头颈部肿瘤放疗患者疾病感知与生活质量的相关性分析

目的：调查头颈部肿瘤放疗患者疾病感知水平及生活质量状况,分析二者的相关性,为提高患者的生活质量提供依据。方法：选取2018年6-12月接受放射治疗的110例头颈部肿瘤患者作为研究对象,利用疾病感知问卷以及生活质量量表评估患者的疾病感知水平及生活质量。连续性变量采用t检验,Pearson相关分析进行变量相关性的检测。结果：全组患者疾病感知得分为（43.7±9.98）分,躯体功能、角色功能、情绪功能、社会功能、整体生活质量分值与疾病感知得分存在负相关;疲劳、恶心呕吐、睡眠障碍、食欲下降、便秘与患者疾病感知得分存在正相关。结论：疾病感知影响头颈部肿瘤放疗患者的生活质量,应采取合理的护理措施,改善患者的疾病感知状态,提高患者的生活质量。     

护理干预对放疗科头颈部肿瘤放疗患者生活质量的影响

目的本文主要研究和探讨护理干预对放疗科头颈部肿瘤放疗患者生活质量的影响。方法将我院2017年2月份至2018年10月份收治的100例头颈部肿瘤放疗患者作为本次研究的对象,在随机原则的指导下把100例患者分为对照组和实验组,每组患者的数量为50例。对照组患者给予常规护理,实验组患者实施护理干预,对两组患者的生活质量、睡眠质量、护理满意度和护理依从性等进行对比分析。结果在生活质量、睡眠质量、护理满意度和护理依从性等方面,组间进行对比分析,实验组都明显优于对照组,P<0.05差异具有统计学意义。结论对头颈部肿瘤放疗患者实施护理干预可以让患者的生活质量、睡眠质量、护理依从性以及护理满意度等都得到显著的改善,从而让患者以一种积极、乐观的心态接受放疗,这对于放疗效果的提高具有重要的作用。总之,这一护理模式应该在临床中进行推广和使用。     

护理干预在改善头颈部肿瘤放疗患者生活质量中应用

分析护理干预在改善头颈部肿瘤放疗患者生活质量中应用效果。回顾性分析放疗治疗的110例头颈部肿瘤患者的临床资料。观察组的社会活动、心理活动、躯体机能、QOL评分均优于对照组,不良反应发生率也低于对照组,差异均具统计学意义(P<0.05)。护理干预在改善头颈部肿瘤放疗患者生活质量中的应用效果显著,值得临床推广应用。     

头颈部肿瘤病人放疗期间生活质量变化的调查研究

目的 探讨头颈部肿瘤病人放疗期间生活质量的变化.方法 选取北京市1家综合医院,1家肿瘤专科医院行放疗的所有成年头颈部肿瘤病人84例,在放疗起始及放疗结束时采用欧洲癌症研究和治疗组织系统开发的癌症患者生命质量测定量表(EORCT QLQ-C30)对病人进行生活质量调查.结果 放疗结束时,病人生活质量明显下降,放疗前后差异具有统计学意义(P<0.01).生活质量各维度中,放疗结束后角色功能下降24分;社会功能下降24分;总体健康状况下降20分.疲倦评分升高36分;疼痛症状评分升高42分;睡眠障碍升高22分;没有食欲升高42分.结论 头颈部肿瘤病人生活质量在放疗前后明显下降,应注意调整护理重点,减轻症状严重程度,帮助病人维持良好的生活质量.     

