妇科恶性肿瘤患者支持性照顾需求的研究

目的 探讨妇科恶性肿瘤患者治疗期间支持性照顾需求未满足及需要帮助情况.方法 采用描述性研究设计,用癌症患者支持性照顾需求问卷(Supportive Care Needs Survey,SCNS)对正在接受治疗的100例妇科恶性肿瘤患者进行调查.结果 本组患者支持性照顾需求各维度平均未满足率分别为健康信息维度76.7%、性维度70.7%、心理维度55.2%、生理与日常生活维度48.5%、照顾与支持维度34.1%;患者上述维度需要帮助程度得分依次为(1.40±0.88)分、(1.38±0.71)分、(0.97±0.51)分、(1.01±0.64)分、(0.80±0.65)分.结论 妇科恶性肿瘤患者支持性照顾各方面均有未满足情况,其中健康信息、性方面需要帮助程度较高.患者期望医生传达与病情、治疗有关的决策和信息,期望护士扮演照顾者、指导者、支持者的角色;期望得到病友心理方面的支持与帮助.     

妇科恶性肿瘤患者支持性照顾需求的调查性研究

【】目的：探讨妇科恶性肿瘤患者治疗期间支持性照顾需求状况及需要帮助情况【方法】采用描述性研究设计,用癌症患者支持性照顾需求问卷(SCNS)对治疗期间的101例妇科恶性肿瘤患者进行问卷调查。【结果】妇科恶性肿瘤患者支持性照顾需求程度得分依次为健康信息维度(3.267±0.679)分, 照顾与支持维度(3.043±0.668)分,心理维度(2.272±0.838)分,生理与日常生活维度(1.993±1.079)分,性维度(1.823±0.956)分;上述维度需要帮助程度得分依次为(2.261±0.754)分,(2.032±0.808)分,(1.602±0.800)分,(1.406±0.962)分,(1.293±1.069)分。【结论】妇科恶性肿瘤患者治疗期间对健康信息、照顾与支持方面的需求程度及需要帮助情况较高,各方面均存在需求及需求未满足情况,需求程度越高,越需要得到帮助。有必要采取护理措施满足患者的需求,帮助患者树立起战胜病魔的勇气和信心。     

妇科恶性肿瘤患者不同治疗阶段支持性照顾需求的调查分析

目的了解不同治疗阶段妇科恶性肿瘤患者支持性照顾需求变化,为制订针对性干预策略提供依据。方法采用一般资料调查表和支持性照顾需求问卷对重庆市3所三级甲等医院的138例初诊妇科恶性肿瘤患者于确诊时、确诊后3个月、确诊后6个月进行跟踪调查。结果妇科恶性肿瘤患者支持性照顾需求各维度除生理与日常生活需求、心理需求维度外,各维度得分在确诊后3个月均呈下降趋势,照顾与支持需求及性需求维度在确诊后6个月出现回升趋势,各维度3个时间点差异均具有统计学意义(P0.01或P0.05)。结论妇科恶性肿瘤患者在疾病进展和治疗过程中支持性照顾需求呈现动态变化趋势,建议动态评估患者需求,做好每一阶段相关症状的预防和针对性护理工作。     

妇科恶性肿瘤175例的化疗护理

现将我科2005—01—2009—07进行化疗的175例患者的护理体会介绍如下。     

胃肠道肿瘤患者支持性照顾需求的现状及影响因素分析

目的:调查胃肠道肿瘤患者支持性照顾需求现状,并探究其影响因素.方法:采用一般资料调查表、支持性照顾需求量表对120例胃肠道肿瘤患者进行调查.结果:胃肠道肿瘤患者的支持性照顾需求得分为(96.05±27.98)分,条目总均分为(2.90±0.82)分.多元线性回归分析显示,文化程度、家庭人均月收入及年龄是影响胃肠道肿瘤患...     

