| ObjectsBy the use of IKAP theory to build continuous, integrated, planned extended care models, a complete system of extended care service system in patients with bladder cancer undergoing bladder perfusion was built. The effect of this extended care of IKAP theoretical model on patients needed bladder instillation was also evaluated.MethodsUsing convenience sampling method, choose the bladder patients needed intravesical instillation, March 2014-March 2015 in a hospital urology.51 patients were included in the study group and 53 patients in the control group, the infusion drugs was pirarubicin. The control group accepted the routine care after the bladder tumor resection by the primary nurses who accept the unified specialized training.At the time of hospitalization, routine health education pathway of bladder infusion chemotherapy was given. The local or systemic symptoms were recored, the patients’ general information scale, quality of life, compliance adverse reactions and the recurrence also were tracked and collected. For the experimental group, we established an "IKAP nursing group". From the first day after operation to the day before discharge, the IKAP model of continuous nursing model was implemented. After 12 months of implementation, we compared the quality of life between the research group and the control group by the quality of life questionnaire QLQ-BLS24(which was developed specifically to superficial bladder cancer by European Cancer Research and Treatment Center) and QLQ-30(Cancer patients quality of life scale). By use of self-compliance behavior scale and the satisfaction survey, the compliance and satisfaction were assessed; The occurrence of adverse reactions and the recurrence rate were also evaluated. SPSS 17.0 statistical software was used for the data analysis and the scale reliability and validity.Results1. The difference in the general socio-demographic data was not statistically significant (P> 0.05). The differences of the sex and whether the first episode were not statistically significant to the tumor recurrence rate(P>0.05). But the age difference was significant (P< 0.05).2. Before nursing intervention, the difference was not significant statistically on the function subscale scores, symptom subscale scores, the scores of each functional area, symptom scale scores and general health relatively between the experimental group and control group (P> 0.05). After 12 months of extended care intervention, the functional sub-scale scores of experimental group was 69.57±12.90, functional area and overall health scores was 69.15±12.19.In the control group, the functional sub-scale score was 64.01± 11.54, the score of the functional area and the overall health status score was 57.39± 11.62,these were lower than the experimental group and the difference was significantly (P<0.05). In the experimental group,the scores of symptom scale (30.88 ± 13.22) and’ symptom scale (22.97±11.32) were lower than those of the control group (37.86 ± 16.26, 26.48 ±12.19, respectively), the difference was significant(P<0.05).3. After the intervention for 12 months, adverse reactions of stimulative symptom of bladder, urethral stricture, gastrointestinal tract reaction, a burning sensation in the urinary bladder incidence of the control group was:22.64%,13.21%,20.75%,13.21%, respectively.The adverse reaction rates of the experimental group was 7.84%,1.96%, 5.88% and 9.8%, respectively.the incidence of adverse reactions of the control group were higher than the adverse reactions of the experimental group, the difference was significant (P< 0.05).4. The recurrence rate of bladder cancer in the experimental group and control group was 5.88%(3/51) and 20.07%(11/53) in 12 months respectively. The recurrence rate of bladder cancer in the experimental group and the control group was higher than that in the control group.The difference was significant (P<0.05).5. After the intervention of 3 months,6 months,9 months,12 months, the scores of compliance in experimental group was higher than that of the control group, the difference was statistically significant (P<0.05).6. After the intervention for 12 months, the scores of the satisfaction degree of the experimental group were higher than in the control group, The difference was statistically significant (P<0.05).ConclusionsThe IKAP theory extended care mode can offer a purposeful and planned extended care to the patients undergoing intravesical instillation during hospitalization and after discharge. There is a significant improvement in the patient’s overall quality of life and the organized systematic functions in many areas, reduced adverse reactions and disease recurrence and improved the quality of life of patients. Furthermore, the patients compliance to treatment was improved and could make the satisfaction and therapeutic effect better. |
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