Application And Effect Of Case Management In Patients With Prostate Cancer After Endocrine Therapy

Objective:Understand the current status of self-care ability and self-efficacy of patients with prostate cancer undergoing endocrine therapy.Explore the effects of case management model on therapy compliance,self-care ability,general self-efficacy,quality of life(QoL)and satisfaction of patients with prostate cancer treated with endocrine therapy.Establish the case management model of comprehensive nursing interventions to improve the self-care ability of patients,delay the progress of the disease,reduce the cost of medical treatment,and improve the QoL of patients.Methods:An experimental study was conducted on patients with prostate cancer who received endocrine therapy at the First Hospital of Jilin University between Sept,2016 and June,2017.The patients were randomly divided into two groups(n=50for each group).The method of out-patient follow-up was applied in the control group,while patients in the experimental group received case management after discharge.In this study,when the patients were discharged,baseline surveys were conducted,such as demographic data,self-care ability,general self-efficacy and QoL.These data were reevaluated three months and six months after intervention,and the satisfaction of patients in the two groups was statistically analyzed.SPSS 24.0software was used for statistical analyses.All of the measurement data were analyzed with the t-test and the enumeration data were analyzed with theχ~2 test.A P value<0.05 was considered statistically significant.Results:(1)Baseline data comparison:There was no statistical difference in age,height,weight,education,marital status,family monthly income and medical expenses between the two groups(P>0.05).(2)Self-care ability comparison:At the time of discharge,there was no significantly statistical difference in self-care ability of patients between the two groups(P>0.05).Three months after discharge,the self-care ability of patients in the experimental group was significantly higher than that of the control group(P<0.05).Six months after discharge,the self-care ability of patients in the experimental group was significantly improved as compared with the control group(P<0.05).(3)General self-efficacy comparison:At the time of discharge,there was no statistical difference in self-efficacy of patients between the two groups(P>0.05).Three months after discharge,the self-efficacy of patients in the experimental group was significantly higher than that of the control group(P<0.05).Six months after discharge,the self-efficacy of patients in the experimental group was still significantly higher as compared to that of the control group(P<0.05).(4)QoL comparison:At the time of discharge,there was no statistical difference in QoL of patients between the two groups(P>0.05).Three months after discharge,the QoL of patients in the experimental group was significantly higher than that of the control group(P<0.05).Six months after discharge,the QoL of patients in the experimental group was significantly improved as compared with the control group(P<0.05).(5)Satisfaction comparison:The satisfaction of patients in the experimental group was significantly higher than that of the control group six months after discharge(P<0.05).Conclusion:(1)The case management model can improve the patients’cognitive level of the disease,establish the patients’confidence to overcome the disease,make patients actively cooperate with the treatment and nursing,and improve the patient’satisfaction.(2)The case management model can improve the self-care ability and general self-efficacy of patients with prostate cancer undergoing endocrine therapy.Therefore,the overall QoL of patients was significantly improved.(3)Case management,as a new chronic disease management mode,can be applied to outpatient management of cancer patients and other chronic diseases.