Yu Zhu, Jia Wen, Sun Xiangmei, Zhang Shuai, Tan Jing, Feng Lili
Altern Ther Health Med. 2023 Jan;29(1):118-123.
Surgery for early-stage lung carcinoma (LC) is invasive and most patients will experience psychological disorders, such as depression and anxiety. Accumulating evidence has shown that a nursing intervention can exert significant improvements in clinical efficacy for perioperative patients.
The study intended to investigate the clinical value during the perioperative period of a nursing service based on Roy's Adaptation Model (RAM), for patients undergoing radical resection for early-stage LC, to provide accurate guidance and reference for a future clinical nursing intervention for LC patients.
The research team designed a retrospective analysis, controlled study.
The study took place at Jiangsu Cancer Hospital in Nanjing, Jiangsu, China.
Participants were 69 patients with early-stage LC who had been admitted to the hospital between March 2018 and March 2020.
The research team assigned participants to an intervention or a control group, with 42 participants in the intervention group receiving RAM nursing during hospitalization, and 27 participants in the control group receiving routine nursing care.
The study measured the alterations in pulmonary function (PF) pre- and postoperatively and assessed the incidence of complications postintervention. At baseline and postintervention, the research team also assessed participants' psychological states using the Self-rating Anxiety Scale (SAS) and the Self-rating Depression Scale (SDS) and their pain levels using a visual analogue scale (VAS). Postintervention, participants competed a nursing satisfaction survey. At baseline and postintervention, the participants completed the Karnofsky Performance Status (KPS) scale for functional status, the Self-Perceived Burden Scale in Cancer Patients (SPBS-CP), the Pittsburgh Sleep Quality Index (PSQI) for sleep quality, and the WHO-QOL-BREF questionnaire.
Postoperatively, the PF indexes had decreased significantly for both groups, but the intervention group's value were significantly higher postoperatively than those in the control group (P < .05). No differences existed in the incidence of adverse reactions between the groups (P > .05). The intervention group had significantly lower SAS and SDS scores, pain scores, and SPBS-CP scores than the control group postintervention but had significantly higher KPS scores (all P < .05). The intervention group significantly higher nursing satisfaction, sleep quality, and quality of life than the control group did (P < .05).
RAM nursing can significantly protect the PF of patients with early-stage LC who are undergoing a radical resection and can effectively improve patients' psychological states, sleep quality, and nursing satisfaction, which makes it worthy of clinical reference and popularization.
早期肺癌（LC）手术具有侵入性，大多数患者会出现心理障碍，如抑郁和焦虑。越来越多的证据表明，护理干预可以显著提高围手术期患者的临床疗效。
本研究旨在探讨基于罗伊适应模式（RAM）的护理服务在早期LC根治性切除患者围手术期的临床价值，为未来LC患者的临床护理干预提供准确的指导和参考。
研究团队设计了一项回顾性分析对照研究。
研究在中国江苏省南京市的江苏省肿瘤医院进行。
参与者为2018年3月至2020年3月期间入院的69例早期LC患者。
研究团队将参与者分为干预组和对照组，干预组42例参与者在住院期间接受RAM护理，对照组27例参与者接受常规护理。
本研究测量了术前和术后肺功能（PF）的变化，并评估了干预后并发症的发生率。在基线和干预后，研究团队还使用自评焦虑量表（SAS）和自评抑郁量表（SDS）评估参与者的心理状态，使用视觉模拟量表（VAS）评估他们的疼痛程度。干预后，参与者完成了护理满意度调查。在基线和干预后，参与者完成了卡氏功能状态量表（KPS）以评估功能状态、癌症患者自我感知负担量表（SPBS-CP）、匹兹堡睡眠质量指数（PSQI）以评估睡眠质量，以及世界卫生组织生活质量简表（WHO-QOL-BREF）。
术后，两组的PF指标均显著下降，但干预组术后的值显著高于对照组（P < 0.05）。两组之间不良反应的发生率没有差异（P > 0.05）。干预组干预后的SAS和SDS评分、疼痛评分和SPBS-CP评分均显著低于对照组，但KPS评分显著更高（所有P < 0.05）。干预组的护理满意度、睡眠质量和生活质量均显著高于对照组（P < 0.05）。
RAM护理可以显著保护接受根治性切除的早期LC患者的PF，并能有效改善患者的心理状态、睡眠质量和护理满意度，值得临床参考和推广。
