| Part I Literature ResearchThis paper summarizes the development status of hospice care and dignity therapy at home and abroad,and provides theoretical basis for the follow-up investigation and intervention research.Part 2 The status quo and correlation of dignity level in patients with advanced cancerObjective: To investigate the status of dignity level and the degree of damage during hospitalization of patients with advanced cancer,to explore the correlation between the degree of dignity damage and the quality of life and the dimensions,and to lay the foundation for the corresponding intervention measures to solve the dignity and related problems of patients with advanced cancer.Methods: 208 patients with advanced cancer who were admitted to 2 Grade 3A hospitals in Yunnan Province from December 2018 to March 2019 were investigated by convenient sampling method.The patients were investigated by general data questionnaire,patient dignity scale(PDI)and quality of life measurement scale(EORTC QLQ-C30).Using frequency,percentage,mean ± standard deviation to describe the sociodemographic characteristics,disease characteristics,patient dignity score and quality of life score of advanced cancer patients;using Spearman correlation analysis of patients respect correlation between the total score of strict scale and each dimension score and each field score of patient quality of life scale.Results: Among the 175 qualified samples,the degree of dignity damage was mainly moderate and severe,including mild dignity damage(15 cases,8.57%),moderate dignity damage(115 cases,65.71%)and severe dignity damage(45 cases,25.71%).total mean score of patient dignity was 68.07,and the average score of each dimension ≥3 was symptom distress and survival distress(3.24,3.01),respectively.In the top five of the patient’s dignity scale entries," feel yourself a burden on others(151,86.29%),feel unwell(pain,shortness of breath,nausea,Vomiting(149 cases,85.14%),feeling that you have unfinished business or unfinished business(145 cases,82.86%),feeling that you have been unable to meet the challenges posed by illness(142 cases,81.14%),feeling that you are unable to play some important roles(137 cases,78.29%).There was a significant correlation between the degree of dignity impairment and the quality of life,in which the total score of dignity and the physical function of the quality of life were moderately negative(r=-0.532,P<0.01),and the total score of dignity was moderately positive correlated with the quality of life pain(r=-0.518.P<.0.01),the symptom distress dimension of dignity was moderately negatively correlated with the emotional function domain of quality of life(r=-0.559,P<0.001),moderately positively correlated with the pain symptom of quality of life(0.594,P<0.001),moderately negatively correlated with the physical function domain of quality of life(r=-0.544,P<0.001).Part 3 Study on the effect of dignity therapy in hospice care for patients with advanced cancerObjective: To explore the effect of dignity therapy on dignity level,quality of life,anxiety and depression,and overall well-being of patients with advanced cancer through 2months of dignity therapy-based hospice intervention.Methods: 90 patients with advanced cancer who were admitted to a Grade 3A hospital in Yunnan Province from March 2019 to September 2019 were selected as the subjects of this study.The patients were divided into intervention group(n=46)and control group(n=44)by random count method.The control group was given routine hospice care,including diet nursing,health education,symptom control,comfort care,psychologicalsupport and humanistic care,while the intervention group received the basis on the basis of the control group at the same time,the intervention period is 2 months.The patient dignity scale(PDI),cancer patient quality of life scale(EORTC QLQ-C30),hospital anxiety and depression scale(HADS)and overall well-being scale(GWB)were used to collect the data of two groups before and after intervention(1 week,1 month,2 months)to evaluate the changes of relative dignity level,quality of life,anxiety and depression and overall well-being in the two groups,using SPSS.25.0 Statistical analysis of data.Results:1.Pre-intervention results show: there was no significant difference in general data,total dignity score and dimension score,quality of life score,anxiety and depression score and overall well-being score between the two groups(P>0.05).2.Results after intervention:(1)Dignity of patients: before and after intervention(1 week,1 month,2 months),the total dignity score of the two groups and each dimension score of the inter-group effects,time effects and interaction effects were statistically significant(P<0.01);multivariate analysis of variance between the two groups compared the total dignity score of the two groups after intervention(1 week,1 month,2 months),and the intervention group dignity score level was significantly lower,and the intervention group dignity impairment problem improved significantly better than the control group.(2)Quality of life: before and after intervention(1 week,1 month,2 months),the difference of time effect between the two groups was significant(P<0.05);except for diarrhea,shortness of breath shortness of breath and cognitive function,the difference was statistically significant(P<0.05).The results of the multivariate analysis of variance showed that the total number of intervention groups was 2 months the improvement of body quality of life was significantly better than that of the control group.(3)Hospital anxiety and depression: Before and after intervention(1 week,1 month and 2 months),there were significant differences in the scores of anxiety between groups(P<0.01).(4)Overall well-being: after the intervention,the overall well-being of the two groups showed an average upward trend,the overall well-being level of the intervention group was significantly better than the control group,after the intervention of 1 month,2months of multivariate analysis of variance had a statistical difference between the two groups(P<0.01);before the intervention,after the intervention(1 week,1 month and 2months),the two groups of patients with overall well-being score between the group effects,time effects and interaction effects were significantly different(P<0.01).Conclusion:1.The degree of dignity damage of patients with advanced cancer is mainly moderate and severe,and the level of dignity is in the upper middle level,which needs to be highly valued by medical staff.2.The degree of dignity damage of patients with advanced cancer is significantly related to all areas of quality of life.It is very important to take timely and effective interventions to maintain the dignity of patients and improve their quality of life.3.This study confirmed that the dignity therapy-based hospice care intervention can effectively improve the dignity level and quality of life of patients with advanced cancer,relieve their anxiety and depression,and improve the overall well-being of patients. |
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