Quality of life of Danish colorectal cancer patients with and without a stoma

Goals of the work As part of a psychosocial intervention study, we wanted to prospectively assess the quality of life of colorectal cancer patients who were given a stoma at the time of their initial operation for cancer or later and those whose initial stoma was removed. Materials and methods A total of 249 colorectal cancer patients were recruited and responded to a questionnaire 3, 6, 12 and 24 months after the initial operation (26–35% had a stoma during follow-up). Main results Although most of the differences between stoma and non-stoma patients failed to reach significance, 22 out of 27 variables indicated a poorer quality of life for those with a stoma. Patients who currently had a stoma had significantly higher levels of depression (p = 0.013), poorer social functioning (p = 0.0085) and more problems with body image (p = 0.0001), future perspectives (p = 0.0058), micturition (p = 0.018) and side effects from chemotherapy (p = 0.008), but fewer problems with constipation (p = 0.034) than non-stoma patients. Male patients with a stoma had more sexual problems than males without a stoma (p = 0.015). Among those with a current stoma, quality of life seemed poorer among those whose stoma was made during follow-up compared with those with an initial stoma. Conclusions Trends suggested that having a stoma led to poorer scores in most aspects of quality of life and that having a stoma made some time after the initial operation was more distressing than having a stoma made during the primary cancer operation.     

Factors associated with lower quality of life among patients receiving palliative care

Title.  Factors associated with lower quality of life among patients receiving palliative care.
Aim.  This paper is a report of a study conducted to (1) assess the quality of life (QoL) and physical functioning status of patients diagnosed with advanced cancer and receiving palliative care; (2) determine if there was a statistically significant relationship between their physical functioning and QoL and (3) identify the demographic and disease-related variables related to their QoL.
Background.  Achieving the best possible QoL is a major goal in palliative care. However, research findings about the relationship between QoL and demographic variables have been inconsistent.
Method.  Three hundred patients with advanced cancer were recruited from four district hospitals in Hong Kong between February 2005 and July 2006. Their QoL and physical functioning status were assessed by face-to-face interview, using the McGill Quality of Life Questionnaire (Hong Kong version) and the Palliative Performance Scale respectively.
Results.  Participants reported reduced ambulation, inability to perform hobbies or housework, and the need for occasional assistance in self-care (mean: 64·6 out of 100, sd : 19·3, range: 20–100). QoL was fair (mean: 6·2 out of 10, sd : 1·5, range: 0·9–10). There was a weak positive association between physical functioning and QoL scores. Multiple regression analysis showed that patients who were older, female, had ever been married, or had higher physical functioning tended to have better QoL.
Conclusion.  More could be done in symptom and psychosocial management to improve patients' QoL, in particular for those who are younger, male or single, or who have lower physical functioning.     

循证护理对结直肠癌患者生活质量的影响

目的:探讨循证护理对结直肠癌患者生活质量的影响。方法:选取2011年7月~2013年9月我院收治的60例结直肠癌患者为研究对象,将其随机等分为对照组和观察组,对照组实施常规护理,观察组实施循证护理。比较两组患者护理干预前和护理干预1周后的生命质量。结果:护理前两组癌症患者生命质量测定量表评分比较无统计学意义(P0.05),而护理干预1周后观察组患者的生命质量测定量表评分均优于对照组,两组比较有统计学意义(P0.05)。结论:循证护理可显著改善结直肠癌患者的生活质量。     

术前预防性口服肠内营养制剂对大肠癌患者生存质量影响的前瞻性研究

目的 探讨术前预防性使用肠内营养制剂对大肠癌患者术后恢复及近期生存质量的影响.方法 前瞻性研究了2009年11月～2010年5月我院胃肠外科中心收治的符合条件的患者59例.将其随机分为两组,对照组31例,术前遵医嘱进普通饮食;实验组28例,术前3d在原有普通饮食的基础上预防性服用安素.术后比较两组营养状况及WHOQOL-BREF量表评分的差异.结果 从术后血清营养学指标上看,两组间前白蛋白、血红蛋白的差异无显著意义(P＞0.05),两组间白蛋白的差异有显著意义(P＜0.05).WHOQOL-BREF评分显示术后试验组在生理领域及四领域总计分上高于对照组,两组间差异有显著意义(P＜0.05).实验组术后营养风险评分低于对照组,差异有显著意义(P＜0.05).结论 术前预防性使用肠内营养制剂可改善患者术后营养状况,提高患者术后生存质量.     

