韩记真+阿米娜·曲海+阿依古丽·买买提

[摘要] 目的 观察PDCA循环护理管理对老年晚期肺癌化疗患者自我效能感、继发感染及护理质量的影响。 方法 收集2012年1月～2014年12月于新疆医科大学附属肿瘤医院特需一科（以下简称“我科”）接受化疗治疗的52例老年晚期肺癌患者作为对照组，2015年1月～2016年12月于我科接受化疗治疗的64例晚期肺癌患者作为观察组。对照组患者给予常规护理干预，观察组患者给予PDCA循环护理管理。分别采用一般自我效能感量表（GSES）和自制问卷调查评价自我效能感和护理质量。回顾性分析患者临床资料，比较两组患者自我效能感、继发感染及护理质量。 结果 干预后，两组患者GSES评分均升高，且观察组干预后评分高于同期对照组（P < 0.05）。观察组继发感染率低于对照组，护理质量评分高于对照组，差异有统计学意义（P < 0.05或P < 0.01）。 结论 PDCA循环护理管理在老年晚期肺癌化疗中应用效果良好，能够提高患者的自我效能感，降低继发感染发生率，提高护理质量，临床上值得应用。

[关键词] PDCA循环；护理管理；老年；晚期肺癌；化疗；自我效能感；继发感染；护理质量

[中图分类号] R473 [文献标识码] A [文章编号] 1673-7210（2017）12（a）-0160-04

[Abstract] Objective To observe the effects of PDCA cycle nursing management on self-efficiency， secondary infection and nursing quality in elderly patients with advanced lung cancer treated with chemotherapy. Methods 52 elderly patients with advanced lung cancer who received chemotherapy in the First Department of VIP Service， Cancer Hospital Affiliated to Xinjiang Medical University （“our department” for short） from January 2012 to December 2014 were collected as the control group， and 64 elderly patients with advanced lung cancer who received chemotherapy in our department from January 2015 to December 2016 were collected as the observation group. The control group was given to conventional nursing intervention， while the observation group was given to PDCA cycle nursing management. General Self-efficiency Scale （GSES） and self-made questionnaire were employed to assess self-efficiency and nursing quality respectively. Retrospectively analyzing their clinical materials， self-efficiency， secondary infection and nursing quality were compared between the two groups then. Results After intervention， in comparison with the control group， the GSES score of the observation group was significantly increased and the incidence of secondary infection was significantly decreased （P < 0.05 or P < 0.01）. Self-made questionnaire showed that the scores of service attitude， professional skill and health education in the observation group was significantly increased compared with the control group （P < 0.05）. Conclusion PDCA cycle nursing management has good application effect in elderly patients with advanced lung cancer treated with chemotherapy. And it can increase self-efficiency， reduce incidence of secondary infection and promote nursing quality.

[Key words] PDCA cycle； Nursing management； Elderly； Advanced lung cancer； Chemotherapy； Self-efficiency； Secondary infection； Nursing quality

肺癌是常見的呼吸系统恶性肿瘤，老年人群占据多数，由于健康意识的薄弱，多数患者确诊时已发展至晚期肺癌，错过手术机会，从而选择化疗治疗[1]。对于接受化疗治疗的老年晚期肺癌患者，自我效能感——即对自己实现特定领域行为目标所需要能力的信心或者信念普遍降低，会对认知行为产生负面调控，不利于疾病治疗[2]。而且，在疾病本身、化疗药物毒副作用、患者免疫力低下等因素作用下，晚期肺癌患者常会发生继发感染，影响肺癌预后[3]。因此，提高患者自我效能感，降低继发感染发生对老年晚期肺癌化疗患者具有重要意义。……