Department of Hepatopancreatobiliary & Thyroid Breast, the first affiliated Hospital of Suchow University, Suzhou, Jiangsu, China.
Medicine (Baltimore). 2023 Aug 25;102(34):e34643. doi: 10.1097/MD.0000000000034643.
Interventional therapies including chemotherapies and radiotherapies are the most preferred treatment for liver cancer. However, these therapies have adverse effects. Therefore, careful care is required to relieve these adverse effects. The objectives of this study were to evaluate the quality of life, pain, anxiety, depression, adverse effects, and satisfaction of patients with liver cancer who received pre- and post-operative comprehensive nursing care against those of patients who received conventional nursing care. Patients with liver cancer who underwent surgeries and interventional therapies for liver cancer received pre- and post-operative comprehensive nursing care (CMN cohort, n = 105) or conventional nursing care (CNN cohort, n = 135), or did not receive any kind of nursing care (NNC cohort, n = 175). Before the non-treatment intervention(s) (BL), none of the patients had absent post-operative pain, all patients had mild or moderate anxiety and depression, and patients had ≤70 overall quality of life score. In the NNC cohort, a few of the patients reported being completely dissatisfied with overall personal satisfaction, and anxiety, depression, and overall the quality of life of patients were clinically worse during the follow-up period generally after completion of all doses of chemo radiotherapies (EL) as compared to BL. Hospital stays due to surgery, visual analog scale (VAS) score, Zung Self-rating Anxiety Scale score, the Self-rating Depression Scale score, and rehospitalization due to any reason(s) in follow-up were fewer and overall quality of life score and overall personal satisfaction score were higher for patients of the CMN cohort than those of patients at BL and those of patients of the CNN and the NNC cohorts at EL (P < .05 for all). Fever, bleeding, urinary retention, gastrointestinal disturbance, and hepatic and renal impairments reported in patients of the NNC cohort. Fever, bleeding, and urinary retention reported in patients of the CNN cohort (P < .05 for all). Nursing non-treatment intervention(s) is necessary for liver cancer patients after surgery, in the follow-up, and between 2 doses of chemoradiotherapies. Pre- and post-operative comprehensive nursing care relieves postoperative pain, psychological burden and improves quality of life in the follow-up period in patients who underwent surgeries and interventional therapies for liver cancer (Level of Evidence: IV; Technical Efficacy: Stage 5).
介入治疗包括化疗和放疗,是肝癌最常用的治疗方法。然而,这些疗法有不良反应。因此,需要谨慎护理以缓解这些不良反应。本研究的目的是评估接受术前和术后综合护理与接受常规护理的肝癌患者的生活质量、疼痛、焦虑、抑郁、不良反应和满意度。接受肝癌手术和介入治疗的肝癌患者接受术前和术后综合护理(CMN 队列,n = 105)或常规护理(CNN 队列,n = 135),或未接受任何护理(NNC 队列,n = 175)。在非治疗干预前(BL),没有患者术后没有疼痛,所有患者均有轻度或中度焦虑和抑郁,患者的整体生活质量评分为≤70 分。在 NNC 队列中,少数患者对整体个人满意度完全不满意,并且焦虑、抑郁和患者的整体生活质量在所有化疗放疗剂量完成后(EL)的随访期间通常比 BL 时更差。手术住院时间、视觉模拟量表(VAS)评分、Zung 自评焦虑量表评分、自评抑郁量表评分以及因任何原因(s)在随访中再次住院的患者较少,并且 CMN 队列患者的整体生活质量评分和整体个人满意度评分均高于 BL 时的患者,以及 EL 时 CNN 和 NNC 队列的患者(所有 P <.05)。NNC 队列的患者出现发热、出血、尿潴留、胃肠功能紊乱以及肝肾功能损害。CNN 队列的患者出现发热、出血和尿潴留(所有 P <.05)。肝癌患者在手术后、随访期间和化疗放疗之间需要护理非治疗干预。术前和术后综合护理可缓解肝癌手术和介入治疗患者术后疼痛、心理负担,并改善随访期间的生活质量(证据水平:IV;技术疗效:阶段 5)。