| Objectives:1.To clarify the impact of continuous care based on WeChat platform on pain,selfmanagement level and sleep quality of patients with bone tumors;2.To explore the effect of continuous nursing on the quality of life of primary malignant bone tumor after limb salvage surgery.Methods:This study is an experimental study,with the bone tumor ward of the two hospitals of Air Force Military Medical University Tangdu Hospital and Xi'an Honghui Hospital as research sites.Objective To select 60 patients with bone tumors,30 in the intervention group and 30 in the control group.Subjects in the intervention group were given continuous nursing measures based on the WeChat platform,including pain home management,sleep quality management,home self-management,psychological care,etc.;the control subjects were given routine nursing measures after discharge.Data were collected using a general data questionnaire.The pain scores,sleep quality scores,selfmanagement scores,and quality of life scores of the two groups were discharged and recorded on the day of discharge,4 weeks,8 weeks,and 12 weeks after discharge.The database was established using Epidata3.1,and statistical analysis was performed using SPSS22.0.The general data of the patients were described by frequency and percentage.The pain score,PSQI score,self-management level score and QOL score of the two groups were average and standard deviation.General data statistics of the two groups of patients: age,gender,past history,surgical methods using Pearson chi-square test;religious belief,smoking,drinking,payment methods,disease diagnosis using continuous calibration chi-square test;marital status,ethnicity,anesthesia Fisher's exact probability test was used;Mann-Whitney U nonparametric test was used for education level,occupation,economic income,and surgical site;t-test for height and weight was compared between two samples.The pain scores,PSQI scores,self-management level scores,and QOL scores of the two groups were statistically inferred using two independent sample t-tests and repeated measures analysis of variance.Results:There were 30 patients in the intervention group and the control group respectively.Before the intervention,there was no significant difference in pain score between the two groups(t=-0.298,P=0.767),and the degree of pain(5.73±0.87)was moderate to severe.At 12 weeks after discharge,the pain scores of both groups decreased,the degree of pain The patients were mild,including the intervention group(1.50±0.51)and the control group(2.13±0.68).Combined with the statistical chart,the pain score decreased obviously in the intervention group compared with the control group from the 8th week.At different time points,except for the hypnotic drug dimension,the scores of PSQI total scores(F=7.968)and PSQI were compared between the two groups.Among them,subjective sleep quality(F=11.345),sleep time(F=7.906),sleep Time(F=3.868),sleep efficiency(F=8.712),sleep disturbance(F=5.648),and daytime function(F=6.043);the score of the intervention group changed at different times.Compared with the control group,the trend was significantly lower in the PSQI total score and subjective sleep quality,sleep time,and sleep efficiency dimension.In the sleep time dimension,the intervention group had a downward trend after 4 weeks of intervention,and the intervention was 8 weeks less than the fourth week.Significant changes,the intervention 12 weeks compared with the 8th week has an upward trend,the control group has a significant upward trend after 8 weeks of intervention,the intervention 12 weeks has a significant downward trend compared with the 8th week;in the sleep disorder dimension,after 4 weeks of intervention,the intervention The scores of the group decreased significantly.After 8 weeks of intervention,the decline trend was slower than that of the 4th week.After 8 weeks of intervention,the scores of the control group decreased significantly.After 12 weeks of intervention,the scores of the control group showed an upward trend.At different time points,the self-management scores of the two groups were improved,and the intervention group had significantly higher self-management scores(F=124.433)and dimensions than the control group,among which,daily life management(F=27.797),symptom management(F=26.514),psychological management(F=12.261),communication with medical staff(F=64.900),information management(F=53.785),selfefficacy(F=42.387).At different time points,the intervention group had a higher trend in the CPAF total score and daily life management,symptom management,information management,and self-efficacy than the control group;in the psychological management,and the communication with healthcare dimension,the intervention was 4 weeks.Before,there was no significant change in the scores of the two groups.After four weeks of intervention,the intervention group had a more obvious trend than the control group.At 12 weeks after discharge,the QOL scores of the two groups were compared.The scores of the quality of life scores of the intervention group were significantly lower than those of the control group in terms of functional total score,total symptom score and functional dimension;pain,nausea and vomiting in the symptom dimension,The scores of fatigue and loss of appetite were significantly lower than those of the control group,among which,the total health score(t=7.146),the total functional dimension(t=-0.525),the total symptom dimension(t=-2.971),and physical function.(t=-4.822),role function(t=0.084),cognitive function(t=-2.112),emotional function(t=-2.993),social function(t=-2.567),pain(t=-2.142)Nausea and vomiting(t=-2.164),fatigue(t=-0.399),and decreased appetite(t=4.018)?At different time points,the quality of life scores of the control group scored lower than the pre-intervention scores in terms of total function scores and total symptom scores;except for the emotional function dimension,the control group scored lower than the preintervention in all dimensions of the functional dimension;The scores of pain,fatigue,constipation,shortness of breath,insomnia,and economic difficulties were lower than those before intervention.The scores of the quality of life scores in the intervention group were lower than those before the intervention;the scores in the dimensions of the functional dimension were lower than those before the intervention;except for the diarrhea dimension,the patients in the intervention group scored in the dimensions of the symptom dimensions.From the statistical point of view,at different time points,the results of the changes in the scores of the functional dimension,the total score of the symptom dimension,the total health status,and the dimensions of the two groups showed that the total scores and symptoms of the functional dimension of the two groups of patients The scores of functional total score,physical function,role function,cognitive function,pain dimension,nausea and vomiting,and loss of appetite decreased in the six dimensions,and the intervention group showed a more obvious decline trend than the control group;in emotional function,social function,insomnia In terms of four dimensions of economic difficulty,the dimensional scores of the two groups showed a downward trend.There was no significant change in the intervention group compared with the control group.The patients in the intervention group showed a downward trend in the two dimensions of fatigue and constipation,and the control group showed an upward trend.The diarrhea and shortness of breath showed a downward trend in the group,and the control group showed a more obvious decline than the intervention group.The scores of the two groups showed an upward trend in the total health status,and the intervention group had a more obvious trend than the control group.All above the difference of results were statistically significant.Conclusion:Continuous nursing care is beneficial to patients with bone tumors after limb salvage rehabilitation.It can effectively alleviate patients' pain,improve sleep quality,improve self-management level,improve patients' quality of life?. |
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