造口访问对结肠造口患者生活质量的影响

目的探讨造口访问对提高结肠造口患者生活质量的效果。方法用随机数字表法将入院拟行肠造口手术的患者80例分为实验组和对照组各40例。对照组由护士按常规实施术前、术后护理,出院后常规定期复查,接受由造口治疗师主导的个体化教育,出院定时造口门诊复诊。实验组在此基础上安排2名造口访问者（由有相似经历并已在各方面调整较好的既往造口患者担任）在患者术前1～2d及术后4～10d探访患者,出院后定期电话访问或上门探访患者。干预的内容包括为患者及家属提供日常生活、运动、工作,以及情感支持、社会支持、造口自我护理等咨询。干预前后采用欧洲癌症研究与治疗组织开发的生活质量核心量表（EORTC QLQ C30）中文版测评患者的生活质量。结果干预前两组人口学资料及生活质量比较,差异均无统计学意义（P〉0.05）。出院后3个月,实验组躯体功能、角色功能、情绪功能、认知功能、社会功能等功能维度和总生活质量得分分别为（85.92±10.06）,（70.05±18.85）,（89.77±17.03）,（90.25±14.85）,（73.15±18.70）,（77.84±16.94）分,均高于对照组的（69.58±12.86）,（41.66±23.35）,（70.43±16.98）,（71.03±15.64）,（40.87±20.88）,（53.16±19.12）分,差异均有统计学意义（t值分别为6.329,5.983,5.086,5.636,7.284,6.110;P〈0.01）。实验组疲倦、疼痛等症状维度得分分别为（19.44±10.96）,（9.46±4.55）分,均低于对照组的（40.74±17.63）,（17.85±8.95）分,差异均有统计学意义（t值分别为-6.489,-5.285;P〈0.01）。实验组单项问题中失眠、食欲缺乏和腹泻的例数分别为17,10,2例,均少于对照组的31,35,8例,差异均有统计学意义（χ2值分别为10.208,31.746,4.114;P〈0.05或P＜0.01）。两组恶心呕吐症状维度得分和气促、便秘单项问题,以及经济困难例数差异均无统计学意义（P〉0.05）。结论造口访问干预能有效提高造口患者的生活质量。     

大肠癌患者癌因性疲乏与生存质量的相关性分析

目的 探讨大肠癌患者癌因性疲乏与生存质量的相关性.方法 选取2010年11月至2011年1月四川大学华西医院胃肠外科中心诊治的大肠癌患者,采用Piper疲乏量表和欧洲癌症研究与治疗组织的生命质量核心量表(EORTC QLQ-C30)对其疲乏和生存质量情况进行评估.结果 共纳入患者74例,28例出现疲乏(Pipers总分＞0),疲乏发生率37.84％;疲乏组生存质量低于无疲乏组;生存质量中功能领域的躯体功能、角色功能、社会功能、情绪功能以及总健康情况均与疲乏存在负相关,而症状领域的疼痛、疲倦、食欲丧失则与疲乏存在正相关.结论 癌因性疲乏从生理、心理及社会功能等方面影响大肠癌患者的生存质量,为临床护理人员制订大肠癌患者癌因性疲乏的干预性护理措施、提高患者生存质量提供了相关参考依据.     

集束化护理干预对肠造口患者病耻感与生活质量的影响

目的 探讨集束化护理干预对肠造口患者的生活质量和病耻感以及造口相关并发症发生率的影响.方法 选择本院肛肠外科连续收治的直肠癌接受手术患者40例为研究对象.干预组接受集束化护理干预,对照组接收常规康复指导.观察指标包括:患者年龄、住院天数、手术切口感染率、社会影响量表及生活质量量表评分.两组均随访6个月,比较各项指标组间差异.结果 干预组20例,年龄(64.95±11.26)岁;对照组20例,年龄(63.85±12.39)岁.与对照组相比,集束化护理干预能显著减少肠造口患者的住院天数(P<0.05),降低切口感染率(P<0.05),提高患者的生活质量,并改善患者的病耻感.结论 集束化护理干预能显著改善肠造口患者的病耻感,提高患者的生活质量,并减少患者切口的感染率.     

