赋能理论指导下的自我护理管理在晚期肺癌癌痛患者中的应用

doi:10.3760/cma.j.cn441417-20241216-13030

摘要/Abstract

摘要：

目的　探讨赋能理论指导下的自我护理管理在晚期肺癌癌痛患者中的应用效果。方法　选取2022年5月至2024年5月驻马店市中心医院收治的晚期肺癌癌痛患者78例进行前瞻性研究，按随机数字表法分为两组，每组39例。对照组男25例，女14例；年龄53～76（64.59±3.21）岁；体重指数18.2～25.7（21.95±1.01）kg/m²；肿瘤分期：Ⅲ期22例，Ⅳ期17例。观察组男26例，女13例；年龄54～77（64.62±3.26）岁；体重指数18.3～25.8（21.96±1.04）kg/m²；肿瘤分期：Ⅲ期23例，Ⅳ期16例。对照组采取常规护理，观察组采取赋能理论指导下的自我护理管理，两组均持续护理观察30 d。比较两组心境状态、疼痛、癌因性乏力、自我管理能力。采用独立样本t检验、配对t检验、χ²检验进行统计学分析。结果　护理后，观察组简明心境问卷（POMS-SF）中紧张-焦虑、愤怒-敌意、疲乏-迟钝、迷惑-混乱、抑郁-沮丧维度评分分别为（9.53±1.07）分、（12.82±1.64）分、（7.35±1.04）分、（8.38±1.08）分、（8.38±1.28）分，均低于对照组的（14.71±1.19）分、（17.63±1.94）分、（11.89±1.17）分、（12.92±1.14）分、（12.43±1.67）分，精力-活力、与自我有关的情绪维度评分分别为（18.98±1.94）分、（15.95±1.42）分，均高于对照组的（13.83±1.81）分、（13.73±1.35）分（t=20.214、11.825、18.112、18.055、12.020、12.122、7.076，均P<0.05）；护理后，观察组视觉模拟评分法（VAS）、癌症疲乏量表（CFS）评分分别为（4.03±0.57）分、（29.06±2.12）分，均低于对照组的（5.49±1.12）分、（35.53±2.18）分（t=7.255、13.287，均P<0.05）；护理后，观察组自我护理能力测定量表（ESCA）中自我护理技能、自我概念、健康知识水平、自我责任感评分分别为（32.51±2.29）分、（23.71±1.84）分、（48.83±2.81）分、（16.86±1.47）分，均高于对照组的（26.43±2.17）分、（19.85±1.73）分、（35.76±2.44）分、（13.39±1.42）分（t=12.035、9.545、21.933、10.603，均P<0.05）。结论　赋能理论指导下的自我护理管理可有效调节晚期肺癌癌痛患者心境状态，减轻生理疼痛，降低癌因性乏力程度，有助于患者更好地管理疾病。

关键词: 晚期肺癌, 癌痛, 赋能理论, 自我护理管理, 心境状态, 癌因性乏力

Abstract:

Objective　To explore the effect of self-care management guided by the empowerment theory in patients with advanced lung cancer pain. Methods　A total of 78 patients with advanced lung cancer pain admitted to Zhumadian Central Hospital from May 2022 to May 2024 were selected for a prospective study, and were divided into two groups according to the random number table method, with 39 cases each group. In the control group, there were 25 males and 14 females, aged 53-76 (64.59±3.21) years, with a body mass index of 18.2-25.7 (21.95±1.01) kg/m², 22 cases in stage Ⅲ and 17 cases in stage Ⅳ. In the observation group, there were 26 males and 13 females, aged 54-77 (64.62±3.26) years, with a body mass index of 18.3-25.8 (21.96±1.04) kg/m², 23 cases in stage Ⅲ and 16 cases in stage Ⅳ. The control group received routine care, while the observation group received self-care management guided by the empowerment theory. Both groups were continuously cared and observed for 30 days. The mood states, pain, cancer-related fatigue, and self-management abilities of the two groups were compared. Statistical analysis was performed using independent sample t-test, paired t-test, and χ² test. Results　After nursing, the scores of tension-anxiety, anger-hostility, wearing-lethality, disorient-confusion, and depression-dejection of the Profile of Mood States (PMS-SF) in the observation group were (9.53±1.07) points, (12.82±1.64) points, (7.35±1.04) points, (8.38±1.08) points, and (8.38±1.28) points, which were lower than those in the control group [(14.71±1.19) points, (17.63±1.94) points, (11.89±1.17) points, (12.92±1.14) points, and (12.43±1.67) points]; the scores of energy-vitality and self-related emotions were (18.98±1.94) points and (15.95±1.42) points, which were higher than those in the control group [(13.83±1.81) points and (13.73±1.35) points] (t=20.214, 11.825, 18.112, 18.055, 12.020, 12.122, and 7.076; all P<0.05). After nursing, the scores of Visual Analogue Scale (VAS) and Cancer Fatigue Scale (CFS) in the observation group were (4.03±0.57) points and (29.06±2.12) points, which were lower than those in the control group [(5.49±1.12) points and (35.53±2.18) points] (t=7.255 and 13.287, both P<0.05). After nursing, the scores of self-care skills, self-concept, health knowledge level, and self-responsibility of the Exercise of Self-Care Agency Scale (ESCA) in the observation group were (32.51±2.29) points, (23.71±1.84) points, (48.83±2.81) points, and (16.86±1.47) points, which were higher than those in the control group [(26.43±2.17) points, (19.85±1.73) points, (35.76±2.44) points, and (13.39±1.42) points] (t=12.035, 9.545, 21.933, and 10.603, all P<0.05). Conclusion　Self-care management guided by the empowerment theory can effectively regulate the mood state in patients with advanced lung cancer pain, alleviate the physiological pain, reduce the degree of cancer-related fatigue, and help patients better manage the disease.

Key words: Advanced lung cancer, , Cancer pain, , Empowerment theory, , Self-care management, , Mood state, , Cancer-related fatigue

郭玉霞王艳慧.

赋能理论指导下的自我护理管理在晚期肺癌癌痛患者中的应用 [J]. 国际医药卫生导报, 2025, 31(13): 2260-2264.

Guo Yuxia, Wang Yanhui.

Application of self-care management guided by the empowerment theory in patients with advanced lung cancer pain [J]. International Medicine and Health Guidance News, 2025, 31(13): 2260-2264.

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