个案管理师在鼻咽癌患者全病程个案管理中的临床实践效果

doi:10.3760/cma.j.issn.1007-1245.2022.01.034

摘要/Abstract

摘要： 目的　探讨个案管理师在鼻咽癌患者全病程个案管理中的临床实践效果。方法　选择佛山市第一人民医院2018年1月至2019年12月初次病理确诊的鼻咽癌患者1 019例，男661例，女358例，年龄（48.22±12.1）岁，随机数字表法分为试验组510例和对照组509例。试验组予常规整体护理模式，同时结合个案管理模式，在患者确诊期、治疗期、随访期由专业的个案管理师介入，为患者提供全程全方位的连续性照护。对照组在住院期间予常规护理模式：患者入院时行入院评估，住院期间责任护士每天按医嘱提供疾病相关的治疗及护理，出院前进行出院健康教育等。观察指标：留治率、出院后半年复查率、随访率、患者住院满意度、治疗中断率。计数资料采用χ²检验。结果　试验组留治率、出院后半年复查率、随访率、患者住院满意度、治疗中断率分别为80%（408/510）、98%（400/408）、95%（388/408）、100%（200/200）、2%（8/408），对照组分别为68%（346/509）、92%（318/346）、80%（277/346）、95%（190/200）、8%（28/346），差异均有统计学意义（均P＜0.05）。结论　应用个案管理模式，个案管理师为患者提供全病程连续性照护，可提高患者及时正确就诊率、留治率、复查率、随访率，降低治疗中断率，提高患者依从性及疾病相关知识知晓率、患者满意度。

关键词: 个案管理师, 鼻咽癌, 常规护理模式, 全病程个案管理, 临床实践效果

Abstract: Objective　To explore the clinical practice effect of case managers in the whole course medical management of patients with nasopharyngeal carcinoma. Methods　From January 2018 to December 2019, 1 019 patients with nasopharyngeal carcinoma confirmed by the pathological diagnosis the first time who were treated at Foshan First People's Hospital were selected, including 661 males and 358 females. They were (48.22±12.1) years old. They were divided into an experimental group (510 cases) and a control group (509 cases) by the random number table method. The experimental group took the routine holistic nursing mode and case management mode; the professional case managers provided continuous care and full-time and all-round service for the patients in the diagnosis, treatment, and follow-up stages. The control group took the routine nursing mode during the period of hospitalization; the patients were evaluated at admission; the nurses in charge provided disease-related treatment and nursing according to the medical advices every day during hospitalization; the patients took health education before discharge; etc. The rate staying for treatment, reexamination rate half year after discharge, patient satisfaction with hospitalization, and rate of treatment interruption were the observation indicators. The enumeration data were compared between these two groups by χ² test. Results　The rate staying for treatment, reexamination rate half year after discharge, patient satisfaction with hospitalization, and rate of treatment interruption were 80% (408/510), 98% (400/408), 95% (388/408), 100% (200/200), and 2% (8/408) in the experimental group, and were 68% (346/509), 92% (318/346), 80% (277/346), 95% (190/200), and 8% (28/346) in the control group, with statistical differences (all P<0.05). Conclusion　The whole course continuous care provided by case managers for patients can improve their timely and correct diagnosis rate, retention rate, reexamination rate, follow-up rate, patient compliance, disease-related knowledge rate, and patient satisfaction, and reduce the rate of treatment interruption.

Key words: Case managers, Nasopharyngeal carcinoma, Routine nursing mode, Whole course medical management, Clinical practice effect

陈春兰, 李素霞. 个案管理师在鼻咽癌患者全病程个案管理中的临床实践效果[J]. 国际医药卫生导报, 2022, 28(1): 131-136.

Chen Chunlan, Li Suxia. Clinical practice effect of case managers in whole course medical management of nasopharyngeal carcinoma patients[J]. International Medicine and Health Guidance News, 2022, 28(1): 131-136.

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