王璐　周洁　连开华

[摘要] 目的 觀察家属参与式疼痛教育对直肠癌术前同步放化疗患者韧性和疼痛控制满意度的影响。 方法 选取2014年4月～2016年4月于青岛市中心医院住院治疗的直肠癌术前同步放化疗患者115例，采用随机数字表法分为观察组（58例）和对照组（57例）。观察组给予家属参与式疼痛教育，对照组给予常规疼痛教育，于干预前和干预后（最后一次放疗结束）采用韧性量表和休斯顿疼痛情况调查表（HPOI）评估并比较两组患者的韧性水平和疼痛控制满意度。 结果 两组干预前韧性量表总分及4个维度评分比较，差异无统计学意义（P > 0.05）；干预后，两组韧性量表总分及4个维度评分均较干预前升高，且观察组均高于对照组，差异有高度统计学意义（P < 0.01）。两组干预前HPOI量表总分及各维度评分比较，差异无统计学意义（P > 0.05）；干预后，两组HPOI量表总分及各维度评分均较干预前升高，且观察组均高于对照组组，差异有统计学意义（P < 0.01或P < 0.05）。 结论 疼痛教育可提高直肠癌术前同步放化疗患者韧性水平和疼痛控制满意度，而家属参与式疼痛教育效果更为明显。

[关键词] 家属参与；疼痛教育；直肠癌；韧性；疼痛控制满意度

[中图分类号] R735.37 [文献标识码] A [文章编号] 1673-7210（2018）09（b）-0147-04

[Abstract] Objective To explore the effects of families involved pain education on resilience and satisfaction of pain control in rectal cancer patients with preoperative chemoradiotherapy. Methods From April 2014 to April 2016， in Qingdao Center Hospital， 115 rectal cancer patients with preoperative chemoradiotherapy were selected， by random number table method， they were divided into observation group （58 cases） and control group （57 cases）. The observation group was given families involved pain education， the control group was given normal pain education， the resilience and satisfaction of pain control were evaluated and compared before and after intervention （the last radiotherapy was over） by resilience scale and Houston pain outcome instrument （HPOI）. Results There were no statistically significant differences on the score of total and 4 dimension in resilience scale before intervention between two groups （P > 0.05）； after the intervention， the scores of 4 dimension and total of resilience scale were higher than before intervention， and those in observation group were higher than control group， the differences were statistically significant （P < 0.01）. There was no statistically significant difference on the score of total and each dimension in HPOI before intervention between two groups （P > 0.05）； after the intervention， the scores of each dimension and total of HPOI were higher than these before intervention， and those in observation group were higher than control group， the differences were statistically significant （P < 0.01 or P < 0.05）. Conclusion Pain education can improve the resilience level and pain control satisfaction of rectal cancer patients with preoperative concurrent chemoradiotherapy， the effect of family involved pain education is more obvious.

[Key words] Family involved； Pain education； Rectal cancer； Resilience； Pain control satisfaction

研究数据显示，2012年我国男、女结直肠癌发病率（世标率）分别约为16.9/10万和11.6/10万，死亡率（世标率）分别约为9.0/10万和6.1/10万，是造成全球范围总伤残调整生命年疾病负担的重要癌种之一[1-2]。经腹会阴联合直肠切除术是当前公认的一种治疗低位直肠癌的有效的手术方式，但是单纯的手术治疗往往效果不能得到患者满意，且部分患者需要做永久性的造瘘口，给患者造成生活的不便和极大的心理压力，生活质量下降明显[3-4]。近年来，在治疗……