A Study Related to Symptom Management for Cancer Patients

这项研究是从1998年到2001年进行的。本研究的目的是检验“综合症状管理方法”（IASM）症状管理模式的有效性。这个模型最初是由UCSF的教师小组开发的，称为“MSM”（症状管理模型），用于处理癌症患者的各种症状，然后由Larson， Uchinuno（1998）修改为IASM用于临床应用。1998年，研究人员开发了一本指南，涵盖了临床应用的症状管理和护理记录的综合方法。还确定了测量模型有效性所需的工具和分析方法。1999年，研究人员和临床护士在这项研究中合作，将综合方法应用于15名癌症患者的症状管理，试图减轻他们的癌症相关症状，包括疼痛、恶心、呕吐、呼吸困难和疲劳。研究发现，在大多数情况下，患者变得更好，更能照顾自己，因此在某种程度上减轻了癌症相关症状。然而，研究还发现，癌症晚期患者难以提高自我护理能力，因此难以缓解身体症状。2000年，为了验证模型的适用性，研究团队将研究对象集中在成绩状态为1-2的患者身上。研究发现，此类患者更容易实现IASM的效果，并且IASM能有效提高患者的自我护理能力，从而缓解癌症相关症状。研究最后一年的目的是检查在整个医院病房引入IASM的有效性。研究小组将该模型引入医院病房，所有护士都同意使用该模型并将其应用于患者护理。使用变化理论对模型的引入过程进行了记录和分析。使用这个模型的护士发现，它导致了他们处理病人症状护理方式的变化。我们发现，在向组织引入项目时，小心地应用变更理论是很重要的。总的来说，本研究明确了以下几点：1)IASM是缓解患者症状的有效方法。2) IASM可以同时引入整个医院病房或单位。3)本模型也可与已开发的旅游指南配套使用。少

This study was conducted from 1998 to 2001. The purpose of this study was to test the validity of the "integrated Approach to Symptom Management" (IASM) model of symptom management. This model was originally developed as "MSM"(Model for Symptom Management) by the UCSF faculty group to deal with the various symptoms of cancer patients, and then modified as the IASM by Larson, Uchinuno, (1998) for clinical application. In 1998, the researchers developed a guidebook that covers an integrated approach to symptom management and nursing records for clinical application. The tools needed to measure the validity of the model and a method of analysis were also determined. In 1999, the researchers and clinical nurses who collaborated in this study applied the integrated approach to the symptom management of 15 ancer patients in an attempt to relieve their cancer related symptoms, including pain, nausea, vomiting, dyspnea, and fatigue. It was found that in most cases, the patients become better a … More ble to care for themselves, and as a result experienced some degree of relief from their cancer-related symptoms. However, it was also found that patients at the end stages of cancer had difficulty in improving their capacity for self care, which therefore made it difficult to achieve relief from their physical symptoms. In 2000, in order to validate the applicability of the model, the research team focused on patients with a performance status of 1-2. It was found that the effects of IASM were realized more easily for such patients, and that IASM was effective in improving the patients capacity for self care, and therefore, in relieving cancer-related symptoms.The purpose for the final year of the study was to examine the effectiveness of IASM introduction to an entire hospital ward. The research team introduced the model to a hospital ward, and all of the nurses agreed to utilize the model and apply it to their patient care. The process of the introduction of the model was recorded and analyzed using the Theory of Change. The nurses who used this model found that it resulted in changes in the way they handled the symptom care of their patients. We found that it is important to apply the theory of change carefully when introducing a project to an organization.Overall, this study has clarified the following : 1) IASM is a valid method for providing the patient with relief from symptoms. 2) IASM can be introduced into an entire hospital ward or unit simultaneously. 3) This model can also be used with the developed guidebook. Less