护理干预对头颈部肿瘤放疗患者生活质量的影响

目的探讨护理干预对头颈部肿瘤放疗患者生活质量的影响。方法将60例放疗患者随机分为对照组和干预组,各30例。对照组进行常规护理及指导,干预组在此基础上进行放疗前、中、后全程护理干预,包括对患者及家属进行疾病知识及护理知识的宣教及遵医行为指导。采用问卷测评两组患者生活质量。结果干预组患者的身体功能、角色功能、情绪功能、总体生活质量得分显著高于对照组,有显著性差异（P〈0．05,P〈0．01）。结论护理干预可有效提高肿瘤放疗患者生活质量。     

护理干预对头颈部肿瘤放疗病人生活质量的影响

[目的]探讨护理干预对头颈部肿瘤放疗病人生活质量的影响。[方法]将100例头颈部肿瘤放疗病人根据分层随机化分组法分为观察组、对照组,每组50例,观察组进行规范化干预护理,对照组进行常规护理,两组均护理4周。比较两组病人护理前后生活质量、护理满意度、护理依从性、1年生存情况。[结果]观察组护理后生活质量评分、护理依从性、满意度、1年生存情况优于对照组,差异有统计学意义(P0.05)。[结论]头颈部肿瘤放疗病人进行规范化干预护理,可改善病人的生活质量,提高生存期。     

头颈部肿瘤患者放疗反应的护理对策

头颈部肿瘤占全身恶性肿瘤的19．9％-30．2％，放射治疗是最有效的治疗方法，但其所导致的副反应严重影响患者的生活质量及放疗疗效，为保证放疗的顺利进行，我们采取了相应的护理措施，取得满意效果。1996年9月-2005年9月，我科住院治疗头颈部肿瘤患者116例，经护理，全部完成了全程放疗，现报道如下。     

饮食护理干预对头颈部肿瘤患者放疗期间营养状况的影响

目的 探讨饮食护理干预对头颈部肿瘤放疗患者营养状况的影响.方法 86例头颈部肿瘤放疗患者随机分为观察组与对照组各43例,对照组采用常规护理干预,观察组在此基础上采用及时饮食护理干预,在整个放射疗程中对两组患者体重等进行分析评估.结果 在放疗早期两组体重等指标差异无统计学意义;在放疗中、后期观察组体重等评价指标明显优于对照组.结论 有效的饮食护理干预可提高头颈部肿瘤放疗患者的营养状况,使患者对放疗不良反应的耐受性增强,保障放疗顺利完成.     

A study to evaluate nurse-led on-treatment review for patients undergoing radiotherapy for head and neck cancer

Aims and objectives. To evaluate a nurse‐led clinic for patients undergoing radiotherapy to the head and neck. Background. The side effects of radiotherapy to the head and neck are superimposed on already significant physical and psychological morbidity. Medical review clinics tend to focus on treatment complications and there is evidence that specialist nurses can provide more holistic care for patients. However, doubts have been raised about the appropriateness of nurse‐led review in this highly symptomatic and complex group. Design. This evaluation compared medical on‐treatment review (Phase 1) with a nurse‐led clinic (Phase 2) for patients having radiotherapy to the head and neck, using an historical control group. Methods. Twenty patients were reviewed by their consultant and 23 by a nurse specialist, using a clinic protocol. A mixed‐method approach to data collection was taken. Patients completed weekly quality of life questionnaires and were asked about their experiences of support and care. General practitioners completed a questionnaire about the communication received from the clinic. Checklists assessed the content of clinic consultations. Results. Patients valued the relationship developed with the nurse specialist, had longer, more frequent consultations and were more often referred to the multidisciplinary team. The nurse specialist managed 83% of consultations without referral to the consultant. Few significant differences in quality of life were found between the groups. There were indications that oral and nutritional problems were managed more effectively in the nurse‐led clinic, although emotional functioning was higher in the medical group. GPs were positive about the timing and content of information received. Conclusions. On‐treatment review for patients with head and neck cancer can be effectively managed by a nurse specialist. Relevance to Practice. Radiotherapy nurse specialists make an important contribution to the supportive care of patients with head and neck cancer. More investment is required to maximize their contribution.     

