Quality of life and symptom control in hospice patients with cancer receiving chemotherapy

The value of palliative chemotherapy for hospice patients is difficult to quantify and little is known about outcomes from these treatments. This study examined quality of life and symptom control in hospice patients with cancer receiving chemotherapy and in a control group of hospice patients with cancer who had not received chemotherapy for at least 3 months. Using a case-control study design matching patients by age, gender, race, and cancer diagnosis, patients receiving chemotherapy reported a similar number of symptoms as patients off chemotherapy. Global symptom distress was comparable in both groups as was quality of life. Patients in both groups were similar at the symptom-specific level, however, patients on chemotherapy had better symptom outcomes for urination problems (p=0.03), numbness/tingling (p=0.03), muscle weakness (p=0.07), and pain (p=0.09). Patients on chemotherapy had poorer symptom control involving change in taste (p=0.01) and cough (p=0.01). Patients on chemotherapy were more likely than those off chemotherapy to report that chemotherapy "made them feel better" (p=0.01) and "allowed better symptom control" (p=0.01), indicating that patients taking chemotherapy had more subjective benefit from chemotherapy when compared to those off chemotherapy. The two groups showed no difference in the rate of survival.     

并发症预警模式护理在经胸壁输液港化疗乳腺癌患者中的应用效果

目的:探究预警模式护理在经胸壁输液港化疗乳腺癌患者中的应用效果。方法:采用便利抽样法,选取2019年1月—2020年10月信阳市中心医院收治的134例乳腺癌患者,采用随机数字表法分为观察组和对照组,各67例。对照组予以并发症常规护理,观察组予以并发症预警模式护理。比较两组并发症发生情况、护理满意度,以及干预前后乳腺癌生...     

Building a dream: creating an oncology day/evening hospital

The demand for inpatient beds has reached and often exceeds capacity producing waiting lists for cancer care. There is a need to explore alternative approaches to oncology treatment. The Oncology Day/Evening Hospital (ODEH), originally envisioned in 1995 as a joint project between an ambulatory cancer centre and a large teaching hospital, is an important cancer treatment initiative offering extended hours of ambulatory oncology treatment on days, evenings, weekends and statutory holidays. A review of current inpatient treatment modalities revealed that many patients receiving inpatient therapy could be safely and effectively managed in the ambulatory setting if treatment regimens were modified and if ambulatory hours of operation were extended. Healthcare improvements expected were: appropriate movement of inpatient activity to the ambulatory setting; more opportunities for patient choice in treatment time thereby allowing for maintenance of normal living; better quality of life for patients through prevention of hospitalization; decrease in treatment waiting times; consolidation of patients into an ambulatory oncology treatment setting as opposed to utilization of adult medicine units; and more rational inpatient bed utilization with reduction of admissions and intra-treatment transfers. This article describes our experience in building a dream, the challenges and lessons learned in implementing a better way to deliver oncology care in an environment of rapid change and staff shortages.     

饮食指导对直肠癌化疗患者生活质量的影响

目的:探讨饮食指导对直肠癌患者生活质量的影响。方法:将249例直肠癌化疗患者随机分为A组125例和B组124例。A组实施饮食指导,B组未实施饮食指导。比较两组患者的生活质量和体重的变化情况。结果:A组患者治疗后生活质量评分明显高于B组(P0.01),A组患者治疗后体重变化情况明显优于B组(P0.01)。结论:化疗期间对患者进行饮食指导可以有效地提高患者的生活质量,对患者的体重增加也有所帮助。     

A review of the role of emergency nurses in management of chemotherapy‐related complications

