分级心理护理模式在鼻咽癌放疗期间的效果评价
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摘要
目的探讨分级心理护理模式对鼻咽癌患者放疗期间症状及生存质量的影响,为临床开展有效的心理护理模式提供参考依据。方法选取2016年8月至2017年3月该院放疗科接受放射治疗的鼻咽癌患者39例作为对照组,临床配对筛选该院2017年4―12月进行治疗的鼻咽癌患者39例作为观察组。对照组给予鼻咽癌放疗常规护理,观察组按照放疗期间SCL-90症状自评量表、匹兹堡睡眠质量指数(PSQI)及口腔黏膜反应评分进行分级心理护理。比较2组患者SCL-90、PSQI、食欲情况、口腔黏膜损伤程度、放疗相关并发症和生存质量。结果经过分级心理护理,观察组PSQI及食欲较对照组均有明显改善(P<0.05);口腔黏膜损伤程度明显低于对照组;QLQ-C30患者在社会角色功能、情绪和记忆功能,以及放疗相关并发症等方面与对照组比较,差异有统计学意义(P<0.05)。结论鼻咽癌患者在放疗的不同阶段开展分级心理护理,效果优于常规心理护理,可明显降低患者负性情绪,减轻放疗相关并发症,促进患者康复并提高生活质量。
Objective To explore the effect of grading psychological nursing care model on the symptoms and quality of life of patients with nasopharyngeal carcinoma during radiotherapy,and to provide reference for an effective clinical psychological nursing care model.Methods Thirty-nine nasopharyngeal carcinoma patients undergoing radiotherapy in our radiology department from August 2016 to March 2017 were selected as the control group;and meanwhile,thirty-nine nasopharyngeal carcinoma patients receiving treatment from April 2017 to December were screened as the observation group by the method of clinical matched pair.Among which,the control group was received routine radiotherapy for nasopharyngeal carcinoma;while the observation group was given grading psychological nursing care according to the Symptom Checklist-90(SCL-90),PSQI and oral mucosal response scores during radiotherapy.SCL-90,PSQI,appetite,injury degree of oral mucosa,radiation-related complications and quality of life patients from each group were compared between the two groups.Results After grading psychological nursing care,both PSQI and appetite of the observation group were significantly improved(P<0.05),and the injury degree of oral mucosal was significantly lower than that of the control group(P<0.05).Compared with the control group,the QLQ-C30 patients were significantly different in the terms of social role,emotion,memory function and radiotherapy complications(P<0.05).Conclusion The effects of grading psychological nursing care for patients with nasopharyngeal carcinoma at different stages of radiotherapy are better than that of conventional psychological care,which could significantly reduce the negative emotions of patients,decrease the incidence of radiotherapy-related complications,and ultimately promote the recovery of patients and improve the quality of their lives.
Objective To explore the effect of grading psychological nursing care model on the symptoms and quality of life of patients with nasopharyngeal carcinoma during radiotherapy,and to provide reference for an effective clinical psychological nursing care model.Methods Thirty-nine nasopharyngeal carcinoma patients undergoing radiotherapy in our radiology department from August 2016 to March 2017 were selected as the control group;and meanwhile,thirty-nine nasopharyngeal carcinoma patients receiving treatment from April 2017 to December were screened as the observation group by the method of clinical matched pair.Among which,the control group was received routine radiotherapy for nasopharyngeal carcinoma;while the observation group was given grading psychological nursing care according to the Symptom Checklist-90(SCL-90),PSQI and oral mucosal response scores during radiotherapy.SCL-90,PSQI,appetite,injury degree of oral mucosa,radiation-related complications and quality of life patients from each group were compared between the two groups.Results After grading psychological nursing care,both PSQI and appetite of the observation group were significantly improved(P<0.05),and the injury degree of oral mucosal was significantly lower than that of the control group(P<0.05).Compared with the control group,the QLQ-C30 patients were significantly different in the terms of social role,emotion,memory function and radiotherapy complications(P<0.05).Conclusion The effects of grading psychological nursing care for patients with nasopharyngeal carcinoma at different stages of radiotherapy are better than that of conventional psychological care,which could significantly reduce the negative emotions of patients,decrease the incidence of radiotherapy-related complications,and ultimately promote the recovery of patients and improve the quality of their lives.
引文
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[9]李芳莲,范丽萍,马茹,等.分级心理护理在喉癌病人围手术期护理中的应用[J].护理研究,2016,30(1):172-174.
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[11]邹莉,郭旗.心理干预对鼻咽癌患者焦虑抑郁症状影响的Meta分析[J].中国老年保健医学,2013,11(2):27-29.
[12]廖美莲,杨秋花,曾海梅.健康教育对鼻咽癌患者依从性的影响[J].中华现代护理杂志,2008,5(16):1510-1511.
[13]许容芳,陆勤美.58例鼻咽癌调强放疗期间的护理干预及效果评价[J].实用临床医药杂志,2010,14(4):13-14.
[14]李艺,柴守霞.全方位护理干预在减少老年鼻咽癌放射性口腔炎中的应用[J].实用临床医药杂志,2010,14(22):12-13.
[2]王跃建,邓燕明,虞幼军,等.鼻咽癌诊断与治疗[M].北京:人民卫生出版社,2013.
[3]NICHOLS K著.刘晓虹,吴菁,译.临床心理护理指南[M].北京:中国轻工业出版社,2007:5-80.
[4]王瑞芝,樊锐太,尤庆山,等.肿瘤放射治疗学[M].北京:人民卫生出版社,2005:122-123.
[5]韦惠云,黄明宜.分级心理护理研究进展[J].中国继续医学教育,2015,7(25):216-217.
[6]刘贤臣.匹兹堡睡眠质量指数(Pmsburgh sleep Quality Index),PSQI[J].中国心理卫生杂志,1999,15(增刊):375-378.
[7]殷蔚伯,余子豪,徐国镇,等.肿瘤放射治疗学[M].4版.北京:中国协和医科大学出版社,2008:1353-1374.
[8]AARONSON N K,AHMEDSAI S,BERGMAN B,et al.The European organization for research and treatment of cancer QLQ-C30:aquality-of-life instrument for use in international clinical trails in oncology[J].J Natl Cancer Inst,1993,32(85):365-369.
[9]李芳莲,范丽萍,马茹,等.分级心理护理在喉癌病人围手术期护理中的应用[J].护理研究,2016,30(1):172-174.
[10]蔺波,姚海霞,曹晓琳.延伸护理对鼻咽癌放疗病人自我管理效能感的影响[J].全科护理,2015,13(3):260-262.
[11]邹莉,郭旗.心理干预对鼻咽癌患者焦虑抑郁症状影响的Meta分析[J].中国老年保健医学,2013,11(2):27-29.
[12]廖美莲,杨秋花,曾海梅.健康教育对鼻咽癌患者依从性的影响[J].中华现代护理杂志,2008,5(16):1510-1511.
[13]许容芳,陆勤美.58例鼻咽癌调强放疗期间的护理干预及效果评价[J].实用临床医药杂志,2010,14(4):13-14.
[14]李艺,柴守霞.全方位护理干预在减少老年鼻咽癌放射性口腔炎中的应用[J].实用临床医药杂志,2010,14(22):12-13.