延伸护理服务对大肠癌术后造口患者生活质量的影响

目的 探究延伸护理服务对大肠癌术后造口患者生活质量的影响.方法 选取2013年5月~2016年10月该院普外科收治的大肠癌术后造口患者150例,随机分为观察组和对照组各75例.在两组患者住院期间均采用常规护理,出院后3个月、6个月、1年对对照组患者进行电话随访调查,而对观察组患者进行家庭随访、电话随访和联谊活动等延伸护理服务.采用生活质量量表(core quality of life questionnaire,QLQ-C30)对患者进行评估.结果 观察组患者在延伸护理干预3个月、6个月和1年后的躯体功能、角色功能、情绪功能、认知功能、社会功能和总体健康状况均明显高于对照组,差异均有统计学意义(均P<0.05).结论 对大肠癌术后造口患者实施延伸护理服务提高了患者对知识的掌握和社会交流能力,有效地提高了患者的生活质量.     

品管圈活动提升低位结直肠癌Miles术患者出院后生活质量的效果

目的 探讨品管圈活动提升低位结直肠癌腹会阴联合直肠癌根治术(Miles术)患者出院后生活质量的效果。 方法 将2011年1月-2014年6月收治的低位结直肠行永久性结肠造口出院患者96例作为研究对象,按照患者知情自愿原则分为对照组42例与观察组54例。对照组出院后进行常规护理,观察组在对照组基础上采用品管圈活动进行护理干预。比较干预6个月后2组患者结肠造口并发症的发生情况及干预后的生活质量评分情况。 结果 观察组造口黏膜脱落及总计并发症的发生率均低于对照组(χ²=4.673,P<0.05; χ²=14.037,P<0.01);干预6个月后,观察组功能维度得分高于对照组,疲劳、疼痛、食欲下降、便秘得分低于对照组。 结论 品管圈活动可有效降低低位结直肠癌Miles术患者结肠造口并发症的发生率,提升生活质量。     

健康教育对乳腺癌术后患者生存质量的影响

目的探讨早期健康教育对乳腺癌患者术后生存质量的影响。方法将83例乳腺癌根治患者随机分为康复组(45例)和对照组(38例),康复组于术后24h开始健康教育;对照组行常规护理及随意自我锻炼。对2组患者分别于术后第30天应用癌症患者生存质量调查表进行问卷调查。结果康复组生存质量明显高于对照组,11项评价指标中有10项差异有显著性(P<0.01)。结论术后健康教育可以促进乳腺癌术后患肢功能康复,提高生存质量。     

重组改构人肿瘤坏死因子用于肝癌介入治疗后毒副反应的护理

重组改构人肿瘤坏死因子是一类基因工程抗肿瘤药物，可直接杀伤肿瘤细胞，使肿瘤出血、坏死、体积缩小。通过肝动脉插管联合化疗药物栓塞，可大大提高肿瘤局部药物浓度，降低非靶区药物浓度，减少化疗药物毒副反应，但其本身可引起一系列的不良反应，给患者的身心带来较大的痛苦。2005年4—6月，我科对20例原发性肝癌患者用rmhTNF与化疗药物联合栓塞治疗后引起的毒副反应实施了有效的护理，取得了良好的效果，现报道如下。     

老年大肠癌患者术前生存质量的前瞻性研究

目的 评估大肠癌患者术前生存质量并探讨年龄对生存质量的影响.方法 选择2010年3～5月收治的100例大肠癌患者,于确诊为大肠癌后2 d内(术前)评估其生存质量.结果 两组生存质量比较:老年组环境领域和总体健康感觉得分均高于非老年组(66.98±14.86vs.59.13±17.30,P=0.024)(3.32±1.03vs.2.86±1.09,P=0.039)(P<0.05).对年龄与生存质量的相关性分析:年龄与生存质量的社会关系领域呈负相关(P=0.018,r=-0.243),与环境领域(P=0.017,r=0.246)和总体健康感觉(P=0.018,r=0.244)均呈正相关;老年组年龄与生存质量的心理领域(P=0.029,r=0.329)、环境领域(P=0.002,r=0.451)和四领域总分(P=0.030,r=0.327)均呈正相关.结论 老年大肠癌患者术前生存质量总体上较非老年组更高,但在社会关系满意度方面较低,应加强其社会支持系统建设.     