Lived experiences of eating problems for patients with head and neck cancer during radiotherapy

Only a small proportion of cancer patients undergo radical radiotherapy to the head and neck, but their needs are particularly complex. Although extensive research describes the side-effects of radiotherapy to the head and neck, few studies focus on patients' subjective experiences of eating problems and the impact these have on the patients' daily life. In this study a phenomenological approach was used, as the purpose was to acquire deeper understanding of head and neck cancer patients' lived experiences of eating problems, their consequences in daily life and patients' strategies of coping with these problems. Eight patients from two radiation therapy departments in mid-Sweden were interviewed in an open dialogue. Data analysis was based on Colaizzi's method. Eating problems experienced were captured in two interrelated main themes: "Ability to chew and swallow" and "Will and desire to eat". The eating problems were found to cause a number of severe consequences in daily life. These are incorporated into one main theme: "The way of life is disturbed". Ways to cope with this disturbance were captured in one main theme: "Trying to see the end - To survive". This study identifies the need to view eating problems as a complex phenomenon in a specific context including the individual patient's life situation. The findings create the opportunity to develop nursing interventions based on patients' own needs. To facilitate this, a specialist nurse should be responsible for reviewing patients regularly throughout radiation therapy. Intervention studies are needed to provide optimal clinical guidelines.     

~(153)钐乙二胺四甲撑磷酸联合放射性疗法治疗头颈肿瘤合并骨转移患者的疗效观察

目的探讨~(153)钐乙二胺四甲撑磷酸(~(153)SmEDTM)联合放射性疗法治疗头颈肿瘤合并骨转移的临床疗效。方法选取120例头颈肿瘤合并骨转移患者,根据随机数表法分为对照组、观察组各60例。对照组患者接受~(153)SmEDTM治疗,观察组患者接受~(153)SmEDTM联合放射性疗法治疗。治疗3个月后,比较2组患者治疗后疼痛缓解情况及骨转移灶变化、毒副作用。结果治疗后,观察组疼痛改善效果显著优于对照组(P0.05),骨转移病灶总缓解率显著高于对照组(P0.05);2组毒副反应发生率比较,差异无统计学意义(P0.05)。结论~(153)SmEDTM联合放射性疗法治疗头颈肿瘤合并骨转移效果显著,安全性较高,能有效减轻患者疼痛,减少骨转移。     

护理干预对头颈部肿瘤放射治疗所致口腔黏膜炎的影响

目的：探讨护理干预对头颈部肿瘤放射治疗所致口腔黏膜炎的影响。方法：99例头颈部肿瘤患者随机分为两组,干预组在对照组的基础上,加强对患者的口腔卫生知识教育,实行口腔护理及物理性预防措施,合理使用抗生素。比较其与对照组之间口腔黏膜炎发生率的差异。结果：干预组口腔黏膜炎发生率66．7％,对照组发生率85．7％,两组比较差异有显著性（P〈0.05）,且干预组发生口腔黏膜炎的程度较轻,差异亦有显著性（P〈0.05）。结论：积极的护理干预可降低头颈部肿瘤放射治疗所致口腔黏膜炎的发生率。     

个体化健康教育对头颈部肿瘤放疗病人口腔黏膜炎的影响1）

[目的]探讨个体化健康教育对头颈部肿瘤放疗病人口腔黏膜炎的影响。[方法]将78例头颈部肿瘤放疗病人随机分为观察组与对照组,每组39例,观察组采取个体化健康教育模式,对照组采取放疗科常规健康教育模式,比较两组病人放疗后口腔黏膜炎的分级。[结果]观察组病人3级、4级严重口腔黏膜炎发生率低于对照组（P＆lt;0.05）。[结论]个体化健康教育可以减少头颈部肿瘤放疗病人严重口腔黏膜炎的发生。     

The effects of oral zinc sulphate during radiotherapy on anti-oxidant enzyme activities in patients with head and neck cancer: a prospective, randomised, placebo-controlled study

