“互联网+”模式护理干预对食管癌化疗患者心理弹性水平的影响

doi:10.3760/cma.j.cn441417-20241205-12033

摘要/Abstract

摘要：

目的　探讨在食管癌化疗患者中应用基于“互联网+”模式的护理干预的效果。方法　采用回顾性分析试验。选取2022年6月至2024年6月南阳市中心医院收治的86例食管癌患者，依据护理方式不同将其分为对照组和观察组，各43例。对照组男23例，女20例，年龄42～76（59.98±3.27）岁；观察组男23例，女20例，年龄42～76（59.98±3.27）岁。对照组采取常规护理，观察组采取基于“互联网+”模式护理。两组均持续干预3个月。比较两组患者营养状况、心理状态水平、心理弹性水平、生活质量水平以及患者对护理服务的满意度。采用t检验、χ²检验进行统计学分析。结果　干预后，观察组血红蛋白（Hb）、白蛋白（ALB）以及前白蛋白（PA）水平均高于对照组［（135.87±16.01）g/L比111.47±15.65）g/L、（43.76±4.41）g/L比（32.78±4.35）g/L、（253.77±22.75）mg/L比（210.15±22.60）mg/L］（t=7.147、11.624、8.920，均P<0.05）；观察组抑郁-焦虑-压力量表（DASS）中压力、抑郁、焦虑评分均低于对照组［（8.18±1.00）分比（12.23±1.01）分、（8.34±1.07）分比（12.19±1.13）分、（8.38±1.03）分比（11.89±1.06）分］，差异均有统计学意义（t=18.685、16.223、15.573，均P<0.05）；观察组心理弹性量表（CD-RISC）中力量性、乐观性、坚韧性评分均高于对照组［（25.52±2.10）分比（19.49±1.84）分、（12.31±1.13）分比（9.62±1.12）分、（40.53±4.22）分比（32.75±4.12）分］，差异均有统计学意义（t=14.162、11.087、8.650，均P<0.05）；观察组生命质量测定量表（QLQ-C30）中躯体功能、角色功能、认知功能、情绪功能、社会功能评分均高于对照组［（81.18±4.36）分比（75.57±4.27）分、（83.37±4.35）分比（76.86±4.21）分、（86.63±4.38）分比（79.92±4.14）分、（85.51±4.29）分比（77.84±3.92）分、（86.67±4.77）分比（79.29±4.65）分］，差异均有统计学意义（t=6.028、7.052、7.301、8.655、7.265，均P<0.05）；观察组护理满意中需求满足情况、服务态度、心理疏导、护理及时性、护理操作技术评分均高于对照组［（85.71±3.94）分比（80.53±3.24）分、（86.16±3.62）分比（82.28±3.53）分、（85.54±3.91）分比（81.97±3.78）分、（86.67±3.61）分比（80.49±3.55）分、（86.86±3.70）分比（82.28±3.64）分］，差异均有统计学意义（t=6.659、5.032、4.305、8.004、5.786，均P<0.05）。结论　“互联网+”护理干预可以有效改善食管癌化疗患者营养状况，调节患者负面情绪，进而提升心理弹性，促进生活质量，患者对护理服务满意度随之提高。

关键词: 食管癌, 化疗, 互联网+, 营养状况, 心理弹性水平, 生活质量, 护理满意度

Abstract:

