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一种基于移动健康的鼻咽癌出院患者健康结局评估护理模式:一项随机对照试验的初步研究

A mHealth-based nursing model for assessing the health outcomes of the discharged patients with nasopharyngeal carcinoma: a pilot RCT.

作者信息

Liao Tingting, Qiu Liyan, Zhu Jingwen, Li Jiayan, Zhang Yanxin, Yang Li

机构信息

Department of Nursing, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi, China.

出版信息

BMC Nurs. 2022 Aug 1;21(1):210. doi: 10.1186/s12912-022-00993-0.

Abstract

BACKGROUND

Nasopharyngeal carcinoma (NPC) is one of the most common head and neck malignancies, having a high incidence in Guangxi, China. Although chemoradiotherapy offers more effective cancer treatment, it also causes a variety of acute and chronic side effects, seriously affecting the quality of life. NPC has evolved into a chronic disease with most patients opting for home-based rehabilitation. Therefore, efforts on improving the home-based extended care services to improve the quality of life of patients are booming. The Chinese government encourages the use of internet technology for expanding the prospect of nursing. This study aimed to evaluate the impact of a mHealth-based care model on the health outcomes of discharged patients with nasopharyngeal carcinoma.

METHODS

An experimental design was applied for this study. The study enrolled 116 discharged patients who were re-examined in the Radiotherapy Department of the First Affiliated Hospital of Guangxi Medical University from November 2019 to February 2020. These patients were randomized into control and intervention groups (n = 58 per group), but during the implementation of the project, there was one dropout in the control group due to the loss of follow-up, and one dropout in the intervention group due to distant metastasis. In the end, 57 patients in the control and intervention groups completed the trial. The control group was subjected to routine discharge guidance and follow-up, while the experimental group was implemented with a mobile health (mHealth)-based continuous nursing intervention model. The scores of the side effects, cancer fatigue, and quality of life were compared between the two groups of patients for 3, 6, and 12 months, respectively after discharge from the hospital.

RESULTS

This study included 114 patients and there were no significant differences in the baseline data between the two groups. After 6 and 12 months of intervention, the severity of radiation toxicity and side effects, the scores of cancer-related fatigue, and quality of life (symptom field) of the patients in the interventional group were significantly lowered statistically compared to those in the control group.

CONCLUSION

This study is based on the mHealth continuous nursing intervention model, which can reduce the side effects of radiotherapy and cancer fatigue, and improve the quality of life.

TRIAL REGISTRATION

This study was retrospectively registered as a randomized controlled trial in the Chinese Clinical Trial Center. Registration Date: January 12, 2021, Registration Number: ChiCTR2100042027.

摘要

背景

鼻咽癌是最常见的头颈部恶性肿瘤之一,在中国广西发病率很高。尽管放化疗能更有效地治疗癌症,但也会引发各种急慢性副作用,严重影响生活质量。鼻咽癌已演变成一种慢性病,大多数患者选择居家康复。因此,改善居家延续性护理服务以提高患者生活质量的工作正在蓬勃开展。中国政府鼓励利用互联网技术拓展护理前景。本研究旨在评估基于移动健康(mHealth)的护理模式对鼻咽癌出院患者健康结局的影响。

方法

本研究采用实验设计。研究纳入了2019年11月至2020年2月在广西医科大学第一附属医院放疗科复诊的116例出院患者。这些患者被随机分为对照组和干预组(每组n = 58),但在项目实施过程中,对照组有1例因失访退出,干预组有1例因远处转移退出。最终,对照组和干预组各有57例患者完成试验。对照组接受常规出院指导和随访,而试验组实施基于移动健康(mHealth)的延续性护理干预模式。分别比较两组患者出院后3个月、6个月和12个月时的副作用、癌因性疲乏及生活质量评分。

结果

本研究共纳入114例患者,两组基线数据无显著差异。干预6个月和12个月后,与对照组相比,干预组患者的放射性毒性和副作用严重程度、癌因性疲乏评分及生活质量(症状领域)在统计学上均显著降低。

结论

本研究基于移动健康延续性护理干预模式,可降低放疗副作用和癌因性疲乏,提高生活质量。

试验注册

本研究在中国临床试验中心进行回顾性注册为随机对照试验。注册日期:2021年1月12日,注册号:ChiCTR2100042027。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0f8b/9344690/7b307b08532e/12912_2022_993_Fig1_HTML.jpg

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