Yenjai Nawiya, Asdornwised Usavadee, Wongkongkam Kessiri, Pinjaroen Nutcha
Master of Nursing Science Program in Adult and Gerontological Nursing, Faculty of Nursing, Mahidol University, Bangkok, Thailand.
Faculty of Nursing, Mahidol University, Bangkok, Thailand.
Belitung Nurs J. 2022 Aug 18;8(4):287-295. doi: 10.33546/bnj.2140. eCollection 2022.
Post transarterial chemoembolization (post-TACE) causes side effects that impact patients, which leads to fatigue symptoms and reduced functional status. However, unrelieved fatigue and reduced functional status may cause patients to withdraw from treatment and negatively affect their lives. Unfortunately, the patients post-TACE only receive routine medical care at the hospital but no follow-up and continuity of care back home. Therefore, comprehensive discharge planning for these problems is necessary.
This study examined the effectiveness of the comprehensive discharge planning program on fatigue and functional status of patients with hepatocellular carcinoma undergoing transarterial chemoembolization.
A randomized clinical controlled trial was used. Fifty-two patients who met the study criteria were randomly assigned to an experimental group ( = 26) receiving the comprehensive discharge planning plus routine care and a control group ( = 26) receiving routine care only. The discharge planning program was developed based on the Transitional Care Model. A demographic and health data questionnaire, Fatigue Severity Scale (FSS), and Enforced Social Dependency Scale (ESDS) were used for data collection. Chi-square, Fisher's exact, Wilcoxon signed-rank, and Mann-Whitney U tests were used for data analysis.
The mean scores for fatigue at 30 days after treatment between the experimental and control groups were significantly different ( = 0.003). The mean scores for the fatigue symptoms in the experimental and control groups were 1.27 ± 0.58 and 1.77 ± 0.85, respectively. The functional status from Day 7 to Day 14 after transarterial chemoembolization was different ( = 0.020). In addition, the mean scores for functional status between the experimental and control groups were significantly different ( = 0.020). On Day 14, after transarterial chemoembolization, the experimental group had an increased score in functional status from Day 7 over the scores for those in the control group.
The comprehensive discharge planning program effectively reduces fatigue symptoms and enhances the functional status in patients with hepatocellular carcinoma undergoing transarterial chemoembolization. Therefore, the comprehensive discharge planning program can be used by nurses and multidisciplinary teams in order to achieve the effectiveness of nursing care for patients.
经动脉化疗栓塞术（TACE）后会产生影响患者的副作用，导致疲劳症状和功能状态下降。然而，疲劳未缓解和功能状态降低可能会使患者停止治疗，并对其生活产生负面影响。不幸的是，TACE术后患者在医院仅接受常规医疗护理，回家后却没有后续跟进和持续护理。因此，针对这些问题进行全面的出院计划很有必要。
本研究探讨了全面出院计划方案对接受经动脉化疗栓塞术的肝细胞癌患者疲劳和功能状态的影响。
采用随机临床对照试验。将52例符合研究标准的患者随机分为实验组（n = 26），接受全面出院计划加常规护理；对照组（n = 26），仅接受常规护理。出院计划方案基于过渡护理模式制定。使用人口统计学和健康数据问卷、疲劳严重程度量表（FSS）和强制社会依赖量表（ESDS）进行数据收集。采用卡方检验、Fisher精确检验、Wilcoxon符号秩检验和Mann-Whitney U检验进行数据分析。
实验组和对照组治疗后30天的疲劳平均得分有显著差异（P = 0.003）。实验组和对照组的疲劳症状平均得分分别为1.27±0.58和1.77±0.85。经动脉化疗栓塞术后第7天至第14天的功能状态有所不同（P = 0.020）。此外，实验组和对照组的功能状态平均得分有显著差异（P = 0.020）。经动脉化疗栓塞术后第14天，实验组的功能状态得分相比第7天有所增加，高于对照组。
全面出院计划方案可有效减轻接受经动脉化疗栓塞术的肝细胞癌患者的疲劳症状，并提高其功能状态。因此，护士和多学科团队可采用全面出院计划方案，以实现对患者的护理效果。
