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目的探讨在医疗机构-社区转诊模式下恶性肿瘤生存者的疼痛、生活质量及有效的心理干预模式。方法应用EORTCQLQ-C30问卷调查表及数字评分疼痛分级法对133例患者进行生活质量测定及疼痛测定;患者出院后转诊至社区医生,继续进行止痛治疗、心理干预及随访,6周后予EORTCQLQ-C30问卷调查,对结果进行比较分析。结果使用三阶梯止痛治疗后,疼痛总缓解率为82.71%。治疗后患者社会功能(57.37±7.36vs.60.01±6.70)、情绪功能(55.12±9.21vs.56.92±9.03)、躯体功能(52.91±8.58vs.54.14±8.28)、失眠(46.03±9.04vs.44.58±8.39)、整体质量(53.93±7.99vs.54.93±7.98)均明显改善,与治疗前相比有显著性差异(P<0.05);心理干预可有效改善患者生活质量(56.47±8.12),较干预前的(54.93±7.98)有显著性差异(P<0.05)。结论三阶梯止痛疗法能有效缓解疼痛,在医疗机构-社区医疗服务模式下建立有效的综合性心理干预措施,能有效的改善恶性肿瘤生存者的生活质量。
Objective To explore the patterns of pain, quality of life and effective psychological intervention for cancer survivors in medical institutions and community referral models. Methods EORTCQLQ-C30 questionnaire and digital grading pain grading method were used to measure the quality of life and pain in 133 patients. After discharge, the patients were referred to community doctors for analgesia treatment, psychological intervention and follow-up. After 6 weeks, the patients were given EORTCQLQ-C30 Questionnaire, comparative analysis of the results. Results The pain relief rate was 82.71% after using the three-step analgesic treatment. After treatment, the social function (57.37 ± 7.36vs.60.01 ± 6.70), emotional function (55.12 ± 9.21vs.56.92 ± 9.03), body function (52.91 ± 8.58vs.54.14 ± 8.28), insomnia (46.03 ± 9.04vs.44.58 ± 8.39), the overall quality (53.93 ± 7.99 vs.54.93 ± 7.98) were significantly improved compared with those before treatment (P <0.05); psychological intervention can effectively improve the quality of life of patients (56.47 ± 8.12) Before intervention (54.93 ± 7.98) there was a significant difference (P <0.05). Conclusion Three-step analgesic therapy can effectively relieve pain and establish effective comprehensive psychological intervention in the medical institution-community medical service model, which can effectively improve the quality of life of cancer survivors.