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Abstract：
OBJECTIVE: To explore the application value of the self-management manual combined with the case management model in postoperative management of nasopharyngeal carcinoma after radiotherapy.
METHODS: Eighty-four patients with nasopharyngeal carcinoma admitted to Yingtan People\'s Hospital from May 2020 to April 2022 were retrospectively included in this study. They were divided into the experimental group (receiving self-management manual combined with case management mode scheme, n=42) and the control group (receiving continuous management after conventional nasopharyngeal carcinoma radiotherapy, n=42) according to mode differences. The cancer-related fatigue [Cancer Fatigue Scale (CFS)], comfort status [General Comfort Questionnaire (GCQ)], self-management efficacy [Chinese Strategies Used by People to Promote Health (C-SUPPH)], self-care ability (self-care ability measurement), pain score [Visual analogue scale (VAS)], and quality of life [European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC QLQ-C30)] were compared between the two groups after 4 weeks of radiotherapy. The adverse reactions of the two groups were recorded. Combined with periodic review and follow-up records, the prognostic factors of the two groups of patients were analyzed.
RESULTS: After treatment, the scores of physical fatigue (12.83±1.10), emotional fatigue (9.78±1.32), cognitive fatigue (5.62±1.31), and total score of CFS (28.24±2.26) in the experimental group were 12.83±1.10. The control group physical fatigue (13.90±1.25) points, emotional fatigue (10.55±1.40) points, cognitive fatigue (6.80±1.75) points, and total CFS (31.33±2.59) points in both groups were lower than before treatment. The experimental group was lower than the control group (ALL P<0.05). The physiological, psychological, spiritual, socio-cultural, and environmental scores of the experimental group were higher than those of the control group (all P<0.05). The scores of health knowledge, self-care skills, self-care responsibility, and self-concept score of patients in the experimental group were higher than the control group (all P<0.05). After intervention, the VAS score of the experimental group was lower than that of the control group (P<0.05). After intervention, the EORTC QLQ-C30 score of both groups increased significantly as compared with pre-intervention. The score in the experimental group was significantly higher than that in the control group [(80.05±10.72) vs (68.11±12.10), P<0.05]. Postoperative (various) adverse reactions in the experimental group were lower than the control group (all P<0.05). The factors influencing the prognosis of nasopharyngeal carcinoma patients were age, tumor stage, and intervention mode by Cox model analysis (all P<0.05).
CONCLUSIONS: The self-management manual combined with the case management mode can alleviate cancer fatigue, improve postoperative self-management ability, self-care ability, and quality of life of patients with nasopharyngeal cancer radiotherapy, reduce the occurrence of adverse reactions and improve the prognosis of patients. It is worth promoting in clinical settings.
METHODS: Eighty-four patients with nasopharyngeal carcinoma admitted to Yingtan People\'s Hospital from May 2020 to April 2022 were retrospectively included in this study. They were divided into the experimental group (receiving self-management manual combined with case management mode scheme, n=42) and the control group (receiving continuous management after conventional nasopharyngeal carcinoma radiotherapy, n=42) according to mode differences. The cancer-related fatigue [Cancer Fatigue Scale (CFS)], comfort status [General Comfort Questionnaire (GCQ)], self-management efficacy [Chinese Strategies Used by People to Promote Health (C-SUPPH)], self-care ability (self-care ability measurement), pain score [Visual analogue scale (VAS)], and quality of life [European Organization for Research and Treatment of Cancer QLQ-C30 (EORTC QLQ-C30)] were compared between the two groups after 4 weeks of radiotherapy. The adverse reactions of the two groups were recorded. Combined with periodic review and follow-up records, the prognostic factors of the two groups of patients were analyzed.
RESULTS: After treatment, the scores of physical fatigue (12.83±1.10), emotional fatigue (9.78±1.32), cognitive fatigue (5.62±1.31), and total score of CFS (28.24±2.26) in the experimental group were 12.83±1.10. The control group physical fatigue (13.90±1.25) points, emotional fatigue (10.55±1.40) points, cognitive fatigue (6.80±1.75) points, and total CFS (31.33±2.59) points in both groups were lower than before treatment. The experimental group was lower than the control group (ALL P<0.05). The physiological, psychological, spiritual, socio-cultural, and environmental scores of the experimental group were higher than those of the control group (all P<0.05). The scores of health knowledge, self-care skills, self-care responsibility, and self-concept score of patients in the experimental group were higher than the control group (all P<0.05). After intervention, the VAS score of the experimental group was lower than that of the control group (P<0.05). After intervention, the EORTC QLQ-C30 score of both groups increased significantly as compared with pre-intervention. The score in the experimental group was significantly higher than that in the control group [(80.05±10.72) vs (68.11±12.10), P<0.05]. Postoperative (various) adverse reactions in the experimental group were lower than the control group (all P<0.05). The factors influencing the prognosis of nasopharyngeal carcinoma patients were age, tumor stage, and intervention mode by Cox model analysis (all P<0.05).