Aims and objectives. To examine the role of emergency nurses in caring for patients who receive chemotherapy in ambulatory oncology settings. Reasons for emergency department presentations are examined, specific sources of clinical risk for patients receiving chemotherapy who require emergency care are discussed and cost implications of emergency department presentations related to chemotherapy are analysed. Background. Given the increased administration of chemotherapy in ambulatory settings, emergency nurses play an important role in the management of patients undergoing adjuvant chemotherapy. Emergency departments are the major entry point for acute inpatient hospital care of complications arising from chemotherapy. Design. Systematic review. Results. Chemotherapy‐related emergency department presentations have considerable clinical and cost implications for patients and the healthcare system. Strategies to improve emergency department management of chemotherapy complications and reduction in preventable emergency department presentations has significant implications for improving cancer patients’ quality of life and reducing the cost of cancer care. Conclusions. Nurses are well placed to play a pivotal role in chemotherapy management and lead interventions such as a specialist oncology nursing roles that provide information and support to guide patients through their chemotherapy cycles. These interventions may prevent emergency department presentations for patients receiving chemotherapy in ambulatory settings. Relevance to clinical practice. Patients receiving chemotherapy require access to specialised care to manage distressing symptoms, as they are at significant clinical risk because of immunosuppression and may not exhibit the usual signs of critical illness. A team approach both within and across nursing specialities may improve care for patients receiving chemotherapy and increase effective use of healthcare resources.     

康艾注射液联合化疗治疗结直肠癌术后患者的临床观察

目的：观察康艾注射液在结直肠癌患者术后辅助化疗中减轻化疗毒副反应的疗效。方法：将60例结直肠癌术后化疗患者随机分为两组。治疗组30例,采用康艾注射液50mL加入0．9％氯化钠注射液250mL中静脉滴注,每日1次,连用10d,化疗当天开始用药,化疗采用FOLFOX4方案。对照组30例,单纯采用FOLFOX4方案化疗,2周为1个周期,所有患者均化疗4个周期,比较两组的化疗不良反应发生情况。结果：治疗组发生骨髓抑制的例数少于对照组,程度轻于对照组,两组比较差异有统计学意义（P〈0．05）。两组在恶心、呕吐方面比较差异无统计学意义（P〉0．05）,但治疗组重度呕吐比例稍低。结论：康艾注射液在结直肠癌术后化疗中对减轻骨髓抑制有明显效果,可以起到化疗减毒作用,提高患者生活质量。     

Quality of life of cancer patients receiving inpatient and home-based palliative care

AIMS: This paper reports a comparative study of the symptom experience, physical and psychological health, perceived control of the effects of cancer and quality of life of terminally ill cancer patients receiving inpatient and home-based palliative care, and the factors that predict quality of life. BACKGROUND: Quality of life is a major goal in the care of patients with terminal cancer. In addition to symptom management, psychological care and provision of support, being cared for at home is considered an important determinant of patient well-being. A more comprehensive understanding of the impact of cancer on patients and their families will inform the delivery of palliative care services. METHODS: Fifty-eight patients with terminal cancer (32 inpatients, 26 home-based) were recruited from major palliative care centres in Australia in 1999. A structured questionnaire designed to obtain sociodemographic information, medical details and standard measures of symptoms, physical and psychological health, personal control and quality of life was administered by personal interview. RESULTS: The two groups were similar on most demographic measures, although more home-care patients were married, of Australian descent and had private health insurance cover. The most prevalent symptoms reported were weakness, fatigue, sleeping during the day and pain. Patients receiving home-based services had statistically significantly less symptom severity and distress, lower depression scores, and better physical health and quality of life than those receiving inpatient care. Home-care patients also reported statistically significantly more control over the effects of their illness, medical care and treatment received, and the course of the disease. Multiple regression analyses showed that better global physical health, greater control over the effects of cancer and lower depression scores were statistically significant predictors of higher quality of life. CONCLUSIONS: The main issues arising from the findings for nurses are the early detection and management of both physical and psychological symptoms, particularly fatigue, pain, anxiety and depression, and the need to use strategies that will empower patients to have a greater sense of control over their illness and treatment. Research is needed to identify other factors that may impact on quality of life, and to establish the extent to which inpatient and home-based care meets the needs of both the patient with terminal cancer and their family.     

