韩小超 叶启乐 顾叶春 林赛赛 朱仁武 夏贝贝 邵阿茜 张益明

[摘要] 目的 研究基于互聯网的合作型培训对于提高社区医护癌痛管理能力的价值。 方法 2015年1月～2016年5月，招募60名社区医护人员作为研究对象，随机分为实验组和对照组。实验组接受网络的综合医院-社区医院合作型培训，对照组接受传统的培训方法。培训结束后再选取2015年6月～2016年12月的相关社区负责的癌症患者180例作为患者研究对象，随机分于对照组与实验组护理人员进行癌痛管理，管理时间为6个月。6个月结束后比较两组护理人员癌痛管理知识、两组患者的NRS评分、对医护人员的满意度、患者的生活质量。 结果 医护人员癌痛知识方面，实验组得分显著高于对照组（P<0.05）；两组患者方面，实验组NRS评分显著低于对照组（P<0.05），实验组对医护人员的满意度显著高于对照组（P<0.05），两组患者的QLT-C30 V3.0中文版测评结果除在气促、腹泻和经济困难三个方面无差异性外（P>0.05），其他均是实验组优于对照组（P<0.05）。 结论 基于互联网的合作型培训能更好地提高社区医护的癌痛管理能力。

[关键词] 合作；培训；社区；癌痛管理；医护人员；NRS评分

[中图分类号] R4 [文献标识码] B [文章编号] 1673-9701（2018）15-0135-04

Research and analysis of cooperative training for general hospital and community hospital based on network in improving the cancer pain management ability of community health care workers

HAN Xiaochao1 YE Qile2 GU Yechun2 LIN Saisai3 ZHU Renwu2 XIA Beibei2 SHAO A'qian2 ZHANG Yiming2

1.Supply Room， the Affiliated Wenzhou Traditional Chinese and Western Medicine Hospital， Zhejiang University of Traditional Chinese Medicine， Wenzhou 325000， China； 2.Department of General Surgery， the Affiliated Wenzhou Traditional Chinese and Western Medicine Hospital， Zhejiang University of Traditional Chinese Medicine， Wenzhou 325000， China； 3.Department of Oncology， the Affiliated Wenzhou Traditional Chinese and Western Medicine Hospital， Zhejiang University of Traditional Chinese Medicine， Wenzhou 325000， China

[Abstract] Objective To study the value of cooperative training for general hospital and community hospital based on network in improving the cancer pain management ability of community health care workers. Methods From January 2015 to May 2016， 60 community health workers were recruited as research subjects and randomly divided into experimental group and control group. The experimental group received the general hospital-community hospital cooperative network training， the control group accepted the traditional training methods. After the training， 180 cancer patients who were in the charge of the relevant community from June 2015 to December 2016 were selected as the study subjects. Patients in the control group and experimental group were randomly assigned to cancer pain management for 6 months. After 6 months， the pain management knowledge of two group nursing staff was compared. The NRS scores of two groups of patients， the satisfaction of medical staff and the quality of life of the patients were compared. Results In the aspect of cancer pain knowledge， the score of experimental group was significantly higher than that of control group（P<0.05）. In both groups， NRS score of experimental group was significantly lower than that of control group（P<0.05）. The Chinese version of QLT-C30 V3.0 in both groups showed that the experimental group was better than the control group（P<0.05） except for three aspects： shortness of breath， diarrhea and economic difficulty（P>0.05）. Conclusion Cooperative training based on Internet can better improve cancer care management in community health care.

[Key words] Cooperation； Training； Community； Cancer pain management； Medical staff； NRS score

癌痛是恶性肿瘤患者最常见的症状，初期发生率约25%，晚期约80%，且越到后期，疼痛程度越重，严重影响癌症患者的生活质量[1-2]。癌痛患者不仅发生在医院，事实上，大部分癌痛患者是很多已回归社区的癌症患者，因而，社区癌痛管理在控制社区癌症患者疼痛方面发挥了重要的作用[2]。但当前相对一部分社区医护的癌痛管理能力仍不足，如不会评估疼痛、缺乏治疗方法、用药方面存在误区等[3-5]。因此，如何提高社区医护人员的癌痛管理能力成为一个重要问题。解决此问题的传统方法为集中、定点培训。然而，此方法受时间、地点的限制而影响其效果。……