Objective　To explore the effect of nursing intervention based on "Internet+" model in patients with esophageal cancer undergoing chemotherapy. Methods　A retrospective analysis was conducted. A total of 86 patients with esophageal cancer admitted to Nanyang Central Hospital from June 2022 to June 2024 were selected, and divided into a control group and an observation group according to different nursing methods. The control group received routine nursing, while the observation group received nursing intervention based on the "Internet +" model. The control group included 43 patients, with 23 males and 20 females, aged 42-76 (59.98 ± 3.27) years. The observation group also included 43 patients, with 23 males and 20 females, aged 42-76 (59.98 ± 3.27) years. The two groups were continuously observed for 3 months. The nutritional status, psychological state, psychological resilience, quality of life, and patient satisfaction with nursing services were compared between the two groups. Statistical analysis was performed using t tests and χ² tests. Results　The levels of hemoglobin (Hb), albumin (ALB), and prealbumin (PA) in the observation group were higher than those in the control group [(135.87 ± 16.01) g/L vs. (111.47 ± 15.65) g/L, (43.76 ± 4.41) g/L vs. (32.78 ± 4.35) g/L, and (253.77 ± 22.75) mg/L vs. (210.15 ± 22.60) mg/L] (t = 7.147, 11.624 and 8.920, all P < 0.05). The stress, depression and anxiety scores of the post-nursing Depression-Anxiety-Stress Scale (DASS) in the observation group were lower than those in the control group [(8.18 ± 1.00) points vs. (12.23 ± 1.01) points, (8.34 ± 1.07) points vs. (12.19 ± 1.13) points, and (8.38 ± 1.03) points vs. (11.89 ± 1.06) points], with statistically significant differences (t = 18.685, 16.223, 15.573, all P < 0.05). The scores of strength, optimism, and fortitude of the post-nursing mental resilience scale (CD-RISC) in the observation group were higher than those in the control group [(25.52 ± 2.10) points vs. (19.49 ± 1.84) points, (12.31 ± 1.13) points vs. (9.62 ± 1.12) points, and (40.53 ± 4.22) points vs. (32.75 ± 4.12) points], with statistically significant differences (t = 14.162, 11.087 and 8.650, all P < 0.05). The scores of physical function, role function, cognitive function, emotional function, and social function in the post-nursing quality of life (QLQ-C30) of the observation group were higher than those of control group [(81.18 ± 4.36) points vs. (75.57 ± 4.27) points, (83.37 ± 4.35) points vs. (76.86 ± 4.21) points, (86.63 ± 4.38) points vs. (79.92 ± 4.14) points, (85.51 ± 4.29) points vs. (77.84 ± 3.92) points, and (86.67 ± 4.77) points vs. (79.29 ± 4.65) points], with statistically significant differences (t = 6.028, 7.052, 7.301, 8.655, and 7.265, all P< 0.05). The scores of demand satisfaction, service attitude, psychological counseling, nursing timeliness, and nursing skills in the nursing satisfaction in the observation group were higher than those in the control group [(85.71 ± 3.94) points vs. (80.53 ± 3.24) points, (86.16 ± 3.62) points vs. (82.28 ± 3.53) points, (85.54 ± 3.91) points vs. (81.97 ± 3.78) points, (86.67 ± 3.61) points vs. (80.49 ± 3.55) points, and (86.86 ± 3.70) points vs. (82.28 ± 3.64) points], with statistically significant differences (t = 6.659, 5.032, 4.305, 8.004, and 5.786, all P < 0.05). Conclusion　Nursing interventions based on the 'Internet +' model can enhance the nutritional status of esophageal cancer patients undergoing chemotherapy, effectively alleviate their negative emotions, strengthen their psychological resilience, improve their overall quality of life, and increase patient satisfaction with nursing care services.

Key words: Esophageal cancer, , Chemotherapy, , Internet +, , Nutritional status, , Psychological resilience level, , Quality of life, , Nursing satisfaction ,

郭婉贞刘向阳朱建欣. “互联网+”模式护理干预对食管癌化疗患者心理弹性水平的影响 [J]. 国际医药卫生导报, 2025, 31(12): 2098-2103.

Guo Wanzhen, Liu Xiangyang, Zhu Jianxin.

Effect of "Internet +" model nursing intervention on psychological resilience of patients with esophageal cancer undergoing chemotherapy [J]. International Medicine and Health Guidance News, 2025, 31(12): 2098-2103.

参考文献

[1]王呈呈,吕秀霞,于川川.精细化护理对食管癌化疗患者焦虑、抑郁情绪的影响[J].国际护理学杂志,2021,40(22):4101-4104. DOI:10.3760/cma.j.cn221370-20200329- 01154.