KAP护理干预模式对肠癌患者术后睡眠质量、生活质量及胃肠功能的影响

目的探讨知、信、行(KAP)护理干预模式对肠癌患者术后胃肠功能及其睡眠质量、生活质量的影响。方法选取江阴市人民医院收治的130例肠癌患者作为研究对象,其中2017年5月至2018年1月65例作为对照组,施行常规护理;2018年5月至2019年4月65例作为研究组,施行常规护理+KAP护理干预模式。对比两组患者的睡眠质量、生活质量和胃肠功能恢复情况。结果护理前,两组患者的睡眠质量无明显差异(P>0.05);干预后,与对照组比较,研究组患者的睡眠质量明显改善,生活质量明显提高,术后胃肠功能恢复时间提前,差异均有统计学意义(P<0.05)。结论KAP护理干预模式有助于改善肠癌患者术后的睡眠质量,提高生活质量,促进胃肠功能恢复。     

静脉输液评估模式在肝病患者中的应用

目的:探讨静脉输液评估模式在肝病临床护理中的应用效果,便于提高静脉输液质量,增加穿刺成功率,减少静脉炎发生。方法:选择2012年6~12月收治的肝病静脉输入药物的患者260例为研究对象,随机分为对照组和观察组各130例,对照组按传统模式进行输液,观察组采用静脉输液评估模式进行输液,采用静脉输液量表进行效果评价。结果:观察组效果显著优于对照组,两组比较差异有统计学意义(P0.05)。结论:采用静脉输液评估模式提高了输液穿刺成功率,满足了患者治疗需求,提高了患者满意度。     

罗伊适应模式在低位直肠癌患者焦虑中的应用研究

目的 探讨罗伊适应模式在低位直肠癌患者焦虑中的临床应用研究.方法 将60例低位直肠癌患者随机分为实验组30例和对照组30例.对照组按直肠癌术后护理常规进行护理,实验组除接受直肠癌常规护理外,按照罗伊适应模式的护理理念方法进行护理干预,采用90项症状自评量表(Symptom Checklist 90,SCL-90)及焦虑自评量表(SAS)用以测定患者的心理状况;应用本院质量检查的满意度调查量表对患者及家属进行评定.结果 实验组焦虑症状明显低于对照组,实验组满意度及住院天数明显优于对照组,两组比较差异有显著性(P＜0.05).结论 严格按罗伊适应模式实施整体护理能减轻低位直肠癌患者焦虑和压抑,提高病人术后自理能力,降低术后并发症的发生率,缩短了住院天数,从而减少病人的住院费用,提高了患者的满意度及生活质量.

Abstract：

Objective To study the application of Roy adaptation model in low rectal cancer patients who were in anxiety. Methods There were 60 rectal cancer patients, who were randomly divided half-and-half into experimental group and control group. The patients in control group were cared according to routine postoperative nursing of cancer, The patients in experimental group were received routine nursing of cancer, and were nursing intervention accordance with Roy adaptation model. The symptom checklist 90 ( SCL -90) and selfrating anxiety scale (SAS) were used to the determine patients'psychological status, and assess the patients and their families according to our hospital quality inspection application of satisfaction survey questionnaire. Results Anxiety symptoms in experimental group were significantly lower than those of the control group, the degree of satisfaction of experimental group was better than that of control group, and inpatient day of experimental group was significantly shorter than that of control group (P ＜ 0. 05 ) . Conclusions Application of Roy adaptation model in holistic nursing can reduce anxiety and depression in colorectal cancer patients , and improve postoperative self - care ability, reduce the incidence of postoperative complications, shorten hospital stay, reduce hospitalization expenses, make better satisfaction and quality of life of patients.     

