發(fā)布時間：2018-03-05 07:40

  本文選題：智能手機(jī)　切入點：應(yīng)用程序　出處：《鄭州大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的:應(yīng)用智能手機(jī)軟件分析鼻咽癌患者接受同期放化療出院后的毒副作用和并發(fā)癥、以及對生存質(zhì)量的影響,并調(diào)查智能手機(jī)應(yīng)用軟件在鼻咽癌患者出院后隨訪中應(yīng)用的可行性。方法:本研究采用隨機(jī)對照實驗。選擇2015年3月1日-2016年3月25日期間,在我院放療科接受同期放化療的患者132名。隨機(jī)分為對照組65名,干預(yù)組67名。對照組出院后采用傳統(tǒng)的健康指導(dǎo)及隨訪方式。干預(yù)組患者出院時指導(dǎo)患者下載及使用自行設(shè)計的智能手機(jī)軟件,軟件包括個人信息、復(fù)診提醒、并發(fā)癥的評估、知識庫、互動5個模塊,具體內(nèi)容包括鼻咽癌患者接受同期放化療后出現(xiàn)的急慢性毒副反應(yīng)及并發(fā)癥的觀察與治療等疾病相關(guān)知識,康復(fù)鍛煉、鼻腔沖洗等的操作視頻。在兩組患者出院時收集患者一般資料;出院時及出院6個月收集兩組患者放化療并發(fā)癥情況及生存質(zhì)量(QLQ-C30);出院3個月及出院6個月時收集兩組患者鼻腔沖洗及張口鍛煉依從性情況;出院6個月時收集干預(yù)組患者使用智能手機(jī)軟件情況。結(jié)果:1.放化療毒副反應(yīng)及并發(fā)癥比較兩組患者出院時,口腔黏膜炎、張口困難、口干、聽力下降、鼻塞的發(fā)生率差異無統(tǒng)計學(xué)意義(p0.05),具有可比性。兩組患者出院后6個月,在口腔黏膜炎、張口困難、口干、鼻塞4個方面比較,差異具有統(tǒng)計學(xué)意義(p0.05),聽力下降方面兩組比較差異無統(tǒng)計學(xué)意義(p0.05)。2.生活質(zhì)量得分比較出院時兩組患者在功能方面、癥狀方面及總生存質(zhì)量得分方面差異無統(tǒng)計意義(p0.05),具有可比性。兩組患者出院時及出院后6個月,干預(yù)組總生存質(zhì)量分別為42.14±10.64、72.03±10.07,對照組總生存質(zhì)量分別為44.15±13.31、60.15±12.17。出院后6個月,干預(yù)組除認(rèn)知功能領(lǐng)域、氣促癥狀、經(jīng)濟(jì)困難項目外,均優(yōu)于對照組,差異均有統(tǒng)計學(xué)意義(p0.05)。3.兩組康復(fù)鍛煉依從性比較出院3個月、6個月時,干預(yù)組在張口鍛煉依從性上明顯高于對照組,差異具有統(tǒng)計學(xué)意義(p0.05)。出院3個月時,患者在鼻腔沖洗依從性上,差異無統(tǒng)計學(xué)意義(p0.05)。出院6個月時,干預(yù)組鼻腔沖洗依從性高于對照組,差異有統(tǒng)計學(xué)意義(p0.05)。4.智能手機(jī)軟件使用情況干預(yù)組患者使用智能手機(jī)應(yīng)用軟件6個月后,對其使用情況進(jìn)行調(diào)查,96%患者通過智能手機(jī)軟件推送消息形式提醒出院后定期復(fù)診可以接受;89%的患者認(rèn)為智能手機(jī)軟件的內(nèi)容設(shè)置能滿足出院后的健康知識需求;87%的患者平均每周可使用一次智能手機(jī)軟件;82%的患者認(rèn)為選擇晚上時間推送消息最為合適。結(jié)論:1.接受放化療出院后的鼻咽癌患者并發(fā)癥及毒副反應(yīng)較多,生存質(zhì)量較差。2.智能手機(jī)應(yīng)用程序的使用可提高放化療鼻咽癌患者出院后鍛煉依從性,降低放化療毒副反應(yīng)和并發(fā)癥。3.智能手機(jī)應(yīng)用程序的使用可提高患者生存質(zhì)量及患者滿意度,具有可行性。
[Abstract]:Objective: to analyze the side effects and complications of nasopharyngeal carcinoma (NPC) patients after receiving radiotherapy, chemotherapy and discharge, and to analyze the effects on quality of life (QOL) of nasopharyngeal carcinoma patients by using smart phone software. To investigate the feasibility of the application of smartphone application software in the follow-up of nasopharyngeal carcinoma patients after discharge from hospital. Methods: a randomized controlled trial was used. The period from March 1st 2015 to March 25th 2016 was selected. 132 patients who received concurrent radiotherapy and chemotherapy in the radiotherapy department of our hospital were randomly divided into the control group (65 cases) and the control group (65 cases). 67 patients in the intervention group were treated with traditional health guidance and follow-up methods after discharge. The patients in the intervention group were instructed to download and use self-designed smartphone software when discharged from the hospital. The software included personal information, follow-up reminder, and evaluation of complications. Knowledge base, interactive 5 modules, specific contents include the patient with nasopharyngeal carcinoma after the concurrent radiotherapy and chemotherapy of acute and chronic side effects and complications of observation and treatment of diseases related knowledge, rehabilitation exercise, Operation video of nasal lavage etc. General data of patients were collected when discharged from the two groups; The complications of radiotherapy and chemotherapy and QLQ-C30 were collected at the time of discharge and 6 months after discharge, and the compliance of nasal irrigation and open mouth exercise were collected at 3 months after discharge and 6 months after discharge. After 6 months of