认知心理干预在血液病患者化疗期间的应用效果
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摘要
目的探究认知心理干预对血液病患者化疗期间输血恐惧情绪、化疗期间疲乏程度及存活质量的影响。方法采用随机数字表法将2014年3月—2016年8月于我院住院化疗的114例血液病患者分为观察组和对照组,各57例。对照组患者予以常规护理干预措施,观察组在上述基础上联合认知心理干预措施。比较二组患者化疗1个月、3个月时疲乏程度[中文版疲劳量表(FACIT)]、睡眠质量[匹兹堡睡眠质量指数(PSQI)]及存活质量[中文版生命质量测定量表(FACT-G)]评估结果差异,分析其干预前后输血恐惧情绪[中文版负性情绪量表(NA量表)]评估结果变化情况。结果化疗1个月、3个月时,观察组患者FACIT、FACT-G评估结果均明显高于同期对照组(t=9.772、12.143、6.140、7.394,均P=0.000),PSQI评估结果则明显低于同期对照组(t=10.636、27.178,均P=0.000)。干预后,观察组患者NA评估结果较干预前及同期对照组明显降低(t=12.606、11.869,均P=0.000),对照组评估结果未见明显改变(t=0.246,P=0.806)。结论认知心理干预在血液病化疗患者中有一定应用价值,对调节其输血恐惧情绪、减轻化疗期间疲乏程度、改善其生活质量具有积极意义。
Objective To explore the effect of cognitive psychological intervention on fear of blood transfusion,fatigue during chemotherapy and quality of life of patients with blood diseases.Methods From March2014 to August 2016,one hundred and fourteen cases with blood diseases treated by chemotherapy in Deyang People′s Hospital were selected and randomly divided into the observation group and the control group,57 cases in each group.The control group was given routine nursing intervention,and the observation group were additionally given cognitive psychological intervention.The scores of fatigue degree(FACIT),sleep quality(PSQI)and quality of life(FACT-G)of the two groups were compared at after 1 month and 9 months of chemotherapy,and the changes of blood transfusion fear emotion(NA scale)before and after intervention were analyzed.Results The results of FACIT and FACT-G in the observation group were significantly higher than those in the control group(t=9.772,12.143,6.140,7.394,P=0.000).After 1 month and 3 months of chemotherapy,scores of FACIT and FACT-G in the observation group were significantly higher than those in the control group(t=9.772,12.143,6.140,7.394,P=0.000),while PSQI score was lower than that in the control group(t=10.636,27.178,P=0.000).After intervention,NA score in the observation group was significantly lower than that before the intervention and that in the control group at the same period(t=12.606,11.869,P=0.000),while there was no significant difference in the control group(t=0.246,P=0.806).Conclusion Cognitive psychological intervention has certain application value in patients with blood diseases.It is of positive significance in regulating the fear of blood transfusion,reducing the fatigue degree and improving the quality of life.
Objective To explore the effect of cognitive psychological intervention on fear of blood transfusion,fatigue during chemotherapy and quality of life of patients with blood diseases.Methods From March2014 to August 2016,one hundred and fourteen cases with blood diseases treated by chemotherapy in Deyang People′s Hospital were selected and randomly divided into the observation group and the control group,57 cases in each group.The control group was given routine nursing intervention,and the observation group were additionally given cognitive psychological intervention.The scores of fatigue degree(FACIT),sleep quality(PSQI)and quality of life(FACT-G)of the two groups were compared at after 1 month and 9 months of chemotherapy,and the changes of blood transfusion fear emotion(NA scale)before and after intervention were analyzed.Results The results of FACIT and FACT-G in the observation group were significantly higher than those in the control group(t=9.772,12.143,6.140,7.394,P=0.000).After 1 month and 3 months of chemotherapy,scores of FACIT and FACT-G in the observation group were significantly higher than those in the control group(t=9.772,12.143,6.140,7.394,P=0.000),while PSQI score was lower than that in the control group(t=10.636,27.178,P=0.000).After intervention,NA score in the observation group was significantly lower than that before the intervention and that in the control group at the same period(t=12.606,11.869,P=0.000),while there was no significant difference in the control group(t=0.246,P=0.806).Conclusion Cognitive psychological intervention has certain application value in patients with blood diseases.It is of positive significance in regulating the fear of blood transfusion,reducing the fatigue degree and improving the quality of life.
