腫瘤晚期患者的护理困惑和应对措施.doc

肿瘤晚期患者的护理困惑及应对措施 沈阳医学院附属中心医院 张红伟 邮编：110024 [摘要]：目的：探讨定期心理座谈和疼痛管理健康教育对于癌症晚期患者疼痛缓解和提高生命质量的效果，同时也探讨定期心理咨询对于减轻肿瘤科护士的焦虑水平是否有效。方法：将我院肿瘤科2011年6月-2012年6月住院的60例肿瘤晚期病人随机分为实验组和对照组，对于对照组的晚期肿瘤患者给予常规护理，对于实验组的晚期肿瘤患者除了进行常规护理之外，还对其进行定期心理咨询和座谈，以及对肿瘤晚期病人进行有关疼痛管理方面的健康宣教。另外，在肿瘤科的40名护士也将被随机分为实验组和对照组，实验组的护士定期进行心理座谈，由心理咨询师给予针对性的指导，以宣泄工作中的不良情绪，并提供心理调节方面的意见和建议，而对照组的护士不进行任何干预。结果：干预前后，对病人进行疼痛量表评分，生活质量量表评分，实验组和对照组干预后的对比结果均具有统计学意义（P0.05）。实验组护士的焦虑情况与对照组护士的焦虑情况对比也具有统计学意义（P0.05）。结论：对晚期肿瘤病人进行健康教育和定期心理咨询对提高病人的生活质量和减轻疼痛有重要意义，同时定期的心理座谈对于护士的心理情况也能起较大作用的改善。 [关键词]肿瘤晚期患者; 疼痛管理的健康宣教；心理干预；生命质量；疼痛水平；护士焦虑水平 Confusions and solutions in caring the terminal cancer patients [Abstract]Target: To investigate the effects of regular health education about pain management and psychological counseling in relieving pains and improving quality of life for terminal cancer patients, meanwhile to see whether regular psychological counseling can reduce nurses’ anxiety in caring terminal cancer patients. Method: In this research, we recruited 60 terminal cancer patients hospitalized in the oncology department of our hospital, they were randomly assigned into the experimental group and the control group, each group has 30 terminal cancer patients. For experimental group ,despite of routine nursing care ,nurses also provide regular pain management education and psychological counseling. For the control group, nurses only provide routine nursing care. In the oncology department, there are a total of 40 nurses, they were randomly assigned into the experimental group and the control group, for nurses in the experimental group, we offer regular psychological counseling for them but not for nurses in the control group .Results: Before and after intervention, both the experimental and control group of terminal cancer patients will test their pain level(VAS) and quality of life(QLQ—C30),according to the statistics, regular health education on pain management and psychological counseling have greater effects(p0.05) in relieving their