Establishment And Application Research Of Nursing Scheme Based On Nursing Outcome For Patients With Radical Resection Of Esophageal Carcinoma Under Thoracic Laparoscopy

Objective:To probe into the core problems of nursing and nursing outcome indexes of patients undergoing radical resection of esophageal carcinoma by thoracic laparoscopy,and to construct a nursing outcome evaluation system for patients with esophageal carcinoma.To construct the nursing intervention scheme of thoracic laparoscopic radical resection of esophageal carcinoma and to apply the intervention to perioperative patients.which provides the basis for improving the nursing outcome and the quality of life of the patients.Methods:1.According to the literature review,Clinical investigation results,two rounds of Delphi expert consultation method,the nursing outcomes and indicators suitable for the evaluation of patients undergoing thoracic laparoscopic radical resection of esophageal carcinoma were selected and established and analytic hierarchy process(AHP)is used to determine the outcome and the weight of the index.2.The constructed nursing outcome oriented intervention program is applied to clinical practice.From May to December,2017,the patients who underwent thoracic laparoscopic radical resection of esophageal carcinoma were selected from to in a Grade 3A Cancer Hospital in Xinjiang.The patients were randomly divided into two groups: the experimental group(n=32)and the control group(n=32).The patients in the experimental group were given nursing care according to the nursing outcome,and the patients in the control group were given routine nursing methods.At different time points,the scores of cognition,behavior and status of nine core nursing problems in the experimental group were compared.And the time of getting out of bed,the time of intestinal ventilation,the days ofhospitalization,the cost of hospitalization,Quality of life and patient satisfaction after intervention were compared between the two groups.Results: 1.The index system of nursing outcomes for patients with thoracic laparoscopic radical resection of esophageal carcinoma was constructed,including 3 first grade indexes,9 second grade indexes and 47 third grade indexes.2.Nursing scheme based on nursing outcomes for patients undergoing radical resection of esophageal carcinoma under thoracic laparoscopy,the results showed that:(1)the scores of cognitive and behavioral outcomes of 9 core nursing problems in the experimental group were significantly higher than those in the control group(P <0.05).With the exception of digestion-hydration outcome score and nutritional outcome score,the outcome scores of other nursing problems were improved in all stages(P <0.05).(2)Comparison of quality of life between the two groups before operation showed that in the functional dimension,the scores of body function,emotional function,cognitive function,social function and general health in the experimental group were higher than those in the control group(P<0.05).In symptom dimension,the scores of pain,insomnia and dry mouth in the experimental group were lower than those in the control group(P < 0.05).One week after operation,the scores of body function,role function,emotional function and general health status in the experimental group were higher than those in the control group(P<0.05).In symptom dimension,the scores of fatigue,pain,shortness of breath,insomnia,esophageal cancer related pain symptom and dry oral dimension in the experimental group were lower than those in the control group(P <0.05).Before patients leaving the hospital,the testing results showed that in the functional dimension,the scores of body function,role function,emotional function,general health status and dysphagia in the experimental group were higher than those in the control group(P<0.05).In symptom dimension,the scores of pain,insomnia and eating habits in the experimental group were lower than those in the control group(P < 0.05).(3)The clinical outcome of the two groups:After intervention,the time of getting out of bed,the time of intestinal ventilation,the days of hospitalization,the cost of hospitalization,the quality of life and the satisfaction of patients were significantly different between the two groups and satistically meaningful(P < 0.05).Conclusion: The application of nursing program based on nursing outcome can reduce postoperative hospitalization time and hospitalization cost,accelerate intestinal recovery and out-off-bed activities,and improve the outcome of nursing care,improve the quality of life and satisfaction with nursing work for patients with esophageal cancer.