章琳 钱江

[摘要] 目的 探讨延续性护理健康教育对结直肠癌术后患者负性情绪和生活质量的影响。 方法 选择2016年1月～2017年1月浙江医院分院普外科收治的结直肠癌术后患者98例，采用随机数字表法分为对照组和观察组，每组各49例。对照组给予常规护理，观察组在对照组基础上给予延续性护理健康教育。比较两组患者依从性，采用焦虑自评量表（SAS）和抑郁自评量表（SDS）比较两组护理前后负性情绪评分，比较两组生活质量评分和出院后6个月患者对护理的满意度。 结果 观察组遵医依从性明显高于对照组，差异有统计学意义（P < 0.05）。护理后观察组SAS、SDS评分均明显低于对照组，差异均有统计学意义（均P < 0.05）。护理后观察组营养状态、精神狀态、睡眠情况、家庭理解与配合、对疾病认知情况和生活日常情况等生活质量评分均高于对照组，差异均有统计学意义，（均P < 0.05）。出院后6个月观察组患者护理的满意度明显高于对照组，差异有统计学意义（均P < 0.05）。 结论 延续性护理健康教育可提高结直肠癌术后患者的依从性，显著缓解其负性情绪，明显改善其生活质量。

[关键词] 延续性护理；健康教育；结直肠癌；生活质量；影响

[中图分类号] R473.5 [文献标识码] A [文章编号] 1673-7210（2018）06（b）-0163-04

[Abstract] Objective To investigate the influence of continuous nursing care education on negative emotions and life quality in patients with colorectal cancer after radical operation. Methods A total of 98 patients with colorectal cancer after radical operation in Department of General Surgery， Branch of Zhejiang Hospital from Janary 2016 to Janary 2017 were selected and divided into the experimental group and the control group by random number table， with 49 cases in each group. The control group was given the conventional nursing， while the experimental group was given continuous nursing care education on the basis of control group. The compliance of patients was compared between the two groups. Self-rating anxiety scale （SAS） and self-rating depression scale （SDS） were used to evaluate the negative emotions of the patients before and after nursing. The score of life quality and the nursing satisfaction after 6 months hospital discharge were compared between the two groups. Results The compliance in the experimental group was significantly higher than that of control group， with statistically significant difference （P < 0.05）. After nursing， the scores of SAS and SDS in the experimental group were significantly lower than those of control group， with statistically significant differences （P < 0.05）； the scores of appetite， spiritual condition， sleep quality， family understanding， knowledge of cancer and daily life in the experimental group were all significantly higher than those of control group， with statistically significant differences （all P < 0.05）. After 6 months hospital discharge， the nursing satisfaction in the experimental group was significantly higher than that of control group， with statistically significant difference （P < 0.05）. Conclusion Continuous nursing health education can improve the compliance of patients with colorectal cancer after radical operation， reduce negative emotions and improve the quality of life.

[Key words] Continuous nursing care； Healthy education； Colorectal cancer； Life quality； Influence

据GLOBOCAN 2012估计，在世界范围内结直肠癌发病率居恶性肿瘤发病第3位，死亡率居恶性肿瘤死亡的第4位。中国结直肠癌新发病例占全球的18.6%，且发病年龄趋于年轻化，结直肠癌居中国人群恶性肿瘤死因第5位[1-2]。结直肠癌的治疗是一个漫长的过程，包括手术、放化疗及生物治疗等，由于手术本身导致的胃肠功能不适、饮食习惯改变及术后放化疗引起的各种不良反应，患者往往长时间面临心理、生理、生活和社会等方面的问题，严重影响患者预后及生活质量，因而需要有效的护理干预[3]。

延续性护理是以患者为中心，通过一系列的行动设计以确保患者在不同的健康照护场所获得同等水平照护，以保证其协调性与延续性[4]。健康教育是针对不同类型患者的特点进行的个体化、人性化的持续健康宣教的护理方式[5]。……