延续护理在体检肿瘤指标阳性老年人中的应用效果

目的：探讨延续护理对体检肿瘤指标阳性老年人的应用效果。方法回顾原有的工作模式下体检首次发现肿瘤指标阳性的78例老年患者的复诊率、健康教育效果以及护理满意度，作为常规组。另78例首次发现肿瘤指标阳性的老年患者作为干预组实施延续护理模式，即：由团队确立复查方案，面对面或电话进行个体化健康教育，帮助患者预约检查时间并收集结果，及时反馈给主管医师，3个月后对入组患者进行评价。结果干预组的复诊率为91．03％（71/78），明显高于常规组的62．82％（49/78），差异有统计学意义（χ2＝17．478，P＜0．01）；干预组健康教育后知识水平得分（14．82＆#177;2．88）分，明显高于健康教育前的（6．76＆#177;0．75）分，差异有统计学意义（ t＝18．104，P＜0．01）；干预组实施延续护理后护理满意度得分为（34．10＆#177;1．19）分，明显高于实施前的（29．76＆#177;1．60）分，差异有统计学意义（t＝7．41，P＜0．01）。影响复诊依从性的因素是行动不便、健康教育以及患者对有创检查的抵触。92．3％（72/78）的患者认为护士有必要提供复查方面的健康教育服务，96．2％（75/78）的患者认为护士有必要提供复查的预约服务。结论抓住切入点对体检发现肿瘤指标阳性老年人实施延续护理，可满足患者的需求，提高患者的相关知识水平、满意度和复诊依从性，把体检早期发现、早期诊断、早期治疗的目的落到实处。

Implementation of continuing nursing care in physical examination for the elderly with positive tumor marker

Objective To explore the application effect of the continuing nursing care in physical examination for the elderly with positive tumor marker .Methods Patients found a positive tumor marker in examination for the first time were selected .Control group （ n=78 ） received the original mode of care , while intervention group （n=78） received the continuing nursing care such as reviewing the program established by the team, face-to-face or telephone individualized health education , helping patients make an appointment time , and timely feedback to the physician in charge .After three months, the referral rates, health education and nursing satisfaction of patients were observed .Results Referral rate in the intervention group was significantly higher than that in the control group （91.03% vs 62.82%; χ2 =17.478,P ＆lt;0.01）.Before and after the intervention , the score of health education knowledge in the intervention group was significantly improved （14.82 ＆#177;2.88） vs （6.76 ＆#177;0.75）;t =18.104,P ＆lt;0.01],and the nursing satisfaction was significantly increased （34.10 ＆#177;1.19） vs （29.76 ＆#177;1.60）;t =7.41,P ＆lt;0.01].The important influencing factors of compliance were elderly with mobility , health education , and contradiction for the invasive examination .And 92.3%（72/78） of patients believed that nurses should provide service for review , and 96.2%（75/78） of patients believed that nurses should provide the service of making a review appointment .Conclusions Continuing nursing care for the elderly with positive tumor markers found in the examination can meet the needs of patients and improve the patients ’ level of knowledge , satisfaction and referral compliance , so as to achieve early detection , early diagnosis , and early treatment .