The purpose was to determine the effects of oral zinc sulphate along with radiotherapy on anti-oxidant enzyme activities in patients with head and neck cancer. Thirty patients with head and neck cancer were randomly assigned to receive either zinc sulphate capsules (including 50 mg zinc) (n = 15) or placebo (n = 15) three times a day, starting on the day of the first radiotherapy fraction and continuing throughout the scheduled radiotherapy course including weekends and 6 weeks after radiotherapy. The patients were treated with telecobalt radiation at conventional fractionation of 2 Gy/fraction and five fractions/ week in 20-35 fractions for a period of 4-7 weeks. Blood samples for biochemical parameters were collected after an overnight fast (12 h) before radiotherapy, the first day and 6 weeks after radiotherapy. In the placebo group, three patients were excluded. No difference was detected in any final measurement activities of erythrocyte anti-oxidant enzyme such as copper-zinc superoxide dismutase (Cu-Zn SOD), catalase (CAT) and glutathione peroxidase (GSH-Px) in the direct comparison between the zinc sulphate and the placebo group, except erythrocyte SOD activities measured the first day after radiotherapy (p < 0.03). In the respective measurement analysis of the groups in themselves, in the zinc sulphate group, while the statistical analysis for the activities of erythrocyte CAT and GSH-Px were significantly different (chi2 = 12.4, p < 0.05; chi2 = 8.9, p < 0.05, respectively) before radiotherapy, the first day and 6 weeks after radiotherapy, the activities of SOD did not differ (chi2 = 4.2, p > 0.05). In these three measurements, there was no statistical significance in the activities of enzymes in erythrocyte Cu-Zn SOD, CAT and GSH-Px in the placebo group. Before radiotherapy, plasma zinc levels were normal in 16 patients (59.2%) and were lower in 11 patients (40.8%) compared with laboratory levels. It would be worthwhile studying the effect of oral zinc sulphate supplements to improve the anti-oxidant enzyme activity in radiation-treated cancer patients, in the hope of reducing radiation-induced toxicity.     

集束化营养干预方案对食管癌同步放化疗患者生活质量和营养状况的影响

目的了解集束化营养干预疗法对食管癌同步放化疗患者生活质量和营养状况的影响程度。方法选取食管癌同步放化疗患者100例,应用随机、单盲、对照研究,采用随机数字表格法将患者分为研究组(采用集束化营养干预措施)和对照组(采用常规营养干预措施)各50例。食管癌放化疗结束后,比较2组患者的生活质量量表(EORTC QLQ-C3.0)及患者的体质量,血红蛋白(Hb)、血清白蛋白(ALB)含量及白细胞计数(WBC)等部分血液检查指标。结果入院时2组患者各项统计指标无统计学意义(P0.05);放化疗治疗结束后,研究组患者总体健康状况、体质量、Hb、ALB、WBC全部优于对照组,差异均具有统计学意义(P0.05)。结论集束化营养干预方案不仅可以明显提高食管癌同步放化疗患者的生活质量,而且可以改善患者的营养状况,值得在临床上进一步研究与应用。     

Assessment of xerostomia and its impact on quality of life in head and neck cancer patients undergoing radiotherapy, and validation of the Taiwanese version of the xerostomia questionnaire

The purposes of this study were to (a) explore the impact of xerostomia and saliva flow on quality of life and (b) validate the Taiwanese version of the Xerostomia Questionnaire (XQ) for patients undergoing radiotherapy (RT) for head and neck cancer in Taiwan. This was a prospective longitudinal study. Instruments consisted of the Xerostomia Questionnaire-Taiwan version (XQ-T) and the Medical Outcomes Study Short Form-36 Taiwan Version. Salivary output was measured by collecting unstimulated whole saliva. The questionnaires and measurements of salivary output were completed before RT was initiated and at two, four, six, and eight weeks after RT had started. Changes in xerostomia scores, quality of life, saliva flow, and predictors of quality of life over time were examined by using general estimating equations. The XQ-T is the first xerostomia measurement instrument developed for use with Taiwanese cancer patients and demonstrated excellent reliability and validity. Saliva flow was significantly correlated with XQ-T scores at two, four, six, and eight weeks after RT had started, but not before RT had begun. Saliva flow and quality-of-life scores significantly diminished and xerostomia scores significantly increased over the eight-week period. Saliva flow and XQ-T scores significantly predicted quality of life, after adjusting for the maturation effect. The results of this study show that the XQ-T is the first xerostomia measurement instrument to be developed for Taiwanese cancer patients and demonstrates excellent reliability and validity.