| 刘勇,陈小妹,廖金花,等.多学科协作模式下的临终关怀在肿瘤终末期病人中应用研究[J].安徽医药,2020,24(12):2463-2469. |
| 多学科协作模式下的临终关怀在肿瘤终末期病人中应用研究 |
| Application of hospice care under multidisciplinary team assistance mode in terminal cancer patients |
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| DOI：10.3969/j.issn.1009?6469.2020.12.033 |
| 中文关键词: 临终关怀医疗 姑息疗法 缓和照顾 多学科协作模式 肿瘤终末期 |
| 英文关键词: Hospice care Palliative therapy Palliative care Multidisciplinary team assistance mode Terminal cancer |
| 基金项目: |
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| 摘要点击次数: 1331 |
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| 中文摘要: |
| 目的探讨多学科协作模式下的临终关怀对肿瘤终末期病人对应的临床获益情况，生命质量改善情况，以及症状负担等方面的影响。方法选取赣州市肿瘤医院姑息治疗病区 2018年 9月至 2019年 6月收治的生存期预期小于 3个月的肿瘤终末期病人 62例，采用随机数字表法分为对照组及观察组，每组各 31例，对照组予以常规的积极治疗，观察组予以多学科协作模式下的临终关怀治疗。分别记录、比较两组治疗前后短期内的欧洲癌症研究与治疗组织开发的生命质量测定量表(EORTC QLQ?C30)、数字分级量表(NRS)、汉密尔顿焦虑量表(HAMA)等量表的评分，两组治疗后短期内的中位生存时间，中位日均药费和最后 2d内产生的中位总药费，以及医疗保健满意度等。结果治疗后，与对照组相比，观察组对应的情绪功能领域［(64.23±16.04)比(53.16±23.35)分］与总体健康状况领域［(31.89±13.04)比(23.92±11.15)分］升高明显(P＜0.05)症状改善程度也存在明显差异(P＜0.05)。观察组对应的中位日均药费 412.19(399.10，425.28)元和最后 2d内产生的中，位总药费 1 186.32(1 158.59，1 214.03)元均显著低于对照组［623.68(607.15，640.21)， 1 762.53(1 740.01，1 785.05)］(P＜0.001)；且病人及其近亲属对医疗保健满意度明显高于对照组［80.645%(25/31)比 41.935%(13/ 31)，P＜0.01］；此外，观察组短期内的中位生存时间与对照组比较差异无统计学意义(P＞0.05)。结论通过实施多学科协作模式下的临终关怀，可以减轻病人痛苦，提高病人生命质量，减轻症状负担，为终末期病人提供规范、合理、优质的 |
| 英文摘要: |
| Objective To explore the impact of hospice care under multidisciplinary team assistance mode on the clinical benefit， improvement of quality of life，and symptom burden of end?stage cancer patients.Methods A total of 62 end?stage cancer pa?tients with an expected survival time of less than 3 months who were admitted to the Palliative Care Department of Ganzhou Can?cer Hospital from September 2018 to June 2019 were selected and randomly divided into a control group and an observation group，with 31 cases each group.The control group was given conventional active treatment，and the observation group was treated with hospice care under multidisciplinary team assistance mode.The quality of life scales(EORTC QLQ?C30)developed by the European Cancer Research and Treatment Organization，digital rating scale(NRS)， Hamilton anxiety scale(HAMA)and other scales in the short term before and after treatment were recorded and compared.The clinical efficacy of the two groups were ob?served and compared after treatment，which based on the assessment levels(such as the median survival time in the short?term treatment，symptom control，the median average daily cost of drug，the median total cost of drug in the last 2 days，and medical care satisfaction).Results After treatment，compared with the control group，the total degree of emotional function(64.23±16.04) vs.(53.16±23.35)points and general health status(31.89±13.04)vs.(23.92±11.15)points improvement in the observation group was significantly promoted(P＜0.05).The total degrees of symptoms improvement in the observation group were significantly high? er than in the control group(P＜0.05).The indicators such as the median average daily cost of drug and the median total cost ofdrug in the last 2 days of the observation group were significantly lower than those of the control group［412.19(399.10，425.28) yuan vs. 623.68(607.15，640.21)yuan, 1 186.32(1 158.59，1 214.03)yuan vs. 1 762.53(1 740.01，1 785.05)yuan, P＜0.001］.In addition，the overall rate about medical care satisfaction of the patients and patients’family members in the observation group was significantly higher than that in the control group［80.645%(25/31)vs. 41.935%(13/31), P＜0.01］.There was no significant dif?ference in the short?term median survival time between the two groups(P＞0.05).Conclusion Hospice care under multidisci? plinary team assistance mode can effectively alleviate the suffering of patients，improve the quality of life of patients，reduce the burden of patients’symptoms.It has positive reference significance for providing standardized，reasonable and high?quality treat? ment for end?stage patients. |
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