| BackgroundLiver cancer is one of the most common malignant tumors in the world. It poses a severe threat to people’s health. Because it is too hard and hidden to be detected before it develops at the middle and advanced stage, only 20% to 30% of the patients are suitable for surgical resection once diagnosed. Most of them have to resort to minimally invasive surgery which has become the most effective and reliable options due to its less trauma. Minimally invasive surgery is a palliative treatment with immediate effects, which is far from satisfactory in the long run. Patients have to be hospitalized many times, which requires long-term care from families, hospitals and society. Continuous care just can satisfy the needs of patients for treatment and care. Continuous care, a new type of nursing service mode, has caught the researchers’ attention. This new nursing mode refers to the treatment and nursing of patients which not only occur in the hospital, but also extend to homes or community rehabilitation centers. The purpose of this nursing model is to raise the patients’awareness of self-management and ensure the fast feedback of diagnosis information and the improvement of patients’life quality. Some departments in some hospitals have tried continuous nursing model on the patients. So far no systematic study of the effect of continuous care has been done on liver patients.ObjectivesThe study aims to build a mode of continuous care of liver cancer patients. Through a comparison between two groups of patients with liver cancer by traditional nursing and continuous care, the effect of continuous care on patients’life quality is examined.Subjects and methodologyDuring July 1st,2013 to August 31st,2013, on the basis of informed consent,298 patients in a tertiary cancer hospital were randomly divided into experimental group and control group, and by comparing the two groups whose data are complete, there is no statistical significance in age, occupation, education levels, religious beliefs, family economic conditions, payment, disease stages and types between these two groups. The experimental group after informed consent was given continuous nursing, and the control group received conventional nursing. Both groups consented to follow-up visits and calls. The experimental group received individualized nursing by cognition shift of diseases, psychological intervention, rehabilitation intervention, family intervention, and social support intervention during the stays in hospital and homes. Anxiety self-assessment questionnaire, quality of life questionnaire, pain questionnaire are used to collect data and information, and SPSS 15.0 is used do statistical analysis to compare two groups’ differences in the quality of life from the start of treatment to the disease progress.ResultsThe continuous nursing mode can improve life quality of patients with liver cancer. Two groups of patients’ life quality will change according to the treatment time. There is no statistical difference in pain grading index PRI between two groups of patients, and there is statistical difference in the intensity of pain visual analog scale VAS and existing PPI in the experimental group when they were discharged from hospital in a month or three months’ time. The findings also indicate adverse reactions of the experimental group was obviously lower than the control group. There is no significant statistical difference between two groups of patients with postoperative complications and postoperative recovery. Self-care ability in both groups of patients has significantly increased, which is a manifestation of an increased self care ability, sense of responsibility and self awareness of health knowledge, and the experimental group improved more significantly than the control group. There is no significant difference in both groups’ quality of life when there were discharged from hospital. but there is a statistical difference in the time of a month, three months, six months after discharge,.The result also shows two groups of patients’ anxiety self-assessment varies with time, and the difference was statistically significant in the time of a month, three months, six months after discharge.Conclusion and suggestionsContinuous care can significantly reduce liver cancer patients’ anxiety, fear, depression and other psychological condition, improve patients self care ability, and reduce the occurrence of complications and adverse events. It may also extend the in-hospital time interval, and improve the life quality of the patients’survival time. Continuity of care may reduce the patients’financial burden, prolong the time interval to visits of hospitals, shorten hospitalization time, reduce the occurrence of complications. Additionally, it helps to allocate nurses properly, use national health resources more effectively and promote the change of the nursing model. But there is no denying the fact that there are many problems, including the overworked burnout, nurses’emotional exhaustion, patient’s excessive demands of medical workers care, and even improper free provision of paid treatment, and human resources allocation and the imbalance of supply and demand, income distribution and active-passive care, etc.. This brings obstacles to the practice of the continuity of care. To solve these problems, much is needed to actively practice and make timely adjustments. Suggestions about continuity of care involves promoting flexible continuous care in other departments based on its own specific features. According to the actual situation of hospital, different continuous nursing measures can be adjusted or expanded if the hospital is better in conditions. It also involves raising the nurses’awareness of the importance of continuous care, in which better care service can be realized. The hospital should give certain financial or policy support to encourage continuous care. Continuous care needs social multi-sector collaboration, and the government should fully organize, coordinate and mobilize various departments to actively participate in it. |
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