症状管理教育对肺癌化疗患者核心症状群的改善效果

目的探讨症状管理教育(SME)对肺癌化疗患者核心症状群的改善效果。方法选取我院2017年2月至2019年2月收治的74例临床表现症状群的肺癌化疗患者为研究对象,将其随机等分为对照组和观察组,对照组给予常规护理,观察组在对照组基础上行症状管理教育。比较两组核心症状、生活质量和自我症状管理行为评分。结果观察组乏力、呼吸困难、夜间咳嗽核心症状评分低于对照组(P<0.05);观察组功能领域、症状领域以及总体生存质量水平优于对照组(P<0.05);观察组自我症状管理行为评分均高于对照组(P<0.05)。结论症状管理教育有利于改善肺癌化疗患者核心症状群,减轻乏力、呼吸困难、咳嗽等症状,提高生活质量和自我管理水平。     

基于电子病历信息的优质护理在晚期乳腺癌患者植入式静脉输液港化疗期间的护理效果

目的 探讨基于电子病历信息的优质护理在晚期乳腺癌患者应用植入式静脉输液港化疗期间的应用效果。方法 选取医院2018年1月—2019年2月收治的晚期乳腺癌术后应用植入式静脉输液港化疗患者142例,按照组间基本特征具有可比性的原则分为对照组与观察组,每组71例。对照组给予常规优质护理,观察组给予基于电子病历信息的优质护理。比较两组护理前、护理干预1个月后的舒适状况量表评分和非计划性拔管率、不良反应发生率、护理不良事件发生率、护理满意度。结果 护理前两组舒适状况量表评分比较差异无统计学意义（P>0.05）,护理后观察组舒适状况量表评分高于对照组（P<0.05）。干预期间观察组非计划性拔管率、不良反应发生率、护理不良事件发生率低于对照组,组间比较差异均有统计学意义（P<0.05）;观察组护患沟通、护理服务和护理环境满意度评分均高于对照组（P<0.05）,两组护理制度满意度评分比较差异无统计学意义（P>0.05）。结论 晚期乳腺癌患者植入式静脉输液港化疗期间接受基于电子病历信息的优质护理不仅可改善舒适度,还可减少非计划性拔管、不良反应和护理不良事件发生率,提升患者的...     

加速康复模式下食管癌患者术后1个月症状群研究

目的 了解加速康复外科治疗后,食管癌患者术后1个月的症状发生情况,探讨常见症状及症状群构成.方法 选取食管癌患者171例,术后1个月随访,使用自制问卷评估常见症状,使用中文版癌症患者生活质量量表评估症状群.结果 食管癌患者加速康复术后1个月,发生率最高的3个症状分别是咳嗽气喘、声音嘶哑和反酸烧心,发生率均低于以往类似研...     

Developing and piloting a nurse-led model of follow-up in the multidisciplinary management of colorectal cancer.

One of the main challenges of colorectal cancer follow-up is the detection of early disease in order to influence survival and improve outcome. Yet, the benefits of follow-up are not only related to survival. It is well documented that patients can experience an array of problems following colorectal cancer surgery which impact upon quality of life, therefore symptom management plays an important part in the overall spectrum of follow-up care. In addition, there is emerging evidence to suggest that clinical nurse specialists are well placed in the multidisciplinary team to co-ordinate such follow-up programmes. This paper reports on a pilot study designed to assess the feasibility of a follow-up programme led by nurse specialists for patients with colorectal cancer. Key outcome areas were adherence to an agreed follow-protocol, quality of life, patient and clinician satisfaction and a cost-analysis of the new model. The study was conducted over one year with 60 patients. This redesign resulted in a smoother pathway of follow-up care, improved quality of life and acceptance to both patients and clinicians alike. The introduction of a nurse-led follow-up model is expected to demonstrate cost savings over a 3 year rolling follow-up programme.     

Palliation of inoperable head and heck cancer: combined intra-arterial infusion chemotherapy and irradiation.