[2]韩辰燕,董昀,窦双婷,等.系统中医化疗保健操对食管癌患者化疗后消化道反应及生存质量的影[J].广西医学,2023,45(2):147-151. DOI:10.11675/j.issn.0253-4304. 2023.02.05.

[3]钱爱新,杨燕,刘江利.基于卡诺模型的人文关怀服务在食管癌化疗期间的应用[J].中国医药导报,2023,20(25):190-193. DOI:10.20047/j.issn1673-72102023.25.42.

[4]吴平,高杰萍,王彬.不同运动强度对食管癌患者同步放化疗期间营养状况和疲乏程度的影响[J].中国实用护理杂志,2022,38(11):849-856. DOI:10.3760/cma.j.cn211501- 20211008-02773.

[5]中国医师协会放射肿瘤治疗医师分会,中华医学会放射肿瘤治疗学分会,中国抗癌协会肿瘤放射治疗专业委员会.中国食管癌放射治疗指南(2019年版)[J].国际肿瘤学杂志,2019,46(7):385-398. DOI:10.3760/cma.j.issn.1673- 422X. 2019.07.001.

[6]张迪,崔胜宇,李玉华,等.抑郁-焦虑-压力量表中文版在临床医学本科生中应用的信效度评价[J].护理研究,2019,33(9):1494-1497. DOI:10.12102/j.issn.1009-6493.2019.09.008.

[7]刘东玮,任兴华,周郁秋,等.中文版心理弹性量表在精神分裂症患者中的信效度测量[J].中国实用护理杂志,2020,36(18):1366-1371. DOI:10.3760/cma.j.cn211501- 20190906-02540.

[8]王岩,朱琳,陈鹏.肿瘤患者生命质量测定量表EORTC QLQ-C30维文版评价[J].中国卫生统计,2015,32(3):512-513.

[9]郭颂莹.IMB模型为基础的护理干预对食管癌手术患者康复、自我效能及生活质量的影响[J].现代中西医结合杂志,2023,32(4):561-564. DOI:10.3969/j.issn.1008-8849. 2023.04.026.

[10]刘畅,钱瑾瑜,曾诗颖,等.本森放松训练对食管癌放化疗患者睡眠质量的影响[J].解放军护理杂志,2021,38(9):82-84. DOI:10.3969/j.issn.1008-9993.2021.09.021.

[11]张小燕,李红云,黎辰晨,等."互联网+"延续护理平台对食管癌患者生命质量的影响[J].川北医学院学报,2023,38(5):711-714. DOI:10.3969/j.issn.1005-3697.2023.05.032.

[12]丁莉莉,颜世娇.应用微信对食管癌放疗患者随访管理效果分析[J].实用预防医学,2021,28(3):361-364. DOI:10.3969/j.issn.1006-3110.2021.03.030.

[13]张令鸣,梁美,陈卫卫.基于IDEAS模式的术前护理在初次行ESD术早期食管癌患者中的应用[J].中华现代护理杂志,2024,30(28):3913-3916. DOI:10.3760/cma.j.cn115682-20231228-02850.

[14]王志存,卢谞华,王学然,等.PDCA循环延续性护理干预中晚期食管癌手术患者的价值[J].现代中西医结合杂志,2023,32(22):3173-3177. DOI:10.3969/j.issn.1008-8849. 2023.22.020.

[15]丁丽萍,程玉霞,张晓微,等.基于支持性照护理论食管癌患者术后延续护理方案的构建与应用[J].中国护理管理,2023,23(7):1059-1064. DOI:10.3969/j.issn.1672-1756. 2023.07.021.

[16]李亚琴,赵清丽,宋丽,等.医护一体化模式下早期行肠内外营养支持及护理干预对食管癌根治术患者营养状态的影响[J].中国药物与临床,2021,21(16):2902-2903. DOI:10.11655/zgywylc2021.16.060.

