云服务个案管理模式对鼻咽癌放疗患者焦虑抑郁情绪、自我效能及预后的影响

目的：探讨云服务个案管理模式对鼻咽癌放疗患者焦虑抑郁情绪、自我效能及预后的影响。方法：选取2015年6月-2017年1月收治的鼻咽癌放疗患者78例，并随机将其分为观察组与对照组各39例。对照组实施常规护理，观察组在对照组基础上应用云服务个案管理模式护理。比较两组患者焦虑及抑郁改善情况、自我管理效能、口腔黏膜急性放射性反应分级情况及生活质量。结果：干预后，观察组焦虑自评量表（self-rating anxiety scale, SAS）与抑郁自评量表（self-rating depression scale, SDS）评分较对照组低（P<0.05），正性态度、自我决策及自我减压评分均较对照组高（P<0.05），口腔黏膜急性放射性反应分级0级-I级患者比例较对照组高（P<0.05），心理功能、躯体功能及社会功能评分高于对照组（P<0.05）。结论：应用云服务个案管理模式可有效缓解鼻咽癌放疗患者焦虑及抑郁状况，提高自我管理效能，减轻口腔黏膜反应，促使生活质量提高。

Influence of cloud service case management model on anxiety,depression, self-efficacy and prognosis of patients with nasopharyngeal carcinoma undergoing radiotherapy

Objective: To explore the influence of cloud service case management model on anxiety, depression, self-efficacy and prognosis of patients with nasopharyngeal carcinoma undergoing radiotherapy. Methods: A total of 78 cases of patients with nasopharyngeal carcinoma undergoing radiotherapy treated in our hospital from June 2015 to January 2017 were selected, and were divided into nursing group and control group randomly, with 39 cases in each group. Patients in the control group were given routine nursing, and patients in the nursing group were given cloud service case management model on the basis of the control group. The improvement of anxiety and depression, self-management efficiency, acute radiation reaction grading in oral mucosa and quality of life were observed in the two groups. Results: After intervention, the scores of anxiety (SAS) and depression (SDS) in the nursing group were lower than those in the control group (P<0.05), while the scores of positive attitude, self-decision and self-stress were higher(P<0.05). The proportion of patients with acute radiation reaction grade 0-I in the nursing group was higher than that in the control group (P<0.05), and the scores of psychological function, physical function and social function were significantly higher (P<0.05). Conclusion: Cloud service case management model can effectively alleviate anxiety and depression in patients with nasopharyngeal carcinoma radiotherapy, and improve self-management efficiency. Meanwhile, it can relieve oral mucous membrane reaction and promote quality of life.