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基于多学科协作的精准护理策略在老年肺癌胸腔镜患者中的应用

Application of Precision Nursing Based on Multidisciplinary Collaboration Model in Older Patients Undergoing Thoracoscopic Surgery for Lung Cancer

  • 摘要:
      目的  探讨基于多学科协作模式的精准护理策略在老年肺癌胸腔镜手术患者中的应用效果。
      方法  采用前瞻性研究方法,将2022年7月–2023年3月入我院拟行肺癌胸腔镜手术的100例患者,使用随机数字表分为采取常规护理方法的对照组以及采用多学科协作模式的精准护理策略的研究组。比较2组患者在入院时、术后1周、术后1个月三个时间点的肺功能、焦虑评分、抑郁评分以及生活质量。
      结果  两组患者3个时间点间1 s用力肺活量(forced expiratory volume in one second, FEV1)(F=156.787,P<0.001)、一秒率〔FEV1/用力肺活量(forced vital capacity, FVC)% 〕(F=25.587,P<0.001)等指标的差异有统计学意义。研究组患者FEV1、FEV1/FVC%、FVC、最大通气量(maximum voluntary ventilation, MVV)指标术后1周和术后1个月时与对照组间的差异有统计学意义(P<0.05)。研究组术后的肺功能情况优于对照组。研究组焦虑、抑郁得分低于对照组,差异有统计学意义(P<0.05),焦虑、抑郁情绪较对照组有所改善。生活质量方面,两组患者在功能领域(F=109.798, P<0.001)、症状领域(F=106.936,P<0.001)、其他项目得分(F=78.798,P<0.001)以及总体健康维度得分(F=174.307,P<0.001)的差异有统计学意义。研究组患者术后1周及术后1个月,功能领域得分高于对照组,症状领域得分低于对照组,总体健康状况好于对照组。
      结论  基于多学科协作模式的精准护理策略可有效改善患者的肺功能,改善情绪,提高患者近期生活质量,具有一定的临床推广价值。

     

    Abstract:
      Objective   To examine the application effect of precision nursing strategies based on multidisciplinary collaboration model in older patients undergoing thoracoscopic surgery for lung cancer.
      Methods   A total of 100 patients who were admitted to our hospital for thoracoscopic surgery for lung cancer between July 2022 and March 2023 were prospectively enrolled for the study. They were assigned, with a random number table, to two groups, a control group receiving routine nursing care and an experimental group receiving nursing care based on multidisciplinary collaborative precision nursing strategies. Their lung function, anxiety and depression scores, and quality of life were assessed at three points of time, including upon admission, one week after surgery, and one month after surgery, and comparison was made between the two groups.
      Results   There were significant differences in forced expiratory volume in one second (FEV1) at the three time points (F=156.787, P<0.001) and the ratio of FEV1 to forced vital capacity (FVC) (FEV1/FVC%) at the three time points (F=25.587, P<0.001) between two groups. There were significant difference between the findings for FEV1, FEV1/FVC%, FVC, and maximum voluntary ventilation (MVV) indexes at 1 week and those at 1 month after surgery in the experimental group (P<0.05). After the surgery, the pulmonary function of the experimental group was better than that of the control group. The anxiety and depression scores of the experimental group were lower than those of the control group, with the difference being statistically significant (P<0.05), which suggested that the experimental group showed improvement in anxiety and depression in comparison with the control group. Regarding the quality of life, there were significant differences between the two groups in the scores for the functional dimension (F=109.798, P<0.001), the symptom dimension (F=106.936, P<0.001), other items (F=78.798, P<0.001), and overall health dimensions (F=174.307, P<0.001). At 1 week and 1 month after surgery, the experimental group had higher scores for the functional dimension and lower scores for the symptom dimension than the control group did, with the differences being statistically significant (P<0.05). The overall health status of the experimental group was better than that of the control group.
      Conclusion   Precision nursing strategies based on multidisciplinary collaboration model can effectively help improve the lung function, the mood, and the quality of life of patients in the short term, showing considerable promise for wide clinical application.

     

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