| Objectives(1)To understand the subjective experience and needs of patients with gastric cancer surgery,and to provide a basis for the construction of case management mode for patients with gastric cancer surgery.(2)Explore the effect of case management mode on the quality of life and self-management efficacy of patients with gastric cancer surgery,thus provide reference for the whole-process management of patients with gastric cancer surgery.Methods(1)Qualitative research:using the purpose sampling,15 patients who underwent surgery for gastric cancer were selected.Based on the layered model of Care and through semi-structured interviews in different time periods,patients' subjective experiences and needs were deeply understood,and the problems and needs in current patient care practice were found from the perspective of patients in order to lay the foundation for the construction of a case management model for patients with gastric cancer surgery.(2)Quasi-experimental study: the selected subjects were divided into intervention group and control group for 6 months.The intervention group used a case management model for patients with gastric cancer that were extracted and improved by previous qualitative studies.Control group used routine care.The effect of case management model on patients with gastric cancer surgery was evaluated at the time of admission,three months after surgery and six months after surgery using quality of life and strategies used by people to promote health.Results(1)Through qualitative research,the analysis framework of subjective experience and the needs of patients with gastric cancer surgery at different stages were extracted.At the stage of admission and diagnosis,patients' subjective experience was: panic about the disease,needs: information needs and emotional needs.On the day before surgery,patients' subjective experience was: concerns about surgery;needs: emotional support,information needs,quick treatment of diseases and the need for care;On the 1st postoperative day,patients' subjective experience were: stomach tube discomfort,pain and other symptoms,demand: symptom management needs.Discharge stage,patients' subjective experience: no treatment for recovery after discharge;concerns about post-treatment;concerns about re-entering the society,needs: continuing care needs,information needs,social needs.(2)After constructing a case management plan for gastric cancer surgery patients,the results showed that:(1)There was no significant difference in the quality of life and the scores of different dimensions between the two groups of gastric cancer patients at admission(P>0.05).At 3 months and 6 months after surgery,the scores of total quality of life and physical psychological problems in the quality of life dimension of the intervention group were significantly higher than those of the control group(P<0.05),no differences were found in interpersonal relationship problems of the quality of life dimension(P>0.05).(2)There was no significant difference in the quality of life and the scores of different dimensions between the two groups of gastric cancer patients at admission(P>0.05).At 3 months and 6 months after surgery,the scores of total self-management effectiveness,positive attitude score and self-decompression score in the self-management effectiveness of the intervention group were significantly higher than those of the control group(P<0.05),no differences were found in self-determination score of the self-management effectiveness dimension(P>0.05).Conclusion(1)Patients with gastric cancer surgery need to conduct case management based on the subjective experience and needs of patients from disease diagnosis to discharge.(2)Case management mode can improve the quality of life of patients with gastric cancer surgery.(3)Case management model can improve the self-management efficacy and promote the recovery of patients with gastric cancer surgery. |
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