胃癌患者支持性照顾需求的现状及其影响因素

目的探讨胃癌患者支持性照顾需求现状,分析其影响因素。方法2018年10月至2019年3月,采用便利抽样法选取在中山大学肿瘤防治中心和中山大学附属第六医院门诊和肿瘤科的178例胃癌患者为研究对象。采用一般情况调查问卷、支持性照顾需求简明问卷(the supportive care needs survey-34-item short form,SCNS-SF34)、安德森症状评估量表胃肠道肿瘤特异性模块(the M.D.Anderson symptom inventory gastrointestinal cancer module,MDASI-GI)及恐惧疾病进展简化量表(fear of progression questionnaire short form,FoP-Q-SF)对其进行调查。结果178例胃癌患者的总体SCNS-SF34得分为(2.87±0.59)分。不同文化程度、肿瘤部位、临床分期、白蛋白数值的胃癌患者SCNS-SF34总分差异均有统计学意义(均P<0.05)。症状严重程度、症状困扰程度得分与胃癌患者SCNS-SF34总分相关,相关系数为0.743、0.777;FoP-Q-SF总分及生理健康维度、社会家庭维度得分与胃癌患者的支持性照顾需求得分相关,相关系数分别为0.818、0.817、0.739。文化程度、症状体验和恐惧疾病进展心理是胃癌患者的支持性照顾需求的主要影响因素。结论胃癌患者支持性照顾需求的满足情况不理想,应通过评估患者症状体验、恐惧疾病进展水平来制定个性化的护理方案以满足患者需求。     

老年妇科恶性肿瘤78例诊疗分析

【目的】探讨老年妇科恶性肿瘤患者的临床特点及诊治经验。【方法】对78例老年妇科恶性肿瘤（观察组）的临床资料进行回顾性分析,并与同期手术住院的96例老年子宫肌瘤（对照组）进行对照。【结果】观察组恶性肿瘤的前三位分别是卵巢癌26例（占33．3％）,宫颈癌25例（占32．1％）,子宫内膜癌17例（占21．8％）;其术中出血量、输血量、手术持续时间及术后住院时间均高于对照组,两组比较差异有显著性（P〈0．05）。【结论】老年妇科恶性肿瘤以卵巢癌、子宫内膜癌和宫颈癌为主,较良性肿瘤而言需要更完善的围术期处理方能安全渡过手术危险期。     

宫颈癌患者支持性照顾需求的调查

目的调查宫颈癌患者治疗期间支持性照顾需求及影响因素。方法采用癌症患者支持性照顾需求调查问卷对正在接受治疗的200例宫颈癌患者进行调查。结果宫颈癌患者支持性照顾需求各维度得分由高到低依次是心理需求、健康信息需求、支持和照顾需求、生理和日常生活需求、性需求。年龄、民族、是否知晓诊断、文化程度和发病情况是宫颈癌患者支持性照顾需求的影响因素(P0.01)。结论医护人员在临床工作中要注意宫颈癌患者文化程度、年龄和民族等差异,重视患者的需求,为患者提供针对性护理服务。     

浅谈妇科肿瘤患者化疗护理干预

目的：探讨妇科肿瘤化疗期有效的护理干预措施,提高护理质量。方法：化疗前针对患者不同的心理状态,进行心理疏导,提供相关信息;化疗时稳定情绪;化疗后可能出现的不良反应实施干预,出院后重点指导。结果：使拒绝化疗者接受化疗,便秘患者建立正常排便习惯,焦虑患者减轻症状等。结论：有效的护理干预,是化疗成功的重要因素之一,进而提高患者的生存质量。     

妇科恶性肿瘤术后胃瘫患者的护理

目的探讨妇科恶性肿瘤术后胃瘫患者的护理。方法对5例妇科恶性肿瘤术后胃瘫患者给予心理护理、胃肠减压、营养支持、活动指导等护理措施促进胃动力恢复。结果5例患者治疗后,4例痊愈,1例患者症状明显改善,至出院时能少量进食。结论通过有效治疗、细致全面的护理,胃瘫是可以非手术治愈的。     