[17]吴含,成钰娜,居馨星,等.健康教育图文册的构建及在食管癌患者术后康复护理的应用[J].护理学杂志,2024,39(16):12-16. DOI:10.3870/j.issn.1001-4152.2024.16.012.

[18]杨华,吴慧娟,郭燕,等.全程健康管理模式在食管癌患者生活质量评估和预后改善中的应用研究[J].中国医学装备,2021,18(1):115-118. DOI:10.3969/J.ISSN.1672-8270. 2021.01.028.

[19]贾佳,楚晓飞,孙爱英,等.紫杉醇、顺铂同步放疗联合早期营养护理对食管癌根治术后患者免疫功能及营养状况的影响[J].贵州医药,2021,45(3):472-474. DOI:10.3969/j.issn.1000-744X.2021.03.070.

[20]陈静,王静.人文护理关怀对食管癌术后患者康复进程和睡眠质量的效果观察[J].贵州医药,2023,47(1):140-141. DOI:10.3969/j.issn.1000-744X.2023.01.078.

[21]朱真真,谷宁,李曼,等.基于穆泽尔模型的摄食相关症状群模式在食管癌放化疗中的应用价值[J].国际医药卫生导报,2022,28(10):1360-1363. DOI:10.3760/cma.j.issn.1007-1245.2022.10.007.

[22]宋洪娟,张晓静,郭亚斌.集束化护理干预对食管癌患者术后肺部感染的预防效果[J].保健医学研究与实践,2023,20(1):113-116. DOI:10.11986/j.issn.1673- 873X. 2023.01.027.

[23]Jiang Shuyin, Zhang Jingxiong. Effect of mental nursing intervention under magnetic resonance imaging on the postoperative outcome of stent the rapy in patients with esophageal cancer[J]. J. Med. Imaging Health Inform, 2021, 11(1):150-155. DOI: 10.1166/jmihi.2021.3439.

[24]周璐,张青,陈梅.ICU过渡性护理对食管癌术后康复及生活质量的影响研究[J].现代中西医结合杂志,2023,32(18):2614-2617. DOI:10.3969/j.issn.1008-8849.2023.18.027.

[25]戴玲玲,付悦,席从林.误吸风险评估下分级饮食护理对食管癌根治术后患者的应用效果研究[J].海军医学杂志,2023,44(10):1081-1085. DOI:10.3969/j.issn.1009-0754. 2023.10.021.

[26]郁俊,谈碧君.跨理论模型健康教育对食管癌术后患者自我效能及癌因性疲乏的影响[J].国际医药卫生导报,2020,26(2):263-266. DOI:10.3760/cma.j.issn.1007-1245. 2020.02.037.

[27]王霞,王巧,顾琼,等.院内规范性疼痛护理管理在食管癌患者中的应用及对患者负性情绪的改善效果研究[J].河北医药,2022,44(8):1278-1280. DOI:10.3969/j.issn.1002- 7386.2022.08.040.

[28]孟祥丽,杨莹,颜冉冉,等.系统护理在高龄食管癌根治术病人ICU转出期间的应用[J].湖南师范大学学报(医学版),2022,19(4):163-167. DOI:10.3969/j.issn.1673- 016X. 2022.04.044.

[29]邓雁,余琼,武福姣,等.基于自我效能理论的护理干预对食管癌根治术后患者的影响[J].中华护理杂志,2022,57(9):1042-1048. DOI:10.3761/j.issn.0254-1769.2022.09.003.

[30]黄笑笑,洪张翔,魏伟瑾.基于ERAS理念的全程综合优质护理对食管癌患者的心理状态及生活质量的影响[J].海南医学,2022,33(6):813-816. DOI:10.3969/j.issn.1003-6350. 2022.06.037.

[31]刘文静,赵紫凝,韩记真.食管癌患者术后应用规范化疼痛护理对于改善患者疼痛情况与负性情绪的效果研究[J].新疆医科大学学报,2021,44(9):1077-1080. DOI:10.3639/j.issn.1009-5551.2021.09.018.