基于KANO模型的老年淋巴瘤auto-HSCT患者全程关怀护理实施效果评价

Evaluation of the Implementation Effect of Whole-Course Compassionate Care for Elderly Lymphoma Patients Undergoing auto-HSCT Based on the KANO Model

摘要: 目的：分析老年淋巴瘤患者行自体造血干细胞移植(auto-HSCT)的全程护理需求，并评价基于KANO模型全程关怀护理策略的实施效果。方法：采用随机对照试验设计，将广西医科大学附属肿瘤淋巴血液及儿童肿瘤内科40例老年淋巴瘤患者分为观察组与对照组。通过焦虑自评量表(SAS)、抑郁自评量表(SDS)、匹兹堡睡眠质量指数(PSQI)及记录移植并发症、护理满意度调查问卷进行评估，比较两组患者的心理状态、并发症发生率及护理满意度。结果：实施基于KANO模型全程关怀护理策略后，观察组患者的SAS评分、SDS评分及PSQI评分均显著低于对照组(均P < 0.001)。观察组在口腔粘膜炎、腹泻、恶心呕吐等并发症发生率上亦显著低于对照组(均P < 0.05)。此外，观察组在基础护理、健康教育、沟通交流及人文关怀四个维度的护理满意度评分均显著高于对照组(均P < 0.001)。结论：针对老年淋巴瘤auto-HSCT患者实施基于KANO模型全程关怀护理策略，能改善其负性情绪与睡眠质量，降低并发症风险，并提升护理满意度。基于KANO模型全程关怀护理策略实施效果理想，能有效满足老年淋巴瘤auto-HSCT患者的多层次需求，具有临床推广意义。

Abstract: Objective: To analyze the comprehensive care needs of elderly lymphoma patients undergoing autologous hematopoietic stem cell transplantation (auto-HSCT) and evaluate the intervention effects of a KANO model-based holistic care strategy. Methods: A randomized controlled trial design was adopted. Forty elderly lymphoma patients admitted to the Department of Lymphatic Hematology and Pediatric Oncology at Guangxi Medical University Affiliated Tumor Hospital were divided into an observation group and a control group. Psychological status, complication rates, and nursing satisfaction were assessed using the Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), Pittsburgh Sleep Quality Index (PSQI), records of transplant-related complications, and a nursing satisfaction questionnaire. Results: After implementing the KANO model-based holistic care strategy, the observation group showed significantly lower SAS, SDS, and PSQI scores compared to the control group (all P < 0.001). The incidence of oral mucositis, diarrhea, nausea, and vomiting was also significantly lower in the observation group (all P < 0.05). In addition, the observation group reported significantly higher nursing satisfaction scores across four dimensions—basic care, health education, communication, and humanistic care (all P < 0.001). Conclusion: Implementing a KANO model-based holistic care strategy for elderly lymphoma patients undergoing auto-HSCT can alleviate negative emotions, improve sleep quality, reduce the risk of complications, and enhance nursing satisfaction. The strategy effectively meets the multi-level needs of this patient population and demonstrates strong potential for clinical application.