喉癌患者术后自理理论护理效果评价及对生活质量的影响

目的 随着对喉癌临床认识的不断加深，治疗理念也在一定程度上得到了转变与更新，术后并发症及不良反应加重了喉癌患者沮丧、自卑等心理应激反应，影响了患者的心理健康，生活质量也随之下降。Orem自理理论护理以人类是生理、心理及社会适应的统一整体，为了更好地保证患者的生存质量，保持健康的心态，延长生存期并提高生存质量。本研究通过对比分析了解Orem自理理论护理干预的作用效果，评价喉癌行部分切除手术患者术后应用Orem自理理论护理效果及对生活质量的影响。 方法 收集哈尔滨医科大学附属第四医院2011年2月—2013年2月收治的喉癌患者68例，根据护理方法的不同将68例患者分入A组与B组，其中A组32例，B组36例，其中A组患者接受常规护理干预，对B组患者则实施Orem自理理论护理干预。比较2组护理干预后发音功能、自护能力及生活质量的情况。 结果 出院时评估B组患者自护能力均显著优于A组，差别具有统计学意义(P＜0.05)；2组患者发音功能比较:A组近正常、良好、中等及差患者分别为5例、12例、14例及1例，B组分别为6例、14例、15例及1例，2组患者术后发音功能差别无统计学意义(χ2=0.782，P=0.258)；随访1年B组患者华盛顿医科大学生存质量量表(UW-QOL)语言交流、活动能力维度及总分显著优于A组(P＜0.05)。 结论 喉癌行部分切除术后应用Orem自理理论可提高患者自护能力，改善生活质量。 

Effectiveness of Dorothea Orem's Self-Care Theory in postoperative nursing intervention and influence on quality of laryngocarcinoma patient

Objective To evaluate the effect of Dorothea Orem ’ s Self-Care Theory in the postoperative nursing intervention and the influence on the QOL of laryngocarcinoma patient. Methods Total 68 laryngeal cancer patients undergoing partial resection in our hospital between February,2011 and February,2013 were enrolled into this study,and were divided into group A(32 cases) and group B(36 cases) according to the nursing approaches.Group A received the routine nursing intervention,while group B received the intervention by Orem Self-Care Theory.The phonatory function,self-care ability and quality of life between the two groups were compared after the nursing intervention. Results The self-care ability in Group B was significantly better than that in group A,the difference was statistically significant(P<0.05).There was no statistical difference in phonatory function between the two groups(χ2=0.782,P=0.258).One year follow-up showed that the verbal communication ability,capacity and total score by Washington Medical Patients Quality of Life Scale(UW-QOL) were significantly better in group B as compared with those in group A(P<0.05). Conclusion The application of Orem’s Self-Care Theory in the postoperative nursing intervention for the laryngeal cancer patients after partial resection can improve their self-care ability and quality of life.