目的 探讨跨理论模型预立医疗照护计划（advanced care planning,ACP）在晚期癌症患者中的应用效果。方法 便利抽样法选取哈尔滨市某肿瘤医院治疗的109例晚期癌症患者为研究对象,按照入组时间分为干预组54例，对照组55例;对照组采用常规护理方法，干预组在常规护理基础上实施1个月跨理论模型预立医疗照护计划干预。比较两组患者干预前后预立医疗照护计划准备度及死亡态度情况。结果 干预组患者预立医疗照护计划准备度和死亡态度描绘（自然接受）评分均高于对照组（均P＜0.05）；死亡态度描绘（死亡恐惧、死亡逃避）评分均低于对照组（均P＜0.05）。结论 跨理论模型预立医疗照护计划干预能提高晚期癌症患者的ACP准备度，改善患者死亡态度，对晚期癌症患者具有重要意义。

Objective To investigate the application effect of advanced care planning (ACP) intervention in patients with advanced cancer based on a cross theoretical model.Methods A total of 109 patients with advanced cancer who were treated in a cancer hospital in Harbin were selected as the study subjects by the convenience sampling method.According to the time of enrollment,54 patients were assigned into intervention group,and 55 patients were assigned into control group.The control group adopted conventional nursing methods,while the intervention group additionally received one-month of ACP intervention based on cross-theoretical model.The ACP intervention preparation and the death attitude of the patients were compared between the two groups before and after the intervention.Results The scores of the ACP intervention preparation scale and death attitude description(natural acceptance) in the intervention group were higher than those in the control group (all P＜0.05);the scores of death attitude description (fear of death,death escape) were lower than those of the control group (all P＜0.05).Conclusions The ACP intervention based on a cross theoretical model can improve the preparation of ACP in patients with advanced cancer,improve their attitude towards death,which is of great significance for the patients with advanced cancer.

R473.73

国家自然科学基金项目（81902954）