“医院-社区-家庭”三元联动癌痛医养结合模式的构建及实施

doi:10.3760/cma.j.issn.1007-1245.2022.11.013

摘要/Abstract

摘要： 目的　构建“医院-社区-家庭”三元联动癌痛医养结合模式，探讨其对癌痛患者的应用效果。方法　本研究为随机对照试验。选取2020年12月至2021年10月广东省中医院肿瘤科收治的126例癌痛患者作为研究对象，随机分为对照组（63例）及观察组（63例）。研究过程脱落6例，共有120例完成随访，每组60例。对照组男38例、女22例，年龄（58.50±9.73）岁；观察组男39例、女21例，年龄（55.52±11.22）岁。对照组实施常规护理，观察组实施“医院-社区-家庭”三元联动癌痛医养结合模式。比较两组患者的结局指标，包括疼痛程度［疼痛评估表（NRS）］、疼痛知识知晓情况（癌症患者疼痛调查表）和负性情绪［焦虑自评量表（SAS）、抑郁自评量表（SDS）］。统计学方法采用独立样本t检验、χ²检验。结果　出院后2周，观察组患者的疼痛知识知晓率［（76.00±11.23）%比（58.00±12.32）%］、按量用药［98.3%（59/60）比86.7%（52/60）］、观察及处理不良反应［90.0%（54/60）比11.7%（7/60）］、疼痛自评［70.0%（42/60）比26.7%（16/60）］、按计划复诊［91.7%（55/60）比73.3%（44/60）］均高于对照组，两组比较差异均有统计学意义（均P<0.05）；观察组患者的爆发痛发生率［5.0%（3/60）比18.2%（11/60）］、疼痛评分［0.87（1.00）分比1.45（1.00）分］、焦虑评分［（41.98±8.59）分比（45.02±6.92）分］及抑郁评分［（52.83±11.00）分比（57.46±9.14）分］均低于对照组（均P<0.05）。结论　“医院-社区-家庭”三元联动癌痛医养结合模式在癌痛患者中的应用具有良好效果，促进患者对癌痛知识的正确掌握，提高遵医行为，缓解不良情绪，改善癌痛结局。

关键词: “医院-社区-家庭”三元联动, 医养结合, 模式构建, 癌痛

Abstract: Objective　To construct the "hospital-community-family" linkage model of medical care and health for cancer pain, and to explore its application effect for cancer pain patients. Methods　This study was a randomized control trial. A total of 126 cancer pain patients who were admitted to Department of Oncology, Guangdong Provincial Hospital of Chinese Medicine from October 2020 to August 2021 were selected. They were randomly divided into a control group and an observation group, with 63 cases in each group. There were 38 males and 22 females in the control group, and they were (58.50±9.73) years old. There were 39 males and 21 females in the observation group, and they were (55.52±11.22) years old. The control group received routine care, and the observation group received continuous nursing based on "hospital-community-family" linkage model of medical care and health for cancer pain. The pain levels [Numerical Rating Scale (NRS)], awareness of pain knowledge (Pain Questionnaire for Cancer Patients), and negative emotions [Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS)] were compared between the two groups. The independent-sample t test and χ² test were applied. Results　After the intervention, the awareness rate of pain knowledge, the medical compliance behavior taking medication according to the amount, the observation and handling of adverse reactions, pain self-assessment, and planned follow-up visits in the observation group were higher than those in the control group [(76.00±11.23)% vs. (58.00±12.32)%, 98.3% (59/60) vs. 86.7% (52/60), 90.0% (54/60) vs. 11.7% (7/60), 70.0% (42/60) vs. 26.7% (16/60), and 91.7% (55/60) vs. 73.3% (44/60)], with statistical differences (all P<0.05). The incidence of burst pain, pain score, anxiety score, and depression score in the observation group were lower than those in the control group [5.0% (3/60) vs. 18.2% (11/60), 0.87 (1.00) vs. 1.45 (1.00), (41.98±8.59) vs. (45.02±6.92), and (52.83±11.00) vs. (57.46±9.14); all P<0.05]. Conclusion　The "hospital-community-family" linkage model of medical care and health for cancer pain can effectively improve the patients' knowledge of cancer pain, compliance behaviors, and cancer pain outcomes, and relieve their adverse emotions.

Key words: , "Hospital-community-family" linkage, Combination of medical care and health, Model construction, Cancer pain

蔡姣芝, 肖舒静, 杨敏菲, 李娟. “医院-社区-家庭”三元联动癌痛医养结合模式的构建及实施[J]. 国际医药卫生导报, 2022, 28(11): 1533-1538.

Cai Jiaozhi, Xiao Shujing, Yang Minfei, Li Juan. Construction and implementation of "hospital-community-family" linkage model of medical care and health for cancer pain [J]. International Medicine and Health Guidance News, 2022, 28(11): 1533-1538.

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