目的:前列腺癌是老年男性最常见的恶性肿瘤之一,根治性前列腺切除术是局部疾病的既定治疗方法。接受这种手术的患者在围手术期经常会经历负面情绪和症状的增加。可能是由于对疾病及其治疗的担忧。本研究旨在研究涉及全过程可视化和协作护理讨论的新型教育方法对前列腺癌根治术患者围手术期症状和情绪健康的影响。
方法:前瞻性收集了2021年6月至2023年12月期间入院的310例患者的数据,所有这些患者均计划接受根治性前列腺切除术。这些患者被随机分为干预组(接受新模式教育)或对照组(接受常规教育),每组155名患者。这项研究比较了基本的人口统计信息,焦虑和抑郁评分,对疾病进展分数的恐惧,生活质量分数,主要症状评分,两组围手术期生命体征的变化。
结果:两组在年龄方面无统计学差异,合并症,保险类型,教育水平,收入,肿瘤病史(P>0.05)。同样,焦虑和抑郁评分没有显著差异,焦虑和抑郁患者的比例,生命体征,在时间1阶段,两组患者对疾病进展的恐惧评分(P>0.05)。在时间2和时间3阶段,干预组表现出更低的焦虑和抑郁评分,焦虑和抑郁患者的比例较低,血压和心率波动明显低于对照组(P<0.05)。根治性前列腺切除术后,患者的主要症状,如疼痛,恶心,和疲劳,在手术后第1-3天使用MADIS症状评估量表进行评估。干预组3种症状评分明显低于对照组(P<0.05);在第4阶段,与对照组相比,干预组患者的生活质量评分也有显著改善(P<0.05).此外,患者的血压和心率在时间4阶段恢复到基线水平,两组间无显著性差异(P>0.05)。然而,干预组在时间4阶段的焦虑和抑郁评分仍显著低于对照组(P<0.05)。此外,两组患者对疾病进展的恐惧评分均低于时间1阶段,与对照组相比,干预组的改善更为明显(P<0.05)。
结论:被诊断为恶性肿瘤的患者通常会对疾病的进展和即将进行的手术感到恐惧和焦虑。以及围绕他们的治疗和预后的不确定性。在围手术期,这种情绪困扰加剧可能会导致更大的症状负担。利用全过程可视化和协作护理讨论方法,与传统的沟通方式相比,已经被证明可以减轻病人的恐惧,减少焦虑和抑郁,并最终减轻围手术期的症状负担。最终,这种方法可以提高恶性肿瘤患者的整体生活质量。
OBJECTIVE: Prostate cancer is one of the most common malignant neoplasms in elderly males, with radical prostatectomy being the established therapeutic approach for localized disease. Patients undergoing this surgical procedure frequently experience increased negative emotions and symptomatology during the perioperative period, likely due to concerns about the illness and its treatment. The present study aims to investigate the effects of a novel educational approach involving a whole-process visualization and collaborative nursing discussions on perioperative symptoms and emotional well-being in radical prostatectomy patients.
METHODS: Data were prospectively collected from 310 patients admitted to the hospital between June 2021 and December 2023, all of whom were scheduled to undergo radical prostatectomy. These patients were randomly assigned to either the intervention group (receiving new model education) or the control group (receiving conventional education), with 155 patients in each group. The study compared basic demographic information, anxiety and depression scores, fear of disease progression scores, quality-of-life scores, main symptom scores, and changes in perioperative vital signs between the two groups.
RESULTS: No statistically significant differences were observed between the two groups in terms of age, comorbidities, insurance type, education level, income, and tumor history (P > 0.05). Similarly, there were no significant differences in anxiety and depression scores, proportion of patients with anxiety and depression, vital signs, and fear of disease progression scores between the two groups at Time 1 stage (P > 0.05). During stages Time 2 and Time 3, the intervention group exhibited lower anxiety and depression scores, a lower proportion of anxious and depressed patients, as well as significantly reduced blood pressure and heart rate fluctuations compared to the control group (P < 0.05). Following radical prostatectomy, the main symptoms of patients, such as pain, nausea, and fatigue, were assessed using the MADIS Symptom Assessment Scale on days 1-3 post-surgery. The intervention group exhibited significantly lower scores for three symptoms compared to the control group (P < 0.05); at Time 4 stage, the patients in the intervention group also demonstrated significantly improved quality-of-life scores compared to the control group (P < 0.05). Additionally, blood pressure and heart rate of patients returned to baseline levels at Time 4 stage, with no significant difference between the two groups (P > 0.05). Nevertheless, the anxiety and depression scores in the intervention group at the Time 4 stage remained significantly lower than those in the control group (P < 0.05). Additionally, the fear of disease progression scores in both groups were lower than those at the Time 1 stage, with a more pronounced improvement observed in the intervention group compared to the control group (P < 0.05).
CONCLUSIONS: Patients diagnosed with malignant tumors often experience fear and anxiety regarding the progression of their disease and upcoming surgery, as well as uncertainty surrounding their treatment and prognosis. This heightened emotional distress can contribute to a greater symptom burden during the perioperative period. Utilizing a whole-process visualization and collaborative nursing discussion approach, as compared to traditional communication methods, has been shown to alleviate patients\' fears, reduce anxiety and depression, and ultimately lessen the symptom burden experienced during the perioperative phase. Ultimately, this approach can enhance the overall quality of life for patients facing malignant tumors.