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结肠癌后的整体状况:一项关于系统整体护理初级保健的随机对照试验。

Holistic conditions after colon cancer: A randomized controlled trial of systematic holistic care primary care.

作者信息

Wang Jing, Qiao Jian-Hong

机构信息

Department of General Surgery, Sunshine Union Hospital, Weifang 261205, Shandong Province, China.

Department of Clinic, The First Affiliated Hospital of Shandong First Medical University (Shandong Provincial Qianfoshan Hospital), Jinan 250014, Shandong Province, China.

出版信息

World J Gastrointest Surg. 2023 Dec 27;15(12):2844-2854. doi: 10.4240/wjgs.v15.i12.2844.

Abstract

BACKGROUND

Study showed that systemic holistic care not only aids in disease treatment and physical recovery to a certain extent but also effectively enhances patient psychological well-being, social support, and overall quality of life (QoL).

AIM

To assess systematic holistic care impact on the recovery and well-being of postoperative patients with colon cancer.

METHODS

Our randomized controlled trial included 98 postoperative patients with colon cancer admitted to our hospital from June 2021 to June 2022. Patients were divided into control and study groups. The control group received conventional postoperative nursing care, whereas the study group received systematic holistic nursing care. We monitored gastrointestinal function recovery, and recorded changes in serum albumin (ALB), prealbumin (PA), psychological state, self-management, self-efficacy, QoL, and the occurrence of complications in patients before, at discharge, and 2 wk post-discharge. Spearman analysis assessed correlations between psychological state, self-management, self-efficacy, and QoL of patients in the study group 2 wk post-discharge.

RESULTS

Following the nursing intervention, we observed significantly shorter postoperative bowel sound recovery time, anal exhaust time, and defecation time in the study group than in the control group ( < 0.05). Patient ALB and PA levels, psychological status, self-management ability, self-efficacy and QoL at discharge and 2 wk post-discharge significantly improved, with greater improvements observed in the study group ( < 0.05). Both groups experienced complications post-interventions, but the intervention group had significantly lower complication rate (3/49, 6.12%) (P < 0.05). In the study group, patient anxiety, depression, self-management and QoL scores at 2 wk post-discharge exhibited a significant negative correlation (3/49, 6.12%) with QoL scores, with correlation coefficients of = -0.273, -0.522, -0.344, and < 0.01, respectively. Conversely, patient self-efficacy scores 2 wk post-discharge showed a positive correlation with QoL scores ( = 0.410, = 0.000).

CONCLUSION

Systemic holistic nursing significantly benefits postoperative patients with colon cancer by promoting gastrointestinal recovery, improving post-operation well-being, reducing complications, and enhancing QoL.

摘要

背景

研究表明,系统的整体护理不仅在一定程度上有助于疾病治疗和身体恢复,还能有效提高患者的心理健康、社会支持和总体生活质量(QoL)。

目的

评估系统整体护理对结肠癌术后患者康复和幸福感的影响。

方法

我们的随机对照试验纳入了2021年6月至2022年6月期间我院收治的98例结肠癌术后患者。将患者分为对照组和研究组。对照组接受常规术后护理,而研究组接受系统整体护理。我们监测了胃肠功能恢复情况,并记录了患者在术前、出院时和出院后2周时血清白蛋白(ALB)、前白蛋白(PA)、心理状态、自我管理、自我效能、生活质量以及并发症发生情况的变化。采用Spearman分析评估研究组患者出院后2周时心理状态、自我管理、自我效能与生活质量之间的相关性。

结果

护理干预后,我们观察到研究组术后肠鸣音恢复时间、肛门排气时间和排便时间明显短于对照组(P<0.05)。患者出院时和出院后2周时的ALB和PA水平、心理状态、自我管理能力、自我效能和生活质量均显著改善,研究组改善更为明显(P<0.05)。两组干预后均出现并发症,但干预组并发症发生率显著较低(3/49,6.12%)(P<0.05)。在研究组中,患者出院后2周时的焦虑、抑郁、自我管理和生活质量评分与生活质量评分呈显著负相关(3/49,6.12%),相关系数分别为r=-0.273、-0.522、-0.344,P<0.01。相反,患者出院后2周时的自我效能评分与生活质量评分呈正相关(r=0.410,P=0.000)。

结论

系统整体护理通过促进胃肠功能恢复、改善术后幸福感低、减少并发症和提高生活质量,使结肠癌术后患者显著受益。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e5d8/10784843/b7ee238ff33f/WJGS-15-2844-g001.jpg

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