Study On The Influence Of Systematic Nursing Intervention On Uncertainty Inillness And The Quality Of Life In Postoperative Patients With Hepatocellular Carcinoma

Objective: Hepatocellular carcinoma(HCC) is one common malignant tumor in our country. Each year, hepatocellular carcinoma is diagnosed more than 600 thousand people worldwide, and the incidence of HCC is highest in our country with 55% of new cases each year. Currently,it’s one of the most common malignant tumor which threaten human health and life seriously.At present, the main treatment for hepatocellular carcinoma is comprehensive treatment based on surgery. Although pathological diagnosis is clear,the patients with hepatocellular carcinoma understand the knowledge of HCC poorly.They suspect the treatment, prognosis and disease occurrence, development and outcome. At the same time, the complexity of the examination and treatment make that the patients don’t know what to do.Combined with the fear of death, great changes in psychology and physiologiy, decline in ability of psychological adjustment and adapt, may lead to that they lack the ability to determine the possible cause of disease-related things, generate illness uncertainty,which may have a great impact on the quality of life and rehabilitation of patients.In this study, we will compare the effect that before and after systematic nursing interventions through questionnaire, investigate the impact of systematic nursing intervention on uncertainty inillness and the quality of life in postoperative patients. Thus,it provides a theoretical basis for the clinical application of systematic nursing interventions.Method:112 patients with hepatocellular carcinoma undergoing surgical operation in Hebei Medical University fourth hospital hepatobiliary surgery between January 2013 and December 2014 were reviewed retrospectively. They were randomly divided into experimental group and control group.In the experimental group, patients were accepted systemic nursing intervention on the basis of routine care. Patients were accepted the first questionnaire in the second day of admission, and the second questionnaire in the day before discharge. Mishel’s Uncertainty in illness Scale and the Chinese version of EORTC QLQ-C3 form in evaluation of quality of life for patients with cancer were used as evaluation criteria for uncertainty in illness and the quality of life.Results:1 Uncertainty in illness and dimensions of patients with hepatocellular carcinoma.In the 112 cases, uncertainty in illness average 74.3 ± 8.21 points which overall in the middle level, “ambiguity” uncertainty score is higher than “complexity” uncertainty.2 Factors of uncertainty in illness of patients with hepatocellular carcinoma.The uncertainty in illness scores and scores of “ambiguity”, “complexity” are related to different education level, household income, sources of medical expenses, surgical methods, unrelated to age, sex, marital status, place of residence(P> 0.05).3 Correlation analysis of the quality of life and uncertainty in illness of patients with hepatocellular carcinoma.The overall quality of life in 112 patients with hepatocellular carcinoma is 56.8 ± 18.3 points, on or below middle level. Pearson correlation analysis showed a significant negative correlation between uncertainty in illness of patients with hepatocellular carcinoma and emotional function, role function, social function, physical function, cognitive function, general health situation(P<0.01, P<0.05); a significant negative correlation between “ambiguity” dimension and emotional function, role function, social function, physical function, cognitive function(P<0.01, P<0.05); a significant negative correlation between “complexity” dimension and emotional function, role function, social function, physical function, cognitive function(P<0.01, P <0.05).4 Comparison of uncertainty in illness and quality of life between the two groups.4.1 Comparison of uncertainty in illness and dimensions between the two groups.Before the intervention, there is no difference between the two groups of patients in uncertainty in illness and dimensions(P>0.05); After systematic nursing intervention, uncertainty scores “ambiguity” scores in the experimental groups are decreased compared with the control groups, and the difference is statistically significant(P<0.05);while “complexity” scores are no statistically difference(P>0.05).4.2 Comparison of quality of life between the two groups.Before the intervention, there is no difference between the two groups of patients in general health situation and 4 kinds of functional areas(P>0.05); After systematic nursing intervention, general health situation, emotional function, role function and cognitive function in the experimental groups scores are increased compared with the control groups, and the difference is statistically significant(P<0.05); while social function and physical function scores are no statistically difference(P>0.05).Conclusion: Systematic nursing intervention can improve uncertainty in illness and dimensions scores and improve the quality of life of patients with hepatocellular carcinoma undergoing operation.