The Effect Of Continuous Nursing Intervention On Complications And Quality Of Life In The Patients With Nasopharyngeal Carcinoma Completed Chemoradiotherapy After Discharge

Objective:To investigate the development of complications of chemoradio-therapy, the changes of psychological status, coping style, family support and quality of life, while the continuous nursing intervention had been implemented on patients with nasopharyngeal carcinoma (NPC) for 6 months after discharge. To explore the effects of nursing intervention on the quality of life in patients discharged with NPC, which would provide the evidence-based information to the rehabilitation nursing.Methods:Patients were randomly divided into two groups. From Decembe-r 2013 to June 2014,130 patients with NPC who was confirmed by histopathol-ogy, had completed chemoradiotherapy and discharged from the department of Radiotherapy of Tumor Hospital of Guangxi Medical University were ranked research samples, and randomly divided into groups as intervention group and control group.10 had been lost.There were 57 patients in the control group and 63 in the intervention group at last. Continuous nursing was applied only in the intervention group for six months on physiological nursing, psychological nursing and family support. Poisonous side reactions of the two groups were investigated at discharge and once a month. Psychological status, social support, coping style and the quality of life of the two groups were investigated at discharge and 6 months after discharge. Compared the differences between the teams. The data were considered to be significant when the P was less than 0.05 (bilateral).Result:1.Comparison of poisonous side reaction.①Incidence trend comparison:with time after discharge, poisonous side reaction as loss of appetite, oral mucositis and rhinobyon decreased. Dental discomfort, memory decline increased. Difficulty in opening mouth decreased first and then increased. Dizziness and headache increased first and then decreased. Dry mouth didn’t change obviously.②Grades comparison:the differences of memory decline compared between the two groups were not statistically significant (P>0.05). Other poisonous side reactions of the intervention group were less than that of the control group in different times (P<0.05).③Scores comparison:patients in the intervention group were less than that in the control group every month (P<0.05).2.Comparison of SDS:the scores of intervention group were lower than that of the control group (P<0.05).3.Comparison of SCSQ:the sores of intervention group were lower than that of the control group on negative coping style, and higher on positive coping style (P<0.05).4.Comparison of PSS-Fa:the sores of intervention group were higher than that of the control group (P<0.05).5.The influencing factors analysis of quality of life of patients with NPC: the level of quality of life of patients with NPC was correlated with the level of education, family support, the level of depression, coping style, poisonous side reaction and economical condition (P<0.05). It was correlative among associated factors(P<0.05).6.Comparison of QLQ① Comparison of QLQ-C30:the sores of intervention group were higher than that of the control group on function and global quality of life, and lower on fatigue, insomnia, appetite loss and constipation (P<0.05).② Comparison of QLQ-H&N35:the sores of intervention group were lower than that of control group on pain, swallowing, senses problems, speech problems, trouble with social eating, trouble with social contact, decreased libido, teeth problem, difficulty of opening mouth, dry mouth, ill feeling and sticky-saliva, and higher on weight gain (P<0.05).Conclusion:1.There were many poisonous side effects and complications when patients with NPC completed the chemotherapy and discharged. It was difficult for patients and their families to deal with so many and complex adverse reactions and complications. The professional medical rehabilitation nursing was necessary.2.Continuous nursing intervention for 6 months after discharge could reduce or (and) mitigate the poisonous side effects and complications except memory decline.3.The quality of life of patients with NPC was correlated with the level of education, family support, the level of depression, positive coping style, negative coping style, poisonous side reaction and economical condition. With the implement of continuous nursing intervention on physical function, psychology and family support of the patients in the intervention group, the level of life of patients in the intervention group was significantly improved.