指导下诚实披露和姑息治疗晚期肺癌的综合方法：对情绪困扰、症状负担和患者满意度的影响

摘要(中文译文)

探讨将引导性开放沟通策略与姑息护理理念相融合的综合护理模式在晚期肺癌患者中的可行性及临床价值，并评估其对患者负性情绪、疼痛反应、癌因性疲乏、生活质量及护理满意度的影响。回顾性分析2023年4月至2025年6月于我院接受治疗的276例晚期肺癌患者的临床资料，根据护理方案不同分为两组：对照组（=138）接受常规护理，观察组（=138）在常规护理基础上加用引导性开放沟通干预联合姑息护理的综合措施。比较两组患者的负性情绪[抑郁-焦虑-压力量表（DASS-21）]、癌痛反应[美国疼痛学会患者结局问卷修订版（APS-POQ-Modified）]、癌因性疲乏[Piper疲乏量表（PFS）]、生活质量[欧洲癌症研究与治疗组织生活质量问卷（EORTC QLQ-C30）]及护理满意度[纽卡斯尔护理满意度量表（NSNS）]。干预后，两组患者的焦虑评分、抑郁评分、压力评分、疼痛强度评分、疼痛对日常生活干扰评分、疼痛信念评分、躯体感觉疲乏评分、情感疲乏评分、行为疲乏评分及认知疲乏评分均较干预前降低；疼痛控制满意度评分、躯体功能评分、角色功能评分、认知功能评分、情绪功能评分、社会功能评分及总体健康状况评分均较干预前升高，且观察组的改善幅度大于对照组（<0.05）。观察组总体护理满意度（94.20%）高于对照组（80.43%）（<0.05）。将引导性开放沟通与姑息护理相融合应用于晚期肺癌患者的护理中可发挥协同效应，不仅能有效缓解焦虑、抑郁等负性情绪，还可减轻疼痛及癌因性疲乏，提高生活质量，提升护理满意度，具有较高的临床推广价值。

Abstract

To explore the feasibility and clinical value of a comprehensive nursing model that integrates guided open communication strategies with the philosophy of palliative care in patients with advanced lung cancer, and to evaluate its impact on patients' negative emotions, pain response, cancer-related fatigue, quality of life, and nursing satisfaction. A retrospective analysis was conducted on the clinical data of 276 patients with advanced lung cancer who received treatment in our hospital from April 2023 to June 2025. According to the different nursing protocols, patients were divided into two groups: the control group ( = 138) received routine nursing care, while the observation group ( = 138) received additional comprehensive measures combining guided open communication intervention with palliative care on top of routine nursing. The two groups were compared in terms of negative emotions [Depression-Anxiety-Stress Scale (DASS-21)], cancer pain response [American Pain Society Patient Outcome Questionnaire Revised Version (APS-POQ-Modified)], cancer-related fatigue [Piper Fatigue Scale (PFS)], quality of life [European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30)], and nursing satisfaction [Newcastle Satisfaction with Nursing Scale (NSNS)]. After the intervention, anxiety score, depression score, stress score, pain intensity score, pain interference with daily life score, pain belief score, physical sensation fatigue score, affective fatigue score, behavioral fatigue score, and cognitive fatigue score in both groups decreased compared with pre-intervention; pain control satisfaction score, physical functioning score, role functioning score, cognitive functioning score, emotional functioning score, social functioning score, and global health status score increased compared with pre-intervention, with the magnitude of improvement being greater in the observation group than in the control group ( < 0.05). The overall nursing satisfaction in the observation group (94.20%) was higher than that in the control group (80.43%) ( < 0.05). The integration of guided open communication and palliative care in the nursing of patients with advanced lung cancer can exert a synergistic effect, not only effectively alleviating anxiety, depression, and other negative emotions, but also reducing pain and cancer-related fatigue, improving quality of life, and enhancing nursing satisfaction, with high value for clinical promotion.

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