持续质量改进在老年癌痛患者管理中的应用

doi:10.3760/cma.j.cn441417-20250220-12030

国际医药卫生导报 ›› 2025, Vol. 31 ›› Issue (12): 2083-2088.DOI: 10.3760/cma.j.cn441417-20250220-12030

持续质量改进在老年癌痛患者管理中的应用

任传薇李会颖沈艳婷

南京大学医学院附属鼓楼医院干部保健中心，南京 210009

收稿日期:2025-02-20 出版日期:2025-06-15 发布日期:2025-06-17
通讯作者: 沈艳婷，Email：812821564@qq.com
基金资助:
国家自然科学基金委员会青年科学基金（82304567）；南京鼓楼医院护理科研立项（ZSA1515）；南京鼓楼医院护理科研立项（ZSA1415）；南京鼓楼医院护理科研立项（ZSA972-1）；南京鼓楼医院护理科研立项（2023-A1515）

Application of continuous quality improvement in the management of elderly patients with cancer pain

Ren Chuanwei, Li Huiying, Shen Yanting

Cadre Health Center,Nanjing Drum Tower Hospital to Nanjing University Medical School , Nanjing 201009, China

Received:2025-02-20 Online:2025-06-15 Published:2025-06-17
Contact: Shen Yanting, Email: 812821564@qq.com
Supported by:
Youth Science Foundation of National Natural Science Foundation(82304567); Nursing Research Project of Nanjing Drum Tower Hospital (ZSA1515); Nursing Research Project of Nanjing Drum Tower Hospital (ZSA1415); Nursing Research Project of Nanjing Drum Tower Hospital (ZSA972-1); Nursing Research Project of Nanjing Drum Tower Hospital (2023-A1515)

摘要/Abstract

摘要：

目的　以疼痛护理质量评价指标监测结果为切入点，组织开展基于监测结果的疼痛护理质量持续改进，提升老年癌痛患者的护理质量。方法　采用自身前后对照方法，选取95例南京大学医学院附属鼓楼医院干部保健中心收治的老年癌痛患者作为研究对象。按照护理干预方式分为对照组和观察组，对照组采取常规护理，观察组在常规护理的基础上实施持续质量改进的癌痛护理方案。对照组男、女例数分别为20例、10例；年龄62~83（72.45±5.18）岁；文化程度小学及以下10例，中学18例，大专及以上2例；癌症Ⅰ期8例，Ⅱ期8例，Ⅲ期10例，Ⅳ期4例。观察组男、女例数分别为42例、23例；年龄61~85（73.58±6.37）岁；文化程度小学及以下15例，中学38例，大专及以上12例；癌症Ⅰ期14例，Ⅱ期19例，Ⅲ期22例，Ⅳ期10例。参与本研究的20名女性护士5人（8.5%）具有大专学历，15人（25.4%）具有本科学历。干预时间为2个月。比较两组患者疼痛护理质量评价指标的达标率（包括疼痛评估频次完成率、健康教育知晓率、用药规范率等），以及持续质量改进措施的应用效果。采用t检验、χ²检验进行统计学分析。结果　观察组患者对疼痛管理的满意度较对照组明显提高［92.31%（60/65）比77.42%（24/31）］（χ²=4.25，P=0.045）；疼痛评估频次完成率、健康教育知晓率及多瑞吉贴剂使用规范率均较对照组明显升高，差异均有统计学意义（均P<0.05）。干预前后入院时疼痛评估覆盖率、疼痛评估工具选择正确率等差异无统计学意义（均P>0.05）。结论　构建疼痛护理质量评价指标并对老年癌痛护理进行持续质量改进，有利于提高老年癌痛护理质量，提升患者的满意度。

关键词: 肿瘤, 老年人, 护理质量评价指标, 质量改进, 疼痛管理

Abstract:

Objective Taking the monitoring results of the evaluation indicators of pain care quality as the entry point, organize and carry out the continuous improvement of pain care quality based on the monitoring results to enhance the care quality of elderly cancer pain patients. Methods By using the self-before-and-after control method, 95 elderly patients with cancer pain admitted to Cadre Health Care Center ,Drum Tower Hospital Affiliated to Nanjing University Medical School were selected as the research subjects. According to the nursing intervention methods, they were divided into a control group and an observation group. The control group received conventional nursing, while the observation group implemented a cancer pain nursing plan with continuous quality improvement on the basis of conventional nursing. The number of male and female cases in the control group were 20 and 10, respectively,aged 62~83 (72.45±5.18) years; there were 10 cases with educational attainment of primary school or below, 18 cases of middle school, and 2 cases of college or above. There were 8 cases of stage I cancer, 8 cases of stage Ⅱ cancer, 10 cases of stage Ⅲ cancer and 4 cases of stage Ⅳ cancer. The number of male and female cases in the observation group were 42 and 23 respectively,aged 61~85 (73.58±6.37) years; there were 15 cases with educational attainment of primary school or below, 38 cases of middle school, and 12 cases of college or above. There were 14 cases of stage Ⅰcancer, 19 cases of stage Ⅱ cancer, 22 cases of stage Ⅲ cancer and, 10 cases of stage Ⅳ cancer. Among the 20 female nurses participating in this study, 5 (8.5%) had a junior college degree and 15 (25.4%) had a bachelor's degree. The intervention period was two months. The compliance rates of pain care quality evaluation indicators (including the completion rate of pain assessment frequency, the awareness rate of health education, the standardized medication rate, etc.) of the two groups were compared, as well as the application effects of continuous quality improvement measures. Statistical analysis was performed using t-tests and χ² tests.Results The satisfaction with pain management in the observation group was significantly higher than that in the control group [92.31% (60/65) vs. 77.42% (24/31)] (χ²=4.25, P=0.045). The completion rate of pain assessment frequency, the awareness rate of health education, and the standardized use rate of Doraji patches were all significantly higher than those in the control group, and the differences were statistically significant (all P<0.05). There were no statistically significant differences in the coverage rate of pain assessment at admission and the correct rate of pain assessment tool selection before and after the intervention (all P>0.05).Conclusion Constructing the evaluation indicators of pain care quality and conducting continuous quality improvement of elderly cancer pain care is conducive to improving the quality of elderly cancer pain care and enhancing patients' satisfaction.

Key words: Tumor, The elderly, Nursing quality evaluation indicators, Quality improvement, Management of pain

任传薇李会颖沈艳婷. 持续质量改进在老年癌痛患者管理中的应用 [J]. 国际医药卫生导报, 2025, 31(12): 2083-2088.

Ren Chuanwei, Li Huiying, Shen Yanting.

Application of continuous quality improvement in the management of elderly patients with cancer pain [J]. International Medicine and Health Guidance News, 2025, 31(12): 2083-2088.

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持续质量改进在老年癌痛患者管理中的应用

Application of continuous quality improvement in the management of elderly patients with cancer pain

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