| ObjectivesChronic renal failure is a kind of serious disease in the world, which has great influence on the quality of life of patients. Additionally, many patients cannnot afford the expensive medical bills. Modern medicine has increased the life span of the patients. At the same time, modern medicine gives rise to a large amount of problems such as problmes of medicine, ethics and economy. With the change of the mode of medicine, researches and practics of traditional Chinese clinical medicine are not merely conducted from the biological and medicine clinical perspectives. Rather, researches and practics of traditional Chinese clinical medicine has expanded to the physical, psychology and social fields. The health and the quality of life of the patients who have chronic renal failure have been critial judgement index when the clinicians evaluate the therapeutic effect. In the process of the clinical traditional Chinese medicine diagnosises, changes that related to the quality of life are regarded as an important judgement index of therapeutic effect of TCM. Based on the study of clinical pathway for chronic renal failure, the research employs WHOQOL-BRIEF as the assessment criterion when evaluate the effect of the clinical path treatment plan. Moreover, the research is a comparison of clinical trials, which compares the changes of quality of life for the patients of the CRF who accept clinical pathway treatment of chronic renal failure before and after the clinical pathway treatment. In this way, the author can exame the influence of the clinical pathway treatment on the patients of chronic renal failure, laying a solid fundation for future studies of clinical pathway treatment of chronic renal failure.MethodsThe research cases are from inpatients of urology department of Guangdong Povincial Hospital of TCM. The research then utilizes the inpatients of urology department who accepted the clinical pathway treatment in Guangdong Povincial Hospital of TCM as the reseach objects, who inpatiented in Guangdong Povincial Hospital of TCM from 1st August,2009 to 17th February,2010. The author conducts a contrastive experiment which compares the therapeutic effect before and after the patients have the the clinical pathway treatment of chronic renal failure, which lasted for two weeks. The comparion is not designed to compared to with the quality of life of other patients but the patient themselves before and after the treatment.49 valid cases are used in the research. The quality of life of the patients is assessed with the help of WHOQOL-BRIEF, which asseses respectively before and after the treament once. In addition, the personal information are collected which includes gender, age, level of education, course of disease, the primary affection and so on. The data of the assesement is analyzed by SPSS11.5, and the analytical methods include description analysis, the paired t-test or match-paired test (in the case of heterogeneity of variance) in the measurement test and so on.Result1. Quality of life and the self-assessment:Clinical pathway is inclined to improve the grade of quality of life assessment and the self assessment of the chronic renal patients. The result of the differences between before and after treatment has statistical significance with P<0.01.2. Physiological and environment-related fields:Clinical pathway is also have impact on the scores of the physiological and environment-related fields, which have statistical significance compared with that before the patients have the clinical pathway treatment with P<0.05 or P<0.01.3.. Psychological and social realms:The scores rise in the psychological and social relation realm after patients have the clinical pathway treatment, which has no significance when the result is compared with that before the patients have the clinical pathway treatment with P>0.05.4. A comprehensive comparison of the scores of before the clinical pathway and after the clinical pathway in all fields that are included in the measuring scale of WHOQOL-BRIEF indicates that the clinical pathway treatment of the chronic renal failure that is implemented by Guangdong Povincial Hospital of TCM is conducive to the quality of life of the chronic renal failure patients. ConclusionThe quality of life is a brand-new health indicator, which can evaluate the physiology, psychology and the social function of individuals and the groups in a comprehensive way. Compared with such assessment ways as life span and the traditional therapeutic effect, the quality of life is equally important with them, and the quality of life can have an overall evaluation of how the diseases impact on the patients. Traditional Chinese Medicine is such a kind of medicine that is unified, systematic and society-related. In the course of treatment, traditional Chinese medicine takes the influence of nature and society on the patients into consideration, which is very similar to the mode of modern medicine that focuses on physiology, psychology and society. Therefore, traditional Chinese medicine has its advantages in the improvement of the quality of life of the patients. The formation, formulation, and implement of clinical pathway that is carried out by Guangdong Povincial Hospital of TCM are strict and society benificial. What is more, the clinical pathway implemented by Guangdong Povincial Hospital of TCM contributes to the reduction of medicine expenses of the country and the patients. The research shows that the chronic renal failure clinical pathway treatment which rests on a healthy diet, effective depressurization and hypoglycemic, symptomatic treatment and the diagnosis and treatment based on an overall analysis of the traditional Chinese medicine can improve the quality of life of the patients of chronic renal failure. The chronic renal failure clinical pathway treatment is probably endowed with advantages in the improvement of self-assessment of the patients and the scores in the physiological field, which deserves more studies. The shorcoming of this research is that the investigation time is short (last for 2 weeks), which cannot have a reflection of a long-term effect of the clinical pathway.
|
PDF Full Text Request