杨竹洁 汪志良 陈文 徐光铮 彭磊

摘 要 目的：探索居家舒缓疗护对晚期恶性肿瘤患者的影响。方法：以上海市徐家汇街道社区卫生服务中心2015年1月至12月收治的37例临终期恶性肿瘤患者为研究对象，随机分为干预组与对照组。干预组患者19例，其中男性11例，女性8例；年龄中位数60.6岁。对照组患者18例，其中男性11例，女性7例；年龄中位数61.4岁。于研究开始时、开始后2周、4周、6周、8周以及结束时用FACT-L生活质量评分量表，抑郁自评量表，患者满意度调查表及家庭医生满意度调查表进行评估。结果：干预后干预组的患者在日常活动、社交/家庭活动、情绪、活动能力及其他因素等生活质量得分均优于对照组（P<0.05），抑郁评分低于对照组（P<0.05），干预组患者及家属的满意度显著提高（P<0.05）。结论：居家舒缓疗护模式有助于提高晚期肿瘤患者生活质量，改善心理，同时提高患者及家属满意度。

关键词 晚期肿瘤患者；居家舒缓疗护模式；生活质量；抑郁；满意度

中图分类号：R197.1 文献标志码：A 文章编号：1006-1533（2018）12-0047-04

Effect of home soothing palliative care mode on patients with the advanced cance

YANG Zhujie， WANG Zhiliang， CHEN Wen， XU Guangzheng， PENG Lei（Lingling Health Service Station of Xujiahui Community Health Service Center of Xuhui District， Shanghai 200030， China）

ABSTRACT Objective： To explore the effect of home soothing palliative care on patients with the advanced cancer. Methods： From January 2015 to December 37 patients with advanced cancer in Xujiahui Community Health Service Center in Shanghai were selected as the research objects and randomly divided into an intervention group and a control group. There were 19 patients in the intervention group， including 11 males and 8 females and the median age was 60.6 years. The control group had 18 patients， including 11 males and 7 females and the median age was 61.4 years. At the beginning， 2 weeks， 4 weeks， 6 weeks， 8 weeks and at the end of the study， FACT-L quality of life scale， self-rating depression scale（SDS）， patient satisfaction questionnaire and family doctor satisfaction questionnaire were used for evaluation. Results： After intervention， the scores of daily activities， social / family activities， emotion， activity and other factors of the intervention group were better than those of the control group（P<0.05）. The score of depression of the intervention group was lower than that of the control group（P<0.05）. The satisfaction degree of the patients and their family members of the intervention group was significantly improved（P<0.05）. Conclusion： Home soothing palliative care mode can help to improve the quality of life of patients with advanced cancer and their mental health， and at the same time to improve the satisfaction of the patients and their family members.

KEY WORDS patients with advanced cancer； home soothing palliative care mode； quality of life； depression； satisfaction

隨着人口老龄化、工业化发展、环境污染加重、生存压力增大以及不良生活方式等诸多原因，癌症已经成为上海居民第二大死因[1]。加之独生子女的大量涌现，社会对临终关怀的需求越来越强烈，需求量也急剧增长[2-3]。舒缓疗护（Palliative Care）是在临终关怀（hospice care）的基础上发展起来的。2011年美国舒缓疗护中心（Center of Advanced Palliative Care，CAPA）对舒缓疗护的定义为：由医生、护士和其他专业人员组成的团队与患者的家庭共同提供一层额外的支持，为有严重疾病的患者提供症状和压力缓解等专业医疗服务，改善患者及家庭的生活质量[4]。本研究旨在探索居家舒缓疗护对晚期肿瘤患者的影响。

1 对象与方法

1.1 对象

2015年1月至2015年12月由上海徐家汇街道社区卫生服务中心收治的临终期恶性肿瘤患者40例。……