【作者】 葛敏；

【导师】 韦丽；

【作者基本信息】 吉林大学 ， 临床医学， 2008， 硕士

【摘要】 为了研究有效提高喉癌术后病人生存质量的护理干预方法,将Orem自我护理理论同临床护理实践相结合,制定出系统自我护理干预措施应用于喉癌术后病人。本研究采用实验性研究设计,将2006年12月-2007年12月吉林大学第二医院耳鼻喉科住院手术治疗的共计76例喉癌病人随机分为干预组和对照组,对照组病人实施喉癌术后常规护理,干预组病人实施能改善自我护理能力的系统自我护理干预措施,主要包括能改善健康知识水平、自我概念、自护责任感和自我护理技能四个方面的认知教育和行为训练,通过自我护理理论的三大系统即完全补偿性、部分补偿性系统及支持教育完成。病人出院后每月定期电话随访或家访,至出院后3个月干预结束。采用个人一般资料调查表、自我护理能力测定量表(ESCA)、欧洲癌调查治疗组织生存质量中心调查表(EORTC QLQ-C30)、欧洲癌调查治疗组织头颈癌生存质量问卷(EORTC QLQ-H&N35)进行调查。数据采用SPSS14.0软件进行统计分析。研究结果显示,喉癌病人的自我护理能力总均分为98.12士14.32,呈现低等水平;喉癌病人的生存质量EOR-TC QLQ-C30总均分为95.57±10.63,呈现中低等水平;EORTCQLQ-H&N35总均分为20.37±11.05,呈现中低等水平;喉癌病人的自我护理能力与生存质量之间存在中等程度的正相关(r=0.40,P=0.01);干预组自我护理能力比对照组明显增强,自我护理干预可明显提高喉癌病人自我护理能力(P<0.05);系统自我护理干预能明显提高喉癌病人的生存质量(P<0.05)。结果表明,系统自我护理干预是提高喉癌病人生存质量的行之有效的方法。对预防喉癌病人术后及远期并发症的发生,提高喉癌病人独立生活的能力,减轻家庭和社会负担,促进病人康复,提高护理质量和服务质量具有现实意义。更多还原

【Abstract】 Objectives:(1)To describe the self-care agency in patients with larynx carcinoma. (2)To Describe the quality of life.(3)To find out the relationship between the self-care agency and quality of life.(4) To explore the effects in patients with larynx carcinoma of systemic self-care management interventions on self-care agency. (5)To explore the effects of systemic self-care management interventions on quality of life in patients with larynx carcinoma.Methods:The study used an experimental design. The 76 patients who came from the ENT Institute inpatient department of the Second Clinical Hospital of Jilin University from Dec 2006 to Dec 2007 were randomly allocated to a control or intervention group.The patients in the control group received routine nursing care.The intervention group received systemic self-care management interventions which included improvement of self–care ability, self-care responsibility, self-esteem and health knowledge. The intervention time was four months. Four questionnaires were used for data collection:a general information sheet of patients,the exercise of Self-care Agency(ESCA), EORTC QLQ-C30 and EORTCQLQ-H&N35 questionnaires.The statis -tical software SPSS for windows version 14.0 was used for data analysis. Results:(1)ESCA scores of All larynx carcinoma was patients 98.12士14.32,perceived a low level of self-care agency. Only 7.89%patients perceived a high level of self-care agency. Factors that can influence significantly self-care agency,used by Linear Regression,were educational level, profession, operating manner and family relationship. (2) EOR-TCQLQ-C30 quality of life scores of all patients was95.57±10.63,EORTCQLQ-H&N35 quality of life scores of all patients was20.37±11.05.patients perceived a middle level of quality of life.(3 )Findings from the present study revealed that there are a significant positive relationship between the self-care agency and quality of life in patients with larynx carcinoma. (4) Systemic self-care management interventions improved self-care agency(P<0.05). (5)Systemic self-care management interventions were significantly improved larynx carcinoma quality(P<0.05). Conclusions: From the results of this study it can be concluded that larynx carcinoma patients perceived a low level of self-care agency and quality of life. There are a significant positive relationship between the self-care agency and quality of life inpatients with larynx carcinoma .Self-care education could improve the self-care agency,enhance quality of life.更多还原