discharge, the patients in the intervention group were collected the use of smart phone software. Results: 1.The side effects and complications of radiotherapy and chemotherapy were compared between the two groups when they were discharged from the hospital, the patients had oral mucositis, difficulty opening mouth, dry mouth, and hearing loss. There was no significant difference in the incidence of nasal congestion (P 0.05), which was comparable. Six months after discharge, the two groups were compared in four aspects: oral mucositis, difficult mouth opening, dry mouth, and nasal congestion. The difference was statistically significant (P 0.05). There was no significant difference in hearing loss between the two groups. The scores of quality of life (QOL) were compared between the two groups at the time of discharge. There was no statistical significance in symptom and total quality of life score (P 0.05). At discharge and 6 months after discharge, the total quality of life of intervention group was 42.14 鹵10.64 鹵10.07, and that of control group was 44.15 鹵13.31 鹵60.15 鹵12.17.The total quality of life in intervention group was 42.14 鹵10.64 鹵10.07, respectively. 6 months after discharge, the total quality of life in intervention group was 44.15 鹵13.31 鹵60.15 鹵12.17 respectively. The intervention group was superior to the control group in terms of cognitive function, symptoms of shortness of breath and economic difficulties, and the difference was statistically significant (p 0.05). The compliance of rehabilitation exercise between the two groups was compared at 3 months and 6 months after discharge. The compliance of the intervention group in open mouth exercise was significantly higher than that in the control group, and the difference was statistically significant (P 0.05). At 3 months after discharge, there was no significant difference in the compliance of nasal irrigation in the intervention group. At 6 months after discharge, there was no significant difference in the compliance of the patients with nasal irrigation. The nasal cavity flushing compliance of the intervention group was higher than that of the control group, and the difference was statistically significant (p 0.05). 4. The use of smart phone software in the intervention group was 6 months after the use of smart phone application software. 96% of patients are reminded to receive regular visits after discharge via smartphone software push message. 89% of the patients think the content settings of smartphone software can meet the health knowledge needs after discharge from the hospital, and 89% of the patients think that the content settings of the smartphone software can meet the needs of health knowledge after discharge. An average of 87% of the patients can use the smartphone software once a week. 82% of the patients think that it is most appropriate to choose the night time to push the news. Conclusion 1. After receiving radiotherapy and chemotherapy, patients with nasopharyngeal carcinoma have more complications and side effects. The use of smart phone applications can improve the exercise compliance of patients with radiotherapy and chemotherapy nasopharyngeal carcinoma after discharge. Reduce side effects and complications of radiotherapy and chemotherapy. 3. The use of smart phone applications can improve patients' quality of life and patient satisfaction, which is feasible.
【學(xué)位授予單位】：鄭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：TP311.56;R739.63

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