食管癌手术患者出院后支持性照护需求和生活质量状况及其相关性的纵向研究 [中文引用][英文引用]

目的  通过纵向调查食管癌手术患者出院后各康复阶段的支持性照护需求特征，并探讨其与生活质量的动态关联，为开展以需求为导向的延续性护理服务提供参考。方法  采用便利抽样法，选取 2024 年 2 月— 8 月在昆明市某三级甲等综合医院行食管癌根治术后的 94 例患者为研究对象。采用食管癌手术患者出院后支持性照护需求量表（supportive care needssurvey for esophageal cancer patients after discharge，SCNS-ED）、欧洲癌症患者生活质量—食管癌专用量表（European Organizationfor Research and Treatment of Cancer quality of life questionnaire–oesophageal cancer module 18，EORTC QLQ-OES18）于患者术后1 个月（T1）、3 个月（T2）、6 个月（T3）进行纵向调查，采用重复测量方差分析比较不同时间点得分的差异，并使用 Pearson 相关分析支持性照护需求与生活质量的相关性。结果  90 例患者完成研究。重复测量方差分析显示，支持性照护需求总分及各维度（生理、信息、情感 /心理、社会需求）得分在 T1、T2、T3均呈下降趋势（P<0.001）。患者生活质量总分随时间推移而下降（P<0.001）。Pearson 相关分析表明，在 3 个时间点上，支持性照护需求总分与生活质量总分呈正相关（r=0.281~0.306，均 P<0.01），即未满足的需求越高，生活质量越差。结论  食管癌手术患者出院后支持性照护需求和生活质量均随时间推移而改善，并且两者存在动态的负相关关系，提示未满足的需求是影响生活质量的重要因素。临床干预应分阶段精准化，术后 1 个月重点满足生理与社会需求，术后 3 个月侧重信息需求，术后 6 个月关注心理需求。

Objective To identify the needs charateristic for supportive care of oesophageal cancer patients at different stages of rehabilitation after discharge and to examine the dynamic correlation between unmet needs and quality of life（QoL）,thereby providing evidence for stage specific and needs based continuity of care. Methods Convenience sampling was employed to recruit the patients after radical resection of oesophageal cancer at a Tier-IIIA hospital in Yunnan Province between February and August 2024. Data were collected through a general demographic questionnaire,the supportive care needs survey for oesophageal cancer patients after discharge （SCNS-ED）,and the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Oesophageal Cancer Module 18（EORTC QLQ-OES18）at three time-pints postoperatively. Repeated measures ANOVA was used to compare changes in scores across the time points. Pearson correlations were calculated to examine the relationship between supportive care needs and QoL. Results Toally 90 patients finished the study. Repeated-measures ANOVA revealed significant decreases in the total scores of needs for supportive care and their dimensions（physiological,informational,emotional/psychological,and social needs）across T1,T2,and T3 （P<0.001）. Scores of QoL improved significantly across the time points（P<0.001）. Pearson correlation analysis demonstrated positive correlations between the needs for supportive care and poorer QoL at all three time-points（r=0.281~0.306,P<0.001）,indicating that higher unmet needs correlated with poorer QoL. Conclusion Both of the needs for supportive care and QoL are improved during the first six months after surgery,but unmet needs continue to exert a negative influence on QoL. Stage specific interventions are recommended on physiological and social support at 1 month,information provision at 3 months and psychological care at 6 months after surgery.