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| 提升食管癌术后胃食管反流患者自我管理能力的综合策略研究 |
| A comprehensive strategy study on improving the self-management ability of patients with gastroesophageal reflux after esophageal cancer surgery |
| 投稿时间：2023-11-01 修订日期：2024-07-08 |
| DOI： |
| 中文关键词: 食管癌术后；胃食管反流；自我管理能力；综合护理；生活质量 |
| 英文关键词: postoperative esophageal cancer; gastroesophageal reflux; self-management ability; comprehensive nursing care; quality of life |
| 基金项目:基金项目1：2022年安徽省教育厅自然科学类重点项目（2022AH052389） 基金项目2：2021年安徽省教育厅质量工程项目（2021gkszgg003） |
| 作者 | 单位 | 邮编 | | 周福君* | 安徽城市管理职业学院 | 230012 |
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| 中文摘要: |
| 目的：探索能够提升食管癌术后胃食管反流患者自我管理能力的综合策略。方法：本研究收纳了本院消化科2021年2月至2023年2月期间收治的100例食管癌术后胃食管反流患者作为研究对象。采用随机数字表法将这100例患者分为对照组和观察组，每组50例。对照组接受常规护理方案，持续时间为1个月；观察组在常规护理方案的基础上，给予提升自我管理能力的综合护理方案，持续时间也为1个月。针对食管癌术后胃食管反流患者的主要症状（胃灼热、反酸、上腹饱胀、疼痛），采用量化评分体系进行评估。使用患者激活测量表（Patient Activation Measure，PAM）评价干预前后两组患者的自我管理能力。采用世界卫生组织生活质量测量工具的简化版本（WHOQOL-BREF）评估干预前后两组患者的生活质量。统计分析干预后所有受试者的症状积分、PAM和WHOQOL-BREF评分的总均值，并进行相关性分析。结果：观察组患者在干预后的胃灼热、反酸、上腹饱胀和疼痛症状积分显著低于干预前（P<0.05）。与对照组相比，观察组患者在同一期间内的症状积分也显著低（P<0.05）。干预后，观察组患者的自我管理能力评分明显高于干预前（P<0.05），且高于对照组同期（P<0.05）。生活质量评分在干预后也显著提高（P<0.05），且观察组高于对照组同期（P<0.05）。相关性分析显示，患者的PAM评分与症状积分呈显著负相关（P<0.05），与WHOQOL-BREF评分呈显著正相关（P<0.05）。结论：综合护理方案能有效提升食管癌术后胃食管反流患者的自我管理能力。该干预措施可以减轻主要症状，提高患者的生活质量。此外，患者的自我管理能力与症状严重程度和生活质量之间存在关联。 |
| 英文摘要: |
| Abstract: Objective: To explore a comprehensive strategy that can improve the self-management ability of gastroesophageal reflux patients after esophageal cancer surgery. Methods: In this study, 100 patients with gastroesophageal reflux after esophageal cancer surgery who were admitted to the Department of Gastroenterology of our hospital from February 2021 to February 2023 were included as research objects. The 100 patients were divided into control group and observation group by random number table method, 50 cases in each group. The control group received the routine nursing program, which lasted for 1 month; the observation group was given a comprehensive nursing program to improve self-management ability on the basis of the routine nursing program, and the duration was also 1 month. A quantitative scoring system was used to evaluate the main symptoms (heartburn, acid reflux, epigastric fullness, and pain) of gastroesophageal reflux patients after esophageal cancer surgery. Patient Activation Measure (PAM) was used to evaluate the self-management ability of the two groups of patients before and after the intervention. The simplified version of the World Health Organization quality of life measurement tool (WHOQOL-BREF) was used to evaluate the quality of life of patients in both groups before and after the intervention. The total mean of symptom scores, PAM and WHOQOL-BREF scores of all subjects after intervention was statistically analyzed, and correlation analysis was performed. Results: The symptom scores of heartburn, acid reflux, epigastric fullness and pain in the observation group after the intervention were significantly lower than those before the intervention (P<0.05). Compared with the control group, the symptom score of the patients in the observation group was also significantly lower during the same period (P<0.05). After the intervention, the self-management ability score of the observation group was significantly higher than that before the intervention (P<0.05), and higher than that of the control group during the same period (P<0.05). The quality of life score was also significantly improved after the intervention (P<0.05), and the observation group was higher than the control group during the same period (P<0.05). Correlation analysis showed that the PAM score of patients was significantly negatively correlated with symptom scores (P<0.05), and significantly positively correlated with WHOQOL-BREF scores (P<0.05). Conclusion: The comprehensive nursing program can effectively improve the self-management ability of gastroesophageal reflux patients after esophageal cancer surgery. This intervention can reduce the main symptoms and improve the patient's quality of life. In addition, there was an association between patients' self-management ability and symptom severity and quality of life. |
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