跨理论模型在喉癌患者术后管理中的应用

目的探讨跨理论模型(TTM)在喉癌患者术后管理中的应用效果。方法采用随机数字表法将150例接受手术治疗的喉癌患者分为干预组和对照组,每组75例,对照组实施常规干预,干预组实施TTM干预。分别采用自制自我管理能力测评量表和中国头颈部癌生命质量测定量表(QLICP-HN)评价干预前(入院时)和干预后(出院6个月后)两组患者的自我管理能力和生活质量,比较两组患者干预后的遵医行为及并发症发生率。结果干预后,两组患者按时服药、健康饮食、症状自处、情绪管理、社交管理评分均高于本组干预前,且干预组患者的上述评分均高于对照组,差异均有统计学意义(P﹤0.05)。干预后,干预组患者中定期复诊、术后接受辅助治疗、进行功能锻炼的比例均明显高于对照组(P﹤0.01)。干预组患者的并发症总发生率明显低于对照组(13.33%vs 33.33%,P﹤0.01)。干预后,两组患者QLICP-HN中躯体功能、心理功能、社会功能和头颈癌特异功能评分均高于本组干预前,且干预组患者的上述评分均高于对照组,差异均有统计学意义(P﹤0.05)。结论TTM干预可有效提高喉癌患者的自我管理能力,强化遵医行为,改善生活质量。

Application of trans-theoretical model in postoperative management of patients with laryngeal cancer

Objective To explore the effect of the trans-theoretical model(TTM)in the postoperative management of patients with laryngeal cancer.Method A total of 150 patients with laryngeal cancer undergoing surgical treatment were selected and divided into an intervention group and a control group,with 75 cases in each group using a random number table.The control group received the conventional intervention,and the intervention group received TTM intervention.The self-made self-management scale and the China version quality of life instruments for cancer patients-head and neck cancer(QLICP-HN)were used to evaluate the self-management and quality of life of the two groups of patients before the intervention(at admission)and after the intervention(6 months after discharge).The compliance and the incidence of complications of the two groups of patients after the intervention were also compared.Result After the intervention,the scores of the two groups of patients on timely medication,healthy diet,self-management of symptoms,emotional management,and social management were higher than those before the intervention,and the scores of the intervention group were higher than those of the control group,the differences were statistically significant(P<0.05).After the intervention,the proportions of patients in the intervention group who received regular follow-up visits,received postoperative adjuvant treatment,and performed functional exercise were significantly higher than those in the control group(P<0.01).The total incidence of complications in the intervention group was significantly lower than that in the control group(13.33%vs 33.33%,P<0.01).After the intervention,the physical function,psychological function,social function,head and neck cancer-specific function scores of the two groups in QLICP-HN were higher than those before the intervention,and the scores of the intervention group were higher than those of the control group,the differences were statistically significant(P<0.05).Conclusion TTM can effectively enhance self-management ability,strengthen compliance and improve the quality of life of patients with laryngeal cancer.