属于比较常见的一种恶性肿瘤疾病，发病率、死亡率均较高[1]。手术作为本病首选方案，在临床应用十分广泛，但其手术创伤、术后生理与病理变化等都可能诱发或加重患者的负性情绪[2]。化疗是治疗本病的有效方法之一，但从本科收治的胃癌化疗患者来看，患者多有焦虑、抑郁等，而且伴有癌性疲乏症状，从而影响患者化疗后恢复，导致住院时间延长，加重医疗负担，影响生活质量[3-5]。为此，针对胃癌化疗患者要积极做好护理干预，促进患者负性情绪改善，缓解癌性疲乏症状，才能更好地提高患者的生活质量与预后[6-8]。医护一体化干预模式在近几年逐渐开展起来，该干预模式围绕患者开展，医生、护士共同参与患者诊疗、护理等全程，作为新型护理模式，有着不错的应用前景，能为患者提供个性化与系统化的服务[9]。为……