安宁疗护对肿瘤晚期患者死亡认知态度及生活质量的影响

目的:探讨安宁疗护对肿瘤晚期患者死亡认知态度及生活质量的影响。方法:将2016年7月1日~2017年12月31日收治的57例肿瘤晚期患者作为对照组,给予常规护理干预;将2018年1月1日~2019年6月30日收治的57例肿瘤晚期患者作为研究组,给予安宁疗护。比较两组护理前、护理2个月主观幸福感[采用总体幸福感量表(GWB)]、睡眠质量[采用睡眠质量自评量表(SRSS)]、生活质量[采用生活质量核心量表(QLQ-30)]及死亡认知态度情况[采用死亡态度描绘修订表(DAP-R)],并记录护理期间患者不适症状。结果:护理2个月,两组GWB评分、SRSS评分、QLQ-30评分均优于护理前(P<0.05),且研究组优于对照组(P<0.05);护理2个月,研究组DAP-R中趋近导向、中性及逃离导向的死亡接受评分均优于对照组(P<0.05);研究组不适症状发生率低于对照组(P<0.05)。结论:对肿瘤晚期患者应用安宁疗护,不仅可有效改善患者死亡认知态度、睡眠质量,还能提升其主观幸福感和生活质量,减轻患者不适症状。

Effects of Hospice Care on Death Cognitive Attitude and Quality of Life in Patients with Advanced Cancer

Objective:To investigate the effects of hospice care on the death cognition and quality of life of patients with advanced cancer.Methods:From July 1,2016 to December 31,2017,57 patients with advanced cancer admitted were taken as the control group and given routine nursing intervention.Fifty-seven patients with advanced cancer admitted from January 1,2018 to June 30,2019 were given hospice care as research group.The subjective well-being[General Well-Being Schedule(GWB)],the sleep quality[Self-Rating Scale of Sleep(SRSS)],the quality of life[Quality of Life Questionnaire(QLQ-30)],cognitive attitude on death[Death Attitude Profile-Revised(DAP-R)],and patient uncomfortable symptoms recorded during nursing were compared between the two groups before nursing and after 2 months of nursing.Results:After 2 months of nursing,GWB score,SRSS score and QLQ-30 score in both groups were better than before nursing(P<0.05),and the research group was better than the control group(P<0.05).After 2 months of nursing,the DAP-R of death acceptance scores of approach-oriented,neutral and escape-oriented in the research group were significantly better than those of the control group(P<0.05).The incidence of discomfortable symptoms in the research group was lower than that in the control group(P<0.05).Conclusion:The application of hospice care to patients with advanced cancer can not only effectively improve the patient′s death cognition attitude and sleep quality,but also promote the patient′s subjective well-being and quality of life,and alleviate the patient′s discomfortable symptoms.