CONCLUSIONS: The self-management manual combined with the case management mode can alleviate cancer fatigue, improve postoperative self-management ability, self-care ability, and quality of life of patients with nasopharyngeal cancer radiotherapy, reduce the occurrence of adverse reactions and improve the prognosis of patients. It is worth promoting in clinical settings.
摘要：
目的：探讨自我管理手册结合个案管理模式在鼻咽癌放疗术后管理中的应用价值。
方法：回顾性纳入2020年5月至2022年4月鹰潭市人民医院收治的84例鼻咽癌患者。分为实验组(接受自我管理手册结合病例管理模式方案,n=42）和对照组（接受常规鼻咽癌放疗后的持续管理，n=42)根据模式差异。癌症相关性疲劳[癌症疲劳量表(CFS)]舒适度状况[一般舒适度问卷(GCQ)]，自我管理效能[人们促进健康的中国策略（C-SUPPH）]，自我护理能力(自我护理能力测量)，疼痛评分[视觉模拟评分(VAS)]，放疗4周后，比较两组患者的生活质量[欧洲癌症研究和治疗组织QLQ-C30（EORTCQLQ-C30）]。记录两组患者的不良反应发生情况。结合定期审查和跟踪记录，分析两组患者的预后因素。
结果：治疗后，身体疲劳评分（12.83±1.10），情绪疲劳（9.78±1.32），认知疲劳（5.62±1.31），实验组CFS总分(28.24±2.26)为12.83±1.10。对照组身体疲劳(13.90±1.25)分,情绪疲劳(10.55±1.40)分,认知疲劳(6.80±1.75)分,两组患者总CFS(31.33±2.59)分均低于治疗前。实验组低于对照组(P<0.05)。生理，心理,精神,社会文化,试验组环境评分高于对照组(均P<0.05)。健康知识的得分，自我护理技能,自我照顾的责任，实验组患者的自我概念评分均高于对照组(均P<0.05)。干预后,实验组VAS评分低于对照组(P<0.05)。干预后,与干预前相比,两组的EORTCQLQ-C30评分均显著升高.实验组评分明显高于对照组[(80.05±10.72)vs(68.11±12.10),P<0.05]。试验组术后（各种）不良反应均低于对照组（均P<0.05）。影响鼻咽癌患者预后的因素有年龄,肿瘤分期,干预模式经Cox模型分析(均P<0.05)。
结论：自我管理手册结合个案管理模式可缓解癌症疲乏，提高术后自我管理能力,自理能力,鼻咽癌放疗患者的生活质量，减少不良反应的发生,改善患者预后。值得在临床上推广。
方法：回顾性纳入2020年5月至2022年4月鹰潭市人民医院收治的84例鼻咽癌患者。分为实验组(接受自我管理手册结合病例管理模式方案,n=42）和对照组（接受常规鼻咽癌放疗后的持续管理，n=42)根据模式差异。癌症相关性疲劳[癌症疲劳量表(CFS)]舒适度状况[一般舒适度问卷(GCQ)]，自我管理效能[人们促进健康的中国策略（C-SUPPH）]，自我护理能力(自我护理能力测量)，疼痛评分[视觉模拟评分(VAS)]，放疗4周后，比较两组患者的生活质量[欧洲癌症研究和治疗组织QLQ-C30（EORTCQLQ-C30）]。记录两组患者的不良反应发生情况。结合定期审查和跟踪记录，分析两组患者的预后因素。
结果：治疗后，身体疲劳评分（12.83±1.10），情绪疲劳（9.78±1.32），认知疲劳（5.62±1.31），实验组CFS总分(28.24±2.26)为12.83±1.10。对照组身体疲劳(13.90±1.25)分,情绪疲劳(10.55±1.40)分,认知疲劳(6.80±1.75)分,两组患者总CFS(31.33±2.59)分均低于治疗前。实验组低于对照组(P<0.05)。生理，心理,精神,社会文化,试验组环境评分高于对照组(均P<0.05)。健康知识的得分，自我护理技能,自我照顾的责任，实验组患者的自我概念评分均高于对照组(均P<0.05)。干预后,实验组VAS评分低于对照组(P<0.05)。干预后,与干预前相比,两组的EORTCQLQ-C30评分均显著升高.实验组评分明显高于对照组[(80.05±10.72)vs(68.11±12.10),P<0.05]。试验组术后（各种）不良反应均低于对照组（均P<0.05）。影响鼻咽癌患者预后的因素有年龄,肿瘤分期,干预模式经Cox模型分析(均P<0.05)。
结论：自我管理手册结合个案管理模式可缓解癌症疲乏，提高术后自我管理能力,自理能力,鼻咽癌放疗患者的生活质量，减少不良反应的发生,改善患者预后。值得在临床上推广。