引文
[1]冀晓红,李草旎.补肾益脾祛毒汤联合改良IA方案治疗中老年白血病的疗效及毒副反应观察[J].四川中医,2016,34(11):55-57
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[14]孙淑华,赵立双,刘宝芹,等.心理干预对自血病化疗患者心理状况影响的研究[J].中国健康心理学杂志,2009,17(4):466-468
[15]张月,许方蕾.认知行为干预对白血病患者疲乏程度和生存质量的影响[J].上海护理,2014,14(5):38-41
[16]李小云,张静平,彭芳,等.急性白血病化疗患者应对及效能认知干预评价[J].中国公共卫生,2012,28(8):1124-1126
[17]季聪华,洪雪文,邵琼,等.中西医结合治疗白血病成本效果分析[J].中国中医药信息杂志,2017,24(2):40-43
[18]张斌,刘爱,张哲,等.血液病患者输血前焦虑状况及影响因素[J].中华现代护理杂志,2012,18(20):2397-2400
[19]李仲平,王淏,郑优荣,等.广州地区HBsAg阴性无偿献血血液输血传播HBV残余风险评估[J].广东医学,2014,35(3):442-445
[2]任金海,郭晓楠,林凤茹,等.2014年急性髓系白血病治疗进展[J].临床荟萃,2015,30(2):157-160
[3]李惠.化疗对急性淋巴细胞白血病患者肾功能影响的临床观察[J].医学临床研究,2013,30(7):1445-1446
[4]孙淑华,赵立双,刘恩君,等.白血病患者心理状况及医学应对方式的研究[J].中国健康心理学杂志,2008,16(8):948-949
[5]侯桂军,杨慧,艾智慧,等.儿童白血病患者化疗过程中行为特征及应对方式[J].湖南师范大学学报(医学版),2016,13(5):14-16
[6]彭芳,张静平,张海苗,等.不同心理干预方法对急性白血病化疗患者社会支持状况的影响研究[J].中国全科医学,2012,15(7):792-794
[7]张之南,沈悌.血液病诊断及疗效标准[M].3版.北京:科学出版社,2007:131-133
[8]张之南,郝玉书,赵永强,等.血液病学[M].2版.北京:人民卫生出版社,2011:886-889
[9]王思远,高敏,赵岳,等.中文版慢性病治疗功能评估-疲劳量表在维持性血液透析患者中的信效度评定[J].中华护理杂志,2014,49(5):613-617
[10]路桃影,李艳,夏萍,等.匹兹堡睡眠质量指数的信度及效度分析[J].重庆医学,2014,43(3):260-263
[11]万崇华,孟琼,汤学良,等.癌症患者生命质量测定量表FACT-G中文版评介[J].实用肿瘤杂志,2006,21(1):77-80
[12]郑泓,李玲艳,李诗晨,等.正性负性情绪量表在乳腺癌患者中的信度和效度(中文版)[J].中国临床心理学杂志,2016,24(4):671-674,670
[13]纪娜.护理干预对进行化疗的急性白血病患者焦虑和抑郁情绪及生活质量的影响[J].现代中西医结合杂志,2016,25(18):2044-2046
[14]孙淑华,赵立双,刘宝芹,等.心理干预对自血病化疗患者心理状况影响的研究[J].中国健康心理学杂志,2009,17(4):466-468
[15]张月,许方蕾.认知行为干预对白血病患者疲乏程度和生存质量的影响[J].上海护理,2014,14(5):38-41
[16]李小云,张静平,彭芳,等.急性白血病化疗患者应对及效能认知干预评价[J].中国公共卫生,2012,28(8):1124-1126
[17]季聪华,洪雪文,邵琼,等.中西医结合治疗白血病成本效果分析[J].中国中医药信息杂志,2017,24(2):40-43
[18]张斌,刘爱,张哲,等.血液病患者输血前焦虑状况及影响因素[J].中华现代护理杂志,2012,18(20):2397-2400
[19]李仲平,王淏,郑优荣,等.广州地区HBsAg阴性无偿献血血液输血传播HBV残余风险评估[J].广东医学,2014,35(3):442-445