Study On Transitional Care In The Application Of Cancerous Pain Management

BackgroundUp to now,cancer has been one of the major diseases that threaten human health.Accompanied by the increasing cancer incidence,the age of the patients is getting younger and younger.Unfortunately,there is no effective treatment to cure cancer.Once diagnosed with cancer,the patient would suffer great trauma both physically and mentally.During the repeated treatment,the body functions as well as immunity are diminished,making patients feel uncomfortable.30%-50%of the cases have different degrees of cancerous pain.There is a correlation between pain and cancer.The higher level the pain has,the more serious the illness is.Meanwhile,the living standards and the quality of life can be lowered down by continuous cancerous pain.It can reduce the patient's well-being,lower down comfort level which has the side-effects on the future treatments and care.Some people believe that taking care of patients is confined to hospitalized patients,and the nursing service is terminated after hospital discharge.Although most of the patient's health problems have been solved during hospitalization,many patients return home with a few health problems,which include either clinical problems or nursing problems.Therefore,patients who have been discharged from the hospital still have a high demand for health care.According to a recent study,without the guidance and education on how to use drugs given by nurses,the curative effect varies from person to person.Transitional care is a new kind of nursing measure,which is developed from the basis holistic nursing,including continuous follow-up and guidance after patients return home or community.The practice of transitional care has been implemented abroad for many years,but in our country,it is still on the exploration stage.Therefore,the effective continuing care among cancer patients is urgently needed.Built in 2014,based on our experience of standardized cancerous pain treatment demonstration ward,our hospital can provide the patients standard treatment and continuing care to make sure the effective of health care.To further explore the effect of continuing nursing in the management of cancerous pain,the project was designed.With this study,we would like to evaluate the possibility of application on continuing care in standardized management of pain caused by cancer.Objective(1)To validate the improvement of continuing care on cancerous pain with programmed drugs;(2)To explore the effects of continuing care on the pain,physical status,psychological condition and quality of life of patients with cancer and help them to improve the confidence and comfortable level;(3)To discuss the way to reduce physician office visits and repeated hospital stays after continuing care,reducing the waste of medical resources and improving the economic and social benefits.MethodsIn this study,the randomized,controlled,open and parallel clinical trial was designed.There were 300 cases who were under treatments coming from Tai'an City Tumor Control Hospital,divided into two groups randomly.One is experimental group,the other is control group.The control group received routine care.Besides routine care,continuing care was carried out in experiment group.To assess the total effects of medical care,we use NRS pain score,physical condition,KPS score,self-evaluation of anxiety scale(SAS),depression self-rating scale(SDS)and quality of life scale(EORTC QLQ C30)as evaluation indexes.t test and x2 test were used to analyze the data.Results(1)Baseline data of these groups were equally matched.There was no statistically significant difference between the two groups in terms of gender,age,disease and marital status,culture,cost,and economic income(P>0.05).(2)There was no statistical difference between the two groups when the patients were discharged from the hospital.The drug use,NRS score,KPS score,SAS score,SDS score and quality of life score were not statistically different between the experimental group and the control group(P>0.05).(3)There was a statistical difference in the standardized medication,NRS score,KPS score,SAS score and SDS score in the first and third months of hospital discharge(P<0.05).(4)There was a statistical difference in the quality of life of the patients between two groups one month after hospital discharge(P<0.05).The score of experimental group on body function,role function,cognitive function,emotional function and social function score of the experimental group were significantly higher than those in the control group,while the score of the symptom field was quite opposite.Conclusion(1)The result shows that continuing care can help patients with cancerous pain maintain high standardized medication after discharge,reduce the pain significantly and improve physical status,prevent the pain of anxiety and depression,improve the psychological status of patients.Therefore,continuing care can improve the patient's health outcomes,and reduces the number of visits to the physicians and the cost of health services.It is helpful to promote certain economic benefits and social benefits.(2)The continuing care can improve patients' physical function,role function,cognitive function,emotional function and social function score,and reduce symptoms score,lower complications and adverse reactions of patients,so that the quality of life could be improved.The continuity and integrity of treatment and nursing care described in this paper lays a good foundation for the follow-up treatment of the disease.(3)With the application of the continuing care on standardized cancerous pain management,there is much more free time for nurses to care patients.This helps nurses to know more about patients both physically and mentally.The friendlier patients feel,the easier communication we make.It also strengthen humanistic care and get the relationship between nurses and patients more harmony.