A Preliminary Study On The Case Management Model Of Nasopharyngeal Carcinoma Based On ERG Theory

?Objective? Case management has been developed for decades in foreign countries and proved to be an effective method to improve patients' health and reduce medical costs.China's Taiwan and Hong Kong are the first to carry out case management,but China's domestic case management is still in the exploration and initial stage.With the acceleration of China's population aging process,the incidence of many chronic diseases has increased significantly.How to effectively control and manage the occurrence and development of chronic diseases,improve people's health and well-being,and relieve the situation of medical resource shortage,case management has become one of the effective ways to solve the above problems.This study explored the current nursing status of single nasopharyngeal carcinoma,and constructed a preliminary practice model of nasopharyngeal carcinoma case management.The practice mode of nasopharyngeal carcinoma case management was finally formed after the implementation of feedback verification,in order to provide reference for the practice of introducing multi-disease case management in the later stage.?Methods? Based on the characteristics of nasopharyngeal carcinoma,the study was divided into three stages,centering on the working process of individual case management.In the first stage,the patients with nasopharyngeal cancer were interviewed by personal in-depth interviews of qualitative research,the persons in charge of the tumor center were interviewed by insiders,and the existing working mode of nasopharyngeal cancer nursing at the research site was explored by participatory observation,so as to clarify the reform direction of nasopharyngeal cancer case management.In the second stage,a preliminary model for the management practice of nasopharyngeal carcinoma was constructed by means of literature review,theoretical research and focus group interviews.In the third stage,the case management model of nasopharyngeal cancer was verified through focus group interviews,group discussions and experimental studies.The above qualitative research data are mainly recorded by recording and taking notes.The data analysis method adopts the content analysis method of descriptive nature research,that is,trying to understand the research data to obtain a sense of wholality.Then,the data are coded,classified and subject determined.SPSS 22.0 was used for statistical analysis of quantitative data.?Results? In the first phase of the study,found that patients with nasopharyngeal carcinoma(NPC)in the treatment of complex and lengthy process has three big need the ERG theory of survival needs to include three topics: 1 The efficiency and quality of medical service demand,2 the demand for professional and continuing care services,3 the associated with the disease,treatment,care and rehabilitation,information demand;ERG needs the need of theoretical interrelationship,including two topics: 1.The need for psychosocial support,2.The need for harmonious interpersonal communication..ERG needs the growth and development of the theory,including one topic: the need for self-realization.At the same time,it was found that the current nursing care of nasopharyngeal carcinoma lacked continuity,and patients could not provide timely,professional and targeted continuous services after discharge,with random return visits and little communication with patients.In the second stage,the preliminary construction of the model and the introduction of an informationalized case management system save time and efficiency in the management of nasopharyngeal cancer patients.The key periods for the management and intervention of nasopharyngeal carcinoma cases are the diagnosis period,the treatment period and the recovery period after the treatment.Case management includes care planning,resource coordination,health education,psychosocial and information support,supervision and follow-up management.The methods of follow-up include telephone follow-up,outpatient follow-up and information system follow-up(We Chat public number,App and SMS).In the third stage of the effectiveness verification of the case management mode,it was found that the construction of the multidisciplinary team for the case management mode of nasopharyngeal cancer needed to be strengthened,the follow-up and referral needed to be improved,and the patients receiving the case management mode had a higher rate of treatment completion as planned.?Conclusion? This study found that case management based on the theory of ERG needs can enhance the patients' sense of information support,psychological support and other support,and reduce the sense of disease uncertainty.The need for survival and interrelationship among patients with nasopharyngeal carcinoma is the strongest and most persistent.Case management is a complex and long-term process,and case managers need full-time positions to further clarify their duties,support from policies and regulations,and more importantly,support and attention from the whole society.It is still necessary to further explore the referral mechanism and improve the connection between the hospital and the outside,and the degree of multidisciplinary team cooperation needs to be strengthened.Case management improves nurses' knowledge and skills,enhances the value of their own lives,enhances their professional identity,and provides a new direction for the development of the nursing profession.