Application of transitional care model in cancer pain management after discharge: a randomized controlled trial

Xuan Wang, Xian-Cui Wu
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引用次数: 3

Abstract

Objective

We sought to determine any benefits of applying a transitional care model in the continuum of cancer pain management, especially after patients' discharge from the hospital.

Methods

A total of 156 eligible participants were recruited and randomly assigned into intervention or control groups. The control group received standard care, while the intervention group received extra, specialized transitional care of pain management. Outcomes were measured at weeks 0 and 2–4 and included demographic data, the Brief Pain Inventory, Global Quality of Life Scale, and Satisfaction Degree of Nursing Service. Adequacy of analgesia and severity of pain were assessed with the Pain Management Index and interview findings.

Results

After 2–4 weeks of intervention, there was a significant difference in the change in average pain score between intervention and control groups (P < 0.05). Reductions in pain scores were significantly greater in the intervention group than in the control group (difference: 0.98, P < 0.05). Regarding pain management outcomes, there was a significantly better condition in the intervention group compared with the control group; in the intervention group, 79% of patients had adequate opioids, whereas in the control group, only 63% of patients reported having adequate opioids. Furthermore, there was a significant difference between the two groups in quality of life (QOL) scores (P < 0.05); the intervention group had significantly higher quality of life than the control group (difference: 1.06). Finally, there was a significant difference in the degree of satisfaction with the home nursing service; the intervention group had a significantly higher degree of satisfaction with the home nursing service in three aspects: quality, content, and attitude of service.

Conclusions

The application of a transitional care model in cancer pain management after discharge could help patients to improve their cancer pain management knowledge and analgesics compliance. In addition, the continuum of care service will contribute to effective communication between health care providers and patients, which could further improve their relationship.

过渡护理模式在癌性疼痛出院后管理中的应用:一项随机对照试验
目的:我们试图确定在癌症疼痛管理的连续性中应用过渡护理模式的任何益处,特别是在患者出院后。方法共招募156名符合条件的受试者,随机分为干预组和对照组。对照组接受标准治疗,干预组接受额外的、专门的疼痛管理过渡治疗。在第0周和第2-4周测量结果,包括人口统计数据、简短疼痛量表、全球生活质量量表和护理服务满意度。通过疼痛管理指数和访谈结果评估镇痛的充分性和疼痛的严重程度。结果干预2 ~ 4周后,干预组与对照组的平均疼痛评分变化差异有统计学意义(P <0.05)。干预组疼痛评分的降低明显大于对照组(差异:0.98,P <0.05)。在疼痛管理结果方面,干预组明显优于对照组;在干预组中,79%的患者有足够的阿片类药物,而在对照组中,只有63%的患者报告有足够的阿片类药物。此外,两组患者的生活质量(QOL)评分也有显著差异(P <0.05);干预组患者的生活质量明显高于对照组(差异1.06)。最后,对家庭护理服务的满意度存在显著差异;干预组对家庭护理服务的满意度在服务质量、服务内容、服务态度三个方面均显著高于干预组。结论过渡护理模式在癌性疼痛出院后管理中的应用有助于患者提高癌性疼痛管理知识和镇痛药物依从性。此外,持续的护理服务将有助于保健提供者和患者之间的有效沟通,从而进一步改善他们的关系。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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