安宁疗护改善重症监护病房晚期肺癌疼痛患者生存质量的效果观察

目的分析安宁疗护改善重症监护室(ICU)晚期肺癌疼痛患者生存质量的效果。方法随机数字表法将100例晚期肺癌患者随机分为对照组与干预组,每组50例,对照组患者接受常规干预措施,干预组患者在此基础上给予安宁疗护。干预前后,根据世界卫生组织(WHO)疼痛分级法比较两组患者的疼痛情况;采用患者尊严量表(PDI)比较两组患者的尊严水平;采用总体幸福感量表(GWB)比较两组患者的主观幸福感;采用欧洲癌症治疗研究组织的生活质量核心问卷(EORTC QLQ-C30)比较两组患者的生存质量。结果干预前,两组患者疼痛程度、PDI量表、GWB量表和EORTC QLQ-C30量表评分比较,差异均无统计学意义(P﹥0.05)。干预后,干预组患者疼痛程度弱于对照组患者,差异有统计学意义(P﹤0.05),干预组患者症状困扰、心理状况、依赖性、精神安宁和PDI量表总分均低于本组干预前和对照组患者(P﹤0.05),生活的满足和兴趣、对健康的担心、精力、抑郁或愉快的心境、对情感和行为的控制、松弛和紧张、幸福感总分均高于本组干预前和对照组患者(P﹤0.05),躯体功能、角色功能、情绪功能、认知功能和总分均高于本组干预前和对照组患者(P﹤0.05)。结论安宁疗护能够减轻ICU晚期肺癌疼痛患者疼痛程度,维护患者临终前尊严,提高其主观幸福感,并改善生存质量。

Effects of hospice care on improving quality of life in patients with advanced lung cancer pain in intensive care unit

Objective To analyze the effects of hospice care on improving the quality of life of patients with advanced lung cancer pain in intensive care unit(ICU).Method One hundred patients with advanced lung cancer in ICU were included in the analysis and randomized as control group or intervention group according to a random number table,with 50 cases in each.Control group was given routine nursing care,and intervention group was administered with hospice care besides routine interventions.Before and after intervention,World Health Organization(WHO) scale for pain assessment was used to evaluate the pain in the two groups;patient dignity inventory(PDI) to compare the dignity level;and general well-being(GWB) scale the subjective perception of well-being;and European Organization for Research and Treatment of Cancer-quality of life questionnaire-core 30(EORTC QLQ-C30) was employed to compare the quality of life of patients in the two groups.Result Before intervention,there were no statistically significant differences in the degree of pain,scores of PDI scale,GWB scale and EORTC QLQ-C30 scale between the two groups(P>0.05).After intervention,the pain level in intervention group was significantly reduced compared to that in control group(P<0.05),and the scores of symptom distress,existential distress,dependence and peace of mind and total score of PDI scale in intervention group were lower than those before intervention group and also decreased compared to control group(P<0.05),additionally,the scores of life satisfaction,anxiety,energy,depression,optimism,self-control,vitality and general health and total well-being score in intervention group were all improved after intervention and higher than those in control group(P<0.05).The scores of body function,role function,emotional function and cognitive function and total score of patients in intervention group were higher after intervention and augmented compared with control group(P<0.05).Conclusion Hospice care can relieve the degree of pain among patients with advanced lung cancer in ICU,maintaining the dignity of patients before dying,improve the subjective well-being and ameliorate the quality of life for patients.