Effect of a multidisciplinary collaborative nursing model in managing skin compliations related to implantable venous access ports during chemotherapy in cancer patients
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摘要:目的
探讨多学科协作护理模式在肿瘤患者化疗期间输液港皮肤并发症管理中的应用效果。
方法选取在首都医科大学附属北京友谊医院接受化疗的恶性肿瘤患者120例，分为干预组和对照组，每组60例，对照组实施输液港标准护理方案，干预组在标准护理基础上实施为期6个月的多学科协作护理方案。比较2组患者输液港使用率、感染发生率、心理状态及希望水平评分。
结果干预组管路使用率100.0%, 显著高于对照组的66.6%, 感染发生率为0%, 显著低于对照组的20.4%;干预组干预后焦虑自评量表(SAS)评分(31.63±4.79)分，抑郁自评量表(SDS)评分(40.40±7.32)分，均显著低于对照组的(35.14±6.21)分和(44.58±6.48)分，干预组在希望水平方面的积极行动维度(12.25±1.48)分、亲密关系维度(12.73±1.49)分及总分(37.08±3.63)分均显著优于对照组的(11.36±0.88)分、(12.08±1.51)分和(35.52±3.39)分。
结论多学科协作护理模式能显著提高输液港管路使用率，降低感染发生率，改善患者心理状态，提升希望水平。
Abstract:ObjectiveTo explore effect of multidisciplinary collaborative nursing model in managing skin complications related to implantable venous access ports (IVAPs) during chemotherapy in cancer patients.
MethodsA total of 120 patients with malignant tumors receiving chemotherapy at Beijing Friendship Hospital Affiliated to Capital Medical University, were selected and divided into intervention group and control group, with 60 patients in each group. The control group received the standard nursing care for IVAPs, while the intervention group received a 6-month multidisciplinary collaborative nursing intervention in addition to the standard care. The IVAPs utilization rate, infection rate, psychological status, and hope level scores were compared between the two groups.
ResultsThe IVAP utilization rate was significantly higher in the intervention group (100.0%) than in the control group (66.6%). The infection rate was significantly lower in the intervention group (0%) than in the control group (20.4%). After the intervention, the scores of Self-Rating Anxiety Scale (SAS) [(31.63±4.79)] and the Self-Rating Depression Scale (SDS) [(40.40±7.32)] were significantly lower in the intervention group than in the control group [(35.14±6.21) and (44.58±6.48), respectively]. The intervention group also scored significantly higher on the positive action dimension [(12.25±1.48)], the intimate relationship dimension [(12.73±1.49)], and the total score [(37.08±3.63)] of the hope level scale compared to the control group [(11.36±0.88), (12.08±1.51), and (35.52±3.39), respectively].
ConclusionThe multidisciplinary collaborative nursing model can significantly increase the utilization rate of IVAPs, reduce the infection rate, improve patients' psychological status, and enhance their hope level.
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表 1 2组心理状态评分比较(Mean±SD)
分 组别 n 时点 SAS评分 SDS评分 对照组 54 干预前 41.96±7.28 50.87±8.16 干预后 35.14±6.21* 44.58±6.48* 干预组 56 干预前 42.25±7.14 51.32±8.43 干预后 31.63±4.79*# 40.40±7.32*# SAS: 焦虑自评量表; SDS: 抑郁自评量表。
与干预前比较, * P < 0.05; 与对照组比较, #P < 0.05。
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表 2 2组患者Herth希望量表评分比较(Mean±SD)
分 组别 n 人生态度 积极行动 亲密关系 总分 对照组 54 12.08±1.38 11.36±0.88 12.08±1.51 35.52±3.39 干预组 56 12.10±1.37 12.25±1.48* 12.73±1.49* 37.08±3.63* 与对照组比较, * P < 0.05。
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