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目的探讨老年初诊癌症患者的病情告知及生活质量促进策略。方法随机抽样筛选出2012年1月-2014年12月期间就诊于湖北省某三甲医院的老年初诊癌症患者240例,随机分为干预组、对照组,各120例。对干预组患者及其家属采用医学应对问卷进行调查筛选出告知对象后,采用SPIKES六步法告知策略进行告知,再针对患者、家属的生活质量调查情况进行针对性治疗、护理。对照组采取常规告知、治疗、护理方法。结果老年初诊癌症患者、家属采取面对的应对方式最多(20.13±1.24分和19.24±2.76分),屈服的应对方式最少(9.77±1.45分和8.74±2.15分),回避的应对方式居中(15.74±1.77分和14.21±2.02分)。告知癌症病情后,干预组和对照组告知对象的生活质量评分均有不同程度的下降,但干预组下降幅度较对照组下降幅度低,两组间差异有统计学意义(P<0.05)。出院时,干预组和对照组告知对象的生活质量评分均有不同程度上升,但干预组上升幅度较对照组上升幅度大,两组间差异有统计学意义(P<0.05)。结论运用医学应对问卷合理选择癌症告知对象,SPIKES六步法科学告知,使用生活质量调查表针对性治疗、护理,能提高老年初诊癌症患者的生活质量,保证信息的对称性。
Objective To investigate the condition of elderly patients with cancer and the quality of life promotion strategies. Methods A total of 240 elderly patients with newly diagnosed cancer in a third-grade hospital in Hubei Province from January 2012 to December 2014 were selected randomly and randomly divided into intervention group and control group, each with 120 cases. Patients in the intervention group and their family members were investigated by using the questionnaire of medical coping to screen the informed target, and then informed by SPIKES six-step notification strategy. Targeted treatment and nursing were conducted according to the quality of life survey of patients and their families. Control group to take regular notice, treatment, nursing methods. Results The incidence of coping styles was the highest (20.13 ± 1.24 and 19.24 ± 2.76), the least coping style was 9.77 ± 1.45 and 8.74 ± 2.15, and the coping style of avoidance was middle (15.74 ± 1.77 points and 14.21 ± 2.02 points). After informed of the cancer condition, the quality of life scores of the subjects in the intervention group and the control group decreased to some extent, but the decrease rate in the intervention group was lower than that in the control group. There was significant difference between the two groups (P <0.05). At discharge from hospital, the quality of life scores of the subjects in the intervention group and the control group increased to some extent, but the increase in the intervention group was larger than that in the control group, with significant difference between the two groups (P <0.05). Conclusions Using the medical questionnaire to reasonably choose the target of cancer notification, SPIKES six-step method of science tells us that the use of quality of life questionnaire targeted treatment and care can improve the quality of life of elderly patients with newly diagnosed cancer and ensure information symmetry.