结直肠癌患者术后支持性照顾需求调查研究

目的：全面了解结直肠癌患者术后支持性照顾需求,为护理人员开展健康指导提供依据,也为护理管理者开展培训和继续教育提供方向。方法选择2012年3-7月在山西省肿瘤医院通过病理检查确诊的结直肠癌接受手术的161例患者,在澳大利亚Bonevski设计的癌症患者支持性照顾需求调查问卷的基础上增加未保肛患者适用的造口支持需求维度进行问卷调查,观察结直肠癌患者术后支持性照顾需求各维度的需求率和得分情况。结果患者6个维度平均需求率为79．12％,平均未满足率为78．63％。患者心理需求得分为（2．71±0．56）分,照顾与支持需求得分为（2．66±0．46）分,生理及日常生活需求为（2．25±0．67）分,健康信息需求得分为（1．94±0．67）分,性需求得分为（1．88±1．25）分,造口需求得分为（0．66±1．18）分。术后支持性照顾需求各维度得分比较差异有统计学意义（F＝867．81, P＜0．05）。结论护理人员应全面了解患者的需求,及时调整护理服务内容。护理管理者应根据患者需求进行护士的继续教育工作,才能有利于护理学科的发展。     

Current practice and knowledge of oral care for cancer patients: a survey of supportive health care providers

Background The Oral Care Study Section of the Multinational Association of Supportive Care in Cancer (MASCC) and the International Society for Oral Oncology (ISOO) conducted a survey on clinical practices of oral/dental management of cancer patients among supportive health care providers. The main purpose was to evaluate the knowledge and current practice for preventing and managing oral side effects associated with intensive chemotherapy (ICT), hematopoietic cell transplant (HCT), and radiation therapy to the head and neck (H&N RT).Materials and methods A questionnaire designed and pretested was sent to 212 MASCC/ISOO members around the world with different dental and medical backgrounds.Main results Seventy-four individuals (35%) responded. The majority of respondents were aware of possible oral complications and provided patients with clinical strategies and recommendations although there was considerable variability among the respondents. Approximately 75% stated that patients were referred for oral/dental care prior to H&N RT and ICT including HCT. However, integrated dental and medical services were reported available in only about 25% of the institutions, and most patients were referred to community-based dental professionals.Main conclusions The survey represents a first review of current, international oral care practices. It suggests a need to develop evidence-based clinical guidelines to support effective oral/dental interventions and management strategies for this population. Furthermore, strategies for implementation of oral care protocols and better integration of dental and medical services should be developed. Caution in interpreting these findings is urged due to the limited response rate.For the Oral Care Study Section of the Multinational Association of Supportive Care in Cancer and the International Society for Oral Oncology. Chairs: Dr. Fred K. L. Spijkervet and Dr. Philip C. Fox.     

癌症患者支持性照顾需求的研究进展

阐述癌症患者支持性照顾需求的概念及国内外研究现状,分析其影响因素,提出目前癌症患者支持性照顾需求研究中存在的不足及研究展望.     

支持性照顾对妇科恶性肿瘤患者生活质量的影响分析

目的探讨支持性照顾在改善妇科恶性肿瘤患者生活质量中的作用。方法将64例妇科恶性肿瘤患者随机分为干预组32例和对照组32例,对照组给予常规护理,干预组在常规护理的基础上给予支持性照顾。采用癌症生活质量问卷核心量表对患者的生活质量进行评价。结果干预前,2组各项目评分差异无统计学意义;干预后,除经济困难外,患者的生活质量评分,其他各项目评分均高于对照组。结论对进行临床治疗的妇科恶性肿瘤患者实施支持性照顾,可以提高患者的生活质量。     

Creating a culture of compassion: developing supportive care for people with cancer

