PDCA管理模式改善乳腺癌患者的自我健康管理和生活质量的效果分析

目的分析计划、实施、检查、处理循环(Plan-Do-Check-Action,PDCA)管理模式改善乳腺癌患者的自我健康管理和生活质量的效果,总结管理经验。方法以本院2014年8月-2017年8月收治的152例乳腺癌患者。按照随机数字表法分为观察组和对照组各76例,对照组给予常规综合治疗与管理,观察组在此基础上接受PDCA管理。比较2组患者管理前后健康知识掌握合格率、满意率、自我管理效能感变化,并运用生活质量量表(QLQC30)评价其生活质量变化。结果随访期间观察组失访1例,对照组失访3例,获得有效随访患者平均随访时间为(14.26±1.17)个月。观察组健康知识掌握合格率(96.00%)、依从性良好率(85.33%)及管理满意度良好率(98.67%)均高于对照组(60.81%,64.86%,72.97%),差异有统计学意义(P<0.05)。观察组管理1年后自我管理效能感评分为(85.17±7.25)分,高于对照组的(48.71±6.41)分,差异有统计学意义(P<0.05)。观察组生活质量功能量表各条目评分均高于对照组;除经济困难外,观察组症状量表各条目评分均低于对照组,差异有统计学意义(P<0.05)。结论PDCA管理模式能够有效改善乳腺癌的自我健康管理能力及生活质量。

Effect of PDCA management model on self health management and quality of life of patients with breast cancer

Objective To evaluate the effect of plan-do-check-action (PDCA) management mode on the self health management and quality of life of patients with breast cancer, and summarize the management experience. Methods A total of 152 patients with breast cancer treated in a hospital from August 2014 to August 2017 were selected as the research objects and divided into a trial group and a control group, with 76 cases in each group, according to the random number table method. The patients in the control group were given the conventional comprehensive treatment and management, and the patients in the trial group were given PDCA management on the basis of the conventional comprehensive treatment and management. The health knowledge mastery rate, satisfaction rate, self-efficacy, and the quality of life were investigated by questionnaires including the quality of life scale (QLQ-C30), and the results were compared between the two groups before and after the management. Results During the follow-up period, 1 case was lost in the trial group, and 3 cases were lost in the control group. The average follow-up time was (14.26±1.17) months. The mastery rate of health knowledge, good compliance rate, and satisfaction rate of management of the trial group were 96.00%, 85.33%, and 98.67% respectively, which were higher than those of the control group (60.81%, 64.86%, and 72.97% respectively) and there were significant differences between two groups (all P<0.05). After 1 year of management, the self-efficacy score of the trial group was (85.17±7.25), which was higher than that of the control group (48.71±6.41), and the difference was statistically significant (P<0.05). The scores of the quality of life scale of the trial group were higher than those of the control group. Except the economic difficulties, the scores of each item of the symptom scale in the trial group were lower than those in the control group, and the difference was statistically significant (P<0.05). Conclusion The PDCA management model can effectively improve the self health management and quality of life of patients with breast cancer.