老年糖尿病患者生活质量的影响因素研究

目的：研究糖尿病(DM)患者生活质量(QOL)的影响因素,以减少并发症发生,延长患者寿命,为临床决策提供理论依据。方法：采用现况调查方法,应用糖尿病综合自护能力评估量表,对老年内科住院的240例患者进行问卷调查,所得有效数据应用SPSS软件包进行统计描述和logistic回归分析。结果：78．9%的DM患者QOL处于中低水平。使QOL呈下降趋势的因素有：病程长短、文化程度、不良嗜好、早期已伴有并发症、不合理用药、未行运动训练者。还包括经济上由他的子女提供帮助,家庭对患者的关心不足；家庭人均收入低于500元；综合自护能力较差。结论：影响DM患者QOL的因素很多,4项对策可提高其QOL。     

护理干预对老年结直肠癌患者术前精神状态及术后生活质量的影响

目的:探讨护理干预对老年结直肠癌患者术前精神状态及术后生活质量的影响.方法:将126例老年结直肠癌患者随机分为观察组70例与对照组56例,对照组患者给予常规护理,观察组在常规护理基础上进行入院评估、认知疗法及心理干预.结果:两组患者护理后SAS评分和SDS评分与护理前比较差异均有统计学意义(P＜0.01),且观察组护理后SAS评分和SDS评分显著低于对照组护理后(P＜0.01);观察组进入手术室前的血压、心率变化较对照组平稳(P＜0.05);观察组护理后的SF-36评分显著高于对照组护理后(P＜0.05).结论:对老年结直肠癌患者加强护理干预可有效缓解其负性情绪,有利于手术顺利进行.     

非离断式底盘剪裁在含支架棒袢式造口患者中的应用效果

目的 探讨非离断式造口底盘剪裁法在含支架棒袢式造口护理中的应用效果。方法 选取2019年1-12月因直肠癌、肠梗阻、肠瘘行含支架棒造口术的患者92例,将其随机分为实验组47例,对照组45例,实验组采用非离断式底盘剪裁造口袋底盘,对照组采用常规方法,干预后第3、6、9天比较2组患者造口周围潮湿相关性皮肤损伤、造口底盘渗漏率、更换造口袋耗时。结果 实验组患者术后第9天造口周围潮湿相关性皮肤损伤发生率低于对照组(χ²=8.950,P=0.003);术后第6天、第9天造口底盘渗漏率发生率均低于对照组(χ²=8.644,P=0.003;χ²=8.644,P=0.003);更换造口袋耗时低于对照组(F_组间=860.531,P＜0.001)。结论 非离断式底盘剪裁可有效降低含支架棒袢式造口患者造口相关并发症。     

Postoperative quality of life among patients with thyroid cancer

BACKGROUND: Thyroid cancer patients have a survival rate of over 90% after thyroidectomy. However, quality of life with a generic focus has rarely been studied in thyroid cancer survivors. AIM: This paper reports a study to examine and describe factors associated with quality of life among patients with thyroid cancer after operation. METHODS: Adult patients who had a thyroidectomy for cancer between January 1999 and June 2001 in a Taiwan city participated in the study. Telephone interviews was completed with 146 (67%) of those 218 eligible, asking about sociodemographic variables, disease/treatment characteristics and social support. Quality of life was measured by the Chinese version of the Quality of Life Index. Multivariate analyses were performed using multiple linear regressions. RESULT: The regression model showed that patients at 19-36 months after operation had lower quality of life compared with those within 18 months of operation. Current symptoms of fatigue and chills were negatively associated with quality of life. Those who rated the impact of operational scar on activities as 'high' had lower quality of life scores. Social support from families and friends had positive effects on quality of life. The model r2 was 48.1%. CONCLUSIONS: Nurses could improve quality of life among patients with thyroid cancer by strengthening their social support and educating them in self-management of uncomfortable symptoms. Surgeons should consider types of operation in which the scar would be less likely to influence the patients' activities.     

视力受损患者家庭支持和生活质量的相关性研究

为了解视力受损患者的家庭支持和生活质量及二者之间的关系,采用家庭支持自评量表(MPSS-Fa)和生活质量自评量表(QOLQ),以随机抽样法,对眼科门诊65名两眼中好眼的最佳矫正视力≤0.3的患者进行问卷调查.结果显示视力受损患者的生活质量与其家庭支持有显著的正相关关系,提示护理人员可通过增加家庭支持来提高患者的生活质量.