Receiving the 2003 Distinguished Merit Award from the European Oncology Nursing Society is a great moment in my professional career. It is also a time for reflection. We can easily become immersed in the specifics of our work and forget the larger picture. An opportunity such as this allows me to step back, reflect and review what I have accomplished. It also challenges me to think about the totality of cancer nursing and cancer care, look at where we have been and about where we should be going. At the heart of this lies the concept of supportive care. I would like to consider three pertinent areas. First, I will define what I consider the domain of supportive care in cancer to be. Second, I will look at what is needed to further supportive care for people with cancer. This involves building the discipline of more rigorous symptom assessment and documentation; better management of the symptoms and concerns that confront people with cancer; moving beyond the traditional framework of treatment and care, embracing a more integrated approach; addressing quality whilst at the same expediting the delivery of supportive care services. Third, I would like to consider the challenges to reform that this presents for cancer nursing and cancer nurses. A road map for change will be presented which highlights both the necessity to promote a supportive care culture whilst simultaneously building a dedicated infrastructure of staff and services. Nurses must play a key role in supportive care. Because of our unique clinical and research base, we are primed to assume leadership roles in both these spheres. Mutual valuing, partnership and shared working are the only means of delivering enhanced cancer care. We should grasp opportunities, confident that together we have the skills and knowledge to move forward. Today is yesterday's tomorrow. We cannot do anything about yesterday, but we can do something about today to ensure tomorrow is how we want it to be. We can become what we dream, let us live that dream outside and really drive forward the care we provide for people with cancer and their families.     

肝癌生存者支持性照顾需求和心理韧性的相关性研究

目的：调查肝癌生存者支持性照顾需求现状及心理韧性,并探讨两者间的相关性,为提高肝癌生存者照顾质量提供依据。方法：采用便利抽样法,选取120例肝癌生存者,采用自制一般资料调查表、支持性照顾需求量表（SCNS-SF34）和心理韧性量表进行问卷调查。结果：肝癌生存者支持性照顾需求总分为69.00（57.00,90.50）,其中健康信息需求得分最高24.00（17.50,32.50）;心理韧性总分为28.00（21.00,34.00）。心理韧性与支持性照顾需求成负相关（r=-0.314,P=0.001) 。结论：肝癌生存者存在不同程度的支持性照顾需求,心理韧性较差的肝癌生存者支持性照顾需求较高,提示医护人员可以通过加强对肝癌生存者支持性照顾需要的护理干预,以改善他们的心理韧性水平。     

The Initial Health Assessment: an intervention to identify the supportive care needs of cancer patients

Background The first step in effective supportive care delivery is an assessment of patient needs. The Initial Health Assessment Form (IHA) was developed to aid clinicians in recognition and documentation of a patient's supportive care needs during their first visit to a comprehensive cancer centre. The purpose of this study was to determine the relative effectiveness of this instrument as compared to routine practice.Methods A before-after study was performed. Charts of consecutive patients with newly diagnosed cancer attending the Hamilton Regional Cancer Centre were selected randomly. Each chart was reviewed to determine the documentation at the initial patient assessment of 22 supportive care items under eight domains of need: physical, psychological, daily living, social, financial, informational, special needs and personal resources. The pre-intervention evaluation (T1) occurred over a 3-month period followed by the introduction of the IHA into clinical practice. Three months after its introduction, the post-intervention (T2) evaluation took place over the ensuing 3 months.Results A total of 306 charts were evaluated (153 each in T1 and T2). Patients from the two time periods were comparable with respect to background demographic variables. Introduction of the IHA increased the mean documentation of supportive care needs and resources from 26% in T1 to 49% in T2 (p=0.001). Significant improvements were found in all domains of need. Despite improvements, documentation of assessment continued to remain low for daily living, social, financial, and informational needs.Conclusions The IHA improved documentation of supportive care needs and resources. There is still room for improvement.Source of financial support: Ontario Ministry of Health and Long-Term Care, Health Systems Linked Research Unit Grant.     

A mixed-method evaluation of nurse-led community-based supportive cancer care

Goals of work  The study purpose was to evaluate a nurse-led supportive care clinical case management program in the community using multi-methods to delineate care processes prior to outcome evaluation. Materials and methods  Multiple data sources including program service records, chart reviews and interviews with nurses and key interdisciplinary informants were used to identify population served (coverage and reach), processes of care (implementation), and providers’ perceptions of the effectiveness of the nurse-led program (reaction). Main results  The program provided care to over 700 cancer patients in a 1-year period. Nurse-led support interventions were focused on direct care inclusive of teaching/coaching for symptom management, counseling and support, and mobilization of services through system navigation based on an initial comprehensive assessment of supportive care needs. Conclusions  Nurse-led models of supportive care have the potential to reduce unmet supportive care needs, improve continuity of care, and overall health-related quality of life that should be tested in future trials.