Palliation of unresectable head and neck cancer remains a difficult problem. Because of excellent results reported by others with infusion of vinblastine, methotrexate, and 5-fluorouracil into the external carotid artery followed by irradiation before curative surgery, we applied this technic to 22 patients with advanced head and neck cancer. Fifteen patients from this group who had chemotherapy infusion followed by radiation therapy are compared with 21 patients who received radiation therapy alone. Both groups were similar in distribution of primary site, histology, and TNM stage. Of 15 patients, 14 (93%) had partial or complete tumor regression after both arterial chemotherapy infusion and irradiation, while 14 of 17 patients (82%) receiving primary irradiation had partial or complete response. Drug toxicity and complications related to infusion occurred in all patients. Most patients in both groups had short survivals (mean of 14.1 months in infusion chemotherapy and radiation vs 9.1 months in primary irradiation). One patient remains alive in the infusion group and two in the control group; however, all have recurrent disease. Results indicate a slight increase in survival time with the addition of infusionchemotherapy to irradiation in palliative treatment of head and heck cancer.     

佩皮劳人际关系模式在妇科首次化疗患者宣教中的应用

目的探讨佩皮劳人际关系模式在首次化疗患者宣教中的应用效果。方法将2013年6月~2014年4月在我科行首次化疗的患者88例作为研究对象,采用随机分组法分为对照组和干预组,各44例。对照组予以常规宣教。干预组采用佩皮劳人际关系模式进行宣教。入院第1d及化疗后第5d采用SF-36量表基础问卷及抑郁自评量表(SDS),分别对患者护理前后的生活质量及抑郁程度进行评价。结果干预组生活质量明显优于对照组,有显著性差异(P0.01);干预组SDS评分明显低于对照组,有显著性差异(P0.01)。结论采用佩皮劳人际关系模式对患者进行宣教后,缓解了初次化疗患者的抑郁情绪,提高了患者的生活质量。     

结肠癌术后辅助化疗患者症状困扰的纵向研究

目的 探讨和描述结肠癌术后辅助化疗患者的症状发生率、频率、严重度以及困扰程度的纵向变化.方法 采用前瞻性研究方法对108例结肠癌术后辅助化疗患者进行连续6个月的症状随访,并分析其结果.结果 结肠癌术后辅助化疗患者的症状困扰主要为疲乏、恶心、食欲下降、味觉改变及四肢麻木,在化疗的初期、中期和后期表现为不同的特点.结论 护理人员应深入了解结肠癌辅助化疗患者在化疗不同时期的症状特点和困扰,帮助其采取积极的应对方式和措施,减轻化疗痛苦,从而提高患者生命质量.     

雷替曲塞等化疗药物低剂量动脉灌注治疗胃癌术后并发恶性肠梗阻

目的探讨雷替曲塞等小剂量化疗药物介人性动脉灌注对胃癌术后腹腔转移致恶性肠梗阻的疗效。方法 42例胃癌术后伴不完全性肠梗阻患者,经肠系膜上动脉或加腹腔动脉、肠系膜下动脉等插管,灌注低剂量化疗药物,药物用量为雷替曲塞2 mg,奥沙利伯50~100 mg,多西他赛20~40 mg,化疗周期为每3~4周动脉灌注1次。本组病例至少灌注1次,最多7次。对照组42例给予内科姑息治疗,未给予化疗药物。结果介人化疗后肠梗阻缓解有效率为80.95%(34/42例);对照组肠梗阻缓解有效率为42.85%(18/42例),两组相比差异显著(P<0.01)。介入化疗组排气、排便及腹痛腹胀的缓解时间均短于对照组,肠道通畅总维持时间长于对照组,两组相比统计学差异均显著。介人化疗组生存时间为2~36个月,中位生存时间5个月;对照组平均生存期为(2.69±2.25)个月,中位生存时间为3个月,两组生存时间统计学差异非常显著(P<0.01)。介入治疗组对腹水治疗的总有效率为76.0(19/25),也高于对照组(P<0.01)。介入治疗组治疗后KPS评分提高,ECOG评分下降。结论小剂量化疗药物动脉灌注对胃癌术后腹腔转移致肠梗阻副作用小,能在短期内明显缓解癌性肠梗阻症状,肠道通畅维持时间长,并能有效控制伴随的腹水症状,延长生存时间,提高生活质量,尤其适用于老年及体质虚弱者。