Effect analysis of case management in the perioperative period of patients with gastrointestinal tumor / 中国实用护理杂志

ABSTRACT

Objective To investigate the effect of case management in the perioperative period of patients with gastrointestinal tumor. Methods The quasi-experiment study were took to design the research. A total of 100 patients were enrolled in this study. Patients were divided into control group (n=50) and intervention group (n=50) by the admission time. The control group received routine nursing care, while the intervention group received routine perioperative care and case management during the perioperative period. The uncertainty of illness was compared between the two groups at the time point admission, on discharge and 5 weeks after surgery. The satisfaction during the process of treatment services, postoperative complications and return visit rate were compared too. After 5 weeks follow up, 10 cases in the control group and 4 cases in the intervention group were lost to follow-up, 86 cases were included in data analysis. Results Two groups patients all had medium uncertainty of illness at the three-different time points(preoptrative, 1 day before discharge and 5 weeks after surgery). The scores of the control group were 103.38 ± 14.94, 109.58 ± 16.06 and 113.90 ± 15.95 respectively.Those of the intervention patients were 108.02 ± 15.29,109.89 ± 16.52 and 113.41 ± 14.70.The uncertainty of illness elevated on the 5th week after surgery. Significant statistical differences were identified in the uncertainty of illness within each group (F=14.117, P<0.01). Significant statistical difference was identified in the visit rate, 100% (46/46)vs.87.5% (35/40) (χ2=6.105,P<0.05). The score of preoperative satisfaction of intervention patients (14.41 ± 1.13) was obviously higher than that of control patients (13.58 ± 1.55) (t=-1.89, P<0.05). Whereas, incidence of postoperative complications was not statistically significant between two groups. Conclusions The specificity of gastrointestinal tumor and the complexity of treatment bring about great pressure to patients. As the type of entire journey care model, the case management could integrate the fragmented management of conditional management model. Meantime, it also could effectively improve the medical experience and outpatient visit rate of patients with gastrointestinal tumor.