ABSTRACT
Objective@#To explore the application and effect of the cancer case management led by cancer case managers in the whole processing management of nasopharyngeal carcinoma (NPC) patients.@*Methods@#A randomized controlled study was designed. 510 patients with nasopharyngeal carcinoma were randomly divided into two groups: the observation group (255 cases) and the control group (255 cases). The observation group adopted the case management led by cancer case managers, and the control group adopted the cancer case management. To evaluate the rate of seeing a doctor, the implementation rate of the treatment plan and the rate of the first follow-up visit between the two groups. M.D. Anderson symptom Inventory-head-neck (MDASI-H&N) was used to evaluate the symptom disturbance (the day of hospitalization, the period of radiotherapy and chemotherapy, 1 months after discharge and 6 months after discharge).@*Results@#The treatment rate was 90.2% (230/255) in the observation group, 78.04% (199/255) in the control group, The rate of implementation of established treatment plans 99.57% (229/230) in the observation group and 90.95% (181/199) in the control group. The first follow-up rate was 98.70% (227/230) in the observation group and 84.42% (168/199) in the control group. The difference was statistically significant (Z=19.768, 15.207, 7.042, P < 0.01). In the observation group, the average value of symptom disturbance, the average severity of symptom distress and the average degree of symptom disturbance in 3 times (the period of radiotherapy and chemotherapy, 1 months after discharge and 6 months after discharge) were (3.00±0.95) , (2.43±0.16) , (2.03±0.34) , (2.95±0.97) , (2.46±0.12) , (2.11±0.16) , (2.89±0.46) , (2.41±0.33) , (1.99±0.16) ; Significantly lower than the control group (3.69±1.51) , (2.82±0.23) , (2.42±0.13) , (3.88±1.39) , (2.87±0.34) , (2.54±0.22) , (3.61±0.75) , (2.72±0.42) , (2.38±0.17) , the difference has the statistical significance (t=-21.152—10.372, P < 0.01).@*Conclusion@#The case management led by cancer case manager can effectively improve the rate of seeing a doctor, the rate of completion of the plan and the rate of the first visit, and ensure the patients to receive effective, standard and full treatment in time. In addition, the case management can effectively improve the symptoms of patients and promote their early return to the community.
ABSTRACT
Objective To build the access standard and role function of cancer case manager which is suitable for China.Methods The draft indicators of access standard and role function of cancer case manager were formulated based on literature review,group discussion and Delphi method.All the indicators were appraised by using two-round Delphi method.Results Round 1 consulting experts 43,and round 2 consulting experts 41.The experts showed high degree on the access standard and role function of cancer case manager during the two rounds of expert advice (two advisory Kendall coordination coefficients were 0.300,0.358 and 0.375,0.358,P ＜ 0.01).The access standard of cancer case manager included 4 first-level indicators and 34 secondary indicators,and the system of role functions included 7 first-level indicators,35 secondary indicators.Conclusions It indicates that the outcome is high reliability.The finding provide scientific basis for the selection of cancer case manager as well as clear identify of role functions which are significant for improving their work efficiency.
ABSTRACT
Objective To investigate the relationship between levels of psychological resilience and coping styles of the patients with recurrence of nasopharyngeal neoplasms during hospitalization,in order to provide scientific data about the clinical psychological intervention.Methods A total of 240 cases of hospitalized patients with recurrence of nasopharyngeal neoplasms were selected and measured with general information questionnaire which was self-designed,resilience scale (CD-RISC) and coping scale.Results Resilience average score of patients with recurrent nasopharyngeal neoplasms was (53.22 ± 12.09) points,the level of resilience was positively correlated with positive coping and avoidance coping,P＜0.05,and negatively correlated with the yield coping,P＜0.05.Conclusions The resilience levels in patients with recurrence of nasopharyngeal neoplasms is below the medium level,resilience have a significant impact on patients' coping styles,and coping styles is affecting the level of resilience.In clinical work,health care workers should take effective measures to improve the resilience of patients so that patients take positive coping with disease.
ABSTRACT
A multi-disciplinary study is proposed for emergency response management of disaster medical and mathematical discipline in the paper. The authors propose to evaluate the physical and chemical fragility and social fragility of Hainan province to search for methods to minimize local fragility; predict the level of disaster pre-warning using the time sequence model; calculate the medical personnel, equipments and drugs to be deployed at specific time and space by means of the probability method, and calculate on this basis the probability of the number of persons to be rescued against various emergencies. This aims at sending warning in advance and precisely mobilizing resources for medical emergency response.