基于共享决策理念的无呕管理方案对肝癌患者经肝动脉栓塞化疗后恶心呕吐的影响

Impact of nausea-free management program based on shared decision-making on nausea and vomiting after transarterial chemoembolization in liver cancer patients

  • 摘要:
    目的 探讨基于共享决策理念构建的无呕管理方案对肝癌患者经肝动脉栓塞化疗(TACE)后恶心呕吐的影响。
    方法 设计共享决策辅助工具,制订无呕管理方案。选取2023年1—12月南通市第三人民医院介入科收治的100例接受TACE治疗的肝癌患者作为研究对象,对照组(2023年1—6月收治)采用常规TACE围术期护理措施,试验组(2023年7—12月收治)在常规护理基础上实施无呕管理方案。比较2组患者术后24 h恶心和呕吐发生情况及分级,干预后呕吐功能性生活指数、生命质量,以及干预前后自我决策效能。
    结果 术后24 h, 试验组恶心和呕吐的发生率及分级均低于对照组,差异有统计学意义(P < 0.05);干预后,试验组肝癌患者生命质量评定量表(QOL-LC)总分及各维度得分均高于对照组,呕吐功能性生活指数总分高于对照组,差异有统计学意义(P < 0.05);干预后,试验组自我决策效能得分高于干预前,且高于对照组,差异有统计学意义(P < 0.05)。
    结论 基于共享决策理念的无呕管理方案可有效降低肝癌患者TACE治疗后恶心和呕吐的发生率及程度,并提升患者的生存质量、呕吐功能性生活指数及自我决策效能。

     

    Abstract:
    Objective To explore the impact of nausea and vomiting management program based on shared decision-making on post-transarterial chemoembolization (TACE) nausea and vomiting in liver cancer patients.
    Methods A shared decision-making aid was designed, and nausea and vomiting management program was developed. A total of 100 liver cancer patients who underwent TACE treatment in the Department of Interventional Radiology at Nantong Third People's Hospital from January to December 2023 were selected as study subjects. The control group (admitted from January to June 2023) received routine TACE perioperative nursing care, while the experimental group (admitted from July to December 2023) implemented the nausea and vomiting management program in addition to routine care. The incidence and severity of nausea and vomiting within 24 hours post-surgery, as well as the vomiting-related functional living index, quality of life, and self-efficacyin decision-making before and after the intervention were compared between the two groups.
    Results Within 24 hours post-surgery, the incidence and severity of nausea and vomiting in the experimental group were lower than those in the control group, with statistically significant differences (P < 0.05). After the intervention, the total and dimensional scores of the Quality of Life in Liver Cancer (QOL-LC) scale and the vomiting-related functional living index in the experimental group were higher than those in the control group(P < 0.05). Additionally, the self-decision-making efficacy score in the experimental group was higher after the intervention than before intervention and higher than that in the control group (P < 0.05).
    Conclusion The nausea and vomiting management program based on shared decision-making can effectively reduce the incidence and severity of post-TACE nausea and vomiting in liver cancer patients, and improve their quality of life, vomiting-related functional living index, and self-decision-making efficacy.

     

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