郑娟霞 郑娟丽 郑娟芬 黄碧芳 杨政坤

[摘要]目的 评价渐进式康复护理对改善胃癌根治术后患者出院后希望水平及生活质量的影响。方法 选取我院2014年5月～2016年5月收治的90例行胃癌根治术患者，按随机数字表法分为观察组和对照组，每组各45例。对照组给予常规住院健康教育、出院指导和随访计划，观察组则在常规护理的基础上加用渐进式康复护理干预。采用Herth希望量表（HHI）及欧洲癌症治疗研究组生活质量问卷（QLQ-C30量表）评价两组出院3、6、9个月时的希望水平和生活质量评分，评价渐进式康复护理对胃癌根治术后患者出院后希望水平和生活质量的影响。结果 观察组出院后3、6、9个月的积极态度、亲密关系以及积极行动评分高于对照组，差异有统计学意义（P<0.05）;观察组出院后3、6、9个月的功能性量表评分、总体健康状况评分高于对照组，症状评分低于对照组，差异有统计学意义（P<0.05）。结论 渐进式康复护理可改善胃癌根治术后患者生活质量并在提高患者的出院后希望水平方面有积极效果，值得临床推广应用。

[关键词]渐进式康复护理;胃癌根治术;生活质量;希望水平

[中图分类号] R473.73          [文献标识码] A          [文章编号] 1674-4721（2019）1（b）-0238-04

[Abstract] Objective To evaluate the effect of progressive rehabilitation nursing on the hope level and quality of life of patients with gastric cancer after radical gastrectomy. Methods From May 2014 to May 2016， 90 patients undergoing radical gastrectomy in our hospital were selected and divided into observation group （n=45） and control group （n=45） according to random number table method. The control group was given routine hospitalization health education， discharge guidance and follow-up plan， in the observation group， the gradual rehabilitation nursing intervention was added on the basis of the control group. The quality of life scale （QLQ-C30） and Herth Hope scale （HHI） were used to evaluate the level of hope and quality of life （QLQC-30） at 3 months， 6 months and 9 months after discharge. The effect of progressive rehabilitation nursing on the level of hope and quality of life after radical gastrectomy were evaluated. Results The scores of positive attitude， intimate relationship and positive action in the observation group were significantly higher than those in the control group 3 months， 6 months and 9 months after discharge （P<0.05）. The scores of functional scale， general health status symptom score of the observation group were higher than those of the control group 3 months， 6 months and 9 months after discharge from hospital， symptom score were lower than those of the control group， the differences were statistically significant （P<0.05）. Conclusion The progressive rehabilitation nursing program can improve the quality of life of patients after radical gastrectomy and improve the level of hope after discharge， which is worthy of clinical application.

[Key words] Progressive rehabilitation nursing; Gastrectomy; Quality of life; Hope level

國内流行病学调查显示，我国胃癌发病率呈逐年上升趋势，且其死亡率位居恶性肿瘤死亡率的首位[1]。由于治疗期间胃癌患者大多有焦虑、抑郁、失望等悲观情绪，而这些问题或多或少影响胃癌患者的疾病发展和转归，随着医学模式的转变，癌症的预后与心理、社会因素有极大的关系，进行有效的康复训练有利于改善胃癌患者的预后[2]。国内外许多研究表明，渐进式康复护理以促进胃癌根治术后患者整体康复为目的，采用渐进式康复指导结合心理干预以提高患者躯体和心理社会功能的一种护理措施，护理服务将继续在家庭或社区中延续，更加关注患者的康复与生活质量[3]。……