内观疗法对消化道肿瘤癌痛患者自我效能感与生活质量的影响
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摘要
目的探讨内观疗法对消化道肿瘤癌痛患者自我效能感与生活质量的影响。方法将100例消化道肿瘤癌痛患者随机分为常规组和观察组各50例,常规组患者给予临床常规疼痛干预措施,观察组患者给予常规干预和内观疗法干预;采用视觉模拟评分法(VAS)、自我效能感和健康量表(SEH)、生活质量(QOL)量表评价两组患者干预前后疼痛、自我效能感和生活质量的差异。结果干预前,两组患者VAS评分比较,差异无统计学意义(P>0.05)。用药前,观察组患者VAS评分明显低于常规组,差异有统计学意义(P<0.01)。常规组患者中有31例应用镇痛药物,多于观察组患者的19例,差异有统计学意义(P<0.05)。用药患者中,用药后6 h两组患者VAS评分比较,差异无统计学意义(P>0.05);用药后12 h,观察组患者VAS评分明显低于常规组,差异有统计学意义(P<0.01)。干预前,两组患者SHE、QOL评分比较,差异均无统计学意义(P>0.05);干预后,常规组患者SEH、QOL各维度评分均明显低于观察组,差异均有统计学意义(P<0.01)。结论内观疗法能够有效提高消化道肿瘤癌痛患者的自我效能感,改善其生活质量,值得临床广泛应用。
Objective To explore the effect of vipassana on self-efficacy and quality of life(QOL) in patients with gastrointestinal cancer who were suffering from cancer pain. Method One hundred patients with gastrointestinal cancer and cancer pain were randomized into the conventional therapy group and observation group, with 50 patients in each, respectively, the conventional therapy group was given routine pain management, and the patients in observation group were managed with vipassana and routine pain management; visual analogue scale(VAS) for pain, self-efficacy and health(SEH), and QOL scale were applied to compare the differences regarding pain, self-efficacy and QOL before and after interventions between the two groups. Result Before intervention, the VAS scores in both groups were similar(P>0.05). Before medication, the VAS in observation group was significantly lower compared with that in conventional therapy group, and the differences were of statistical significance(P<0.01). Thirty-one patients reported use of analgesics in conventional therapy group, while there were 19 cases in observation group, the difference was statistically significant(P<0.05). Among those who had taken analgesics, the VAS in the two groups in 6 h after medication did not show any significant difference(P>0.05); while in 12 h after medication, the VAS in observation group was evidently lower than that in control group(P<0.01). Before intervention, the SEH and QOL scores were comparable between the two groups(P>0.05), while the score for each domain of SEH and QOL in conventional therapy group was consistently lower compared with that in observation group, and the differences were of statistical significance(P<0.01). Conclusion Vipassana can effectively improve the self-efficacy of gastrointestinal cancer patients with cancer pain, and ameliorate their quality of life.
Objective To explore the effect of vipassana on self-efficacy and quality of life(QOL) in patients with gastrointestinal cancer who were suffering from cancer pain. Method One hundred patients with gastrointestinal cancer and cancer pain were randomized into the conventional therapy group and observation group, with 50 patients in each, respectively, the conventional therapy group was given routine pain management, and the patients in observation group were managed with vipassana and routine pain management; visual analogue scale(VAS) for pain, self-efficacy and health(SEH), and QOL scale were applied to compare the differences regarding pain, self-efficacy and QOL before and after interventions between the two groups. Result Before intervention, the VAS scores in both groups were similar(P>0.05). Before medication, the VAS in observation group was significantly lower compared with that in conventional therapy group, and the differences were of statistical significance(P<0.01). Thirty-one patients reported use of analgesics in conventional therapy group, while there were 19 cases in observation group, the difference was statistically significant(P<0.05). Among those who had taken analgesics, the VAS in the two groups in 6 h after medication did not show any significant difference(P>0.05); while in 12 h after medication, the VAS in observation group was evidently lower than that in control group(P<0.01). Before intervention, the SEH and QOL scores were comparable between the two groups(P>0.05), while the score for each domain of SEH and QOL in conventional therapy group was consistently lower compared with that in observation group, and the differences were of statistical significance(P<0.01). Conclusion Vipassana can effectively improve the self-efficacy of gastrointestinal cancer patients with cancer pain, and ameliorate their quality of life.
引文
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[15]张永艳,赵景新,王秀梅,等.药物联合改良式森田疗法及内观疗法治疗慢性精神分裂症的临床疗效[J].国际精神病学杂志,2016,43(6):999-1001;1010.
[16]杨玉婷.内观认知疗法对抑郁症患者临床症状与生活质量的影响探讨[J].基层医学论坛,2018,22(1):56-57.
[17]唐晨曦,刘小红,宋燕.恶性肿瘤住院患者癌因性疲乏与心理弹性的关系[J].中国健康心理学杂志,2018,26(12):1813-1816.
[18]杨柳.乳腺癌患者术后生活质量与自我效能的相关性研究[J].锦州医科大学学报,2018,39(5):68-71.
[2]唐卫文.以奥沙利铂为基础的三种联合方案治疗晚期消化道肿瘤患者的疗效比较[J].临床医药文献电子杂志,2017,4(94):18553-18554.
[3]彭睿,毛富强,靳秀,等.中国内观疗法文献分析(1988-2015年)[J].中国健康心理学杂志,2016,24(10):1524-1529.
[4]王祖承.内观疗法[M].北京:人民卫生出版社,2011:138-141.
[5]严广斌.视觉模拟评分法[J].中华关节外科杂志,2014,8(2):273.
[6]Gandoy-Crego M,Clemente M,Gómez-Cantorna C,et al.Self-efficacy and health:the SEH scale[J].Am J Health Behav,2016,40(3):389-395.
[7]Burckhardt CS,Anderson KL.The quality of life scale(QOLS):reliability,validity,and utilization[J].Health Qual Life Outcomes,2003,1:60.
[8]张媛,陶劲.消化系统恶性肿瘤的临床研究[J].中国实用医药,2016,11(23):197-198.
[9]杨婕琳,赵东强.消化系统恶性肿瘤与氧化应激关系的研究进展[J].胃肠病学,2015,20(2):113-115.
[10]黄永珍,黄海超,李萱.消化系统恶性肿瘤5年来的诊治分析[J].中国中西医结合外科杂志,2014,20(3):300-302.
[11]车群,刘春文.内观疗法对伴有儿童期创伤焦虑障碍的治疗影响[J].中国民康医学,2018,30(15):94-96.
[12]黄理好.责任护理小组对食管癌放化疗患者癌痛及自我效能感的影响[J].中外医学研究,2018,16(28):68-69.
[13]纪英,王倩,宋萍.自我效能干预对恶性肿瘤放化疗患者癌痛及生活质量的护理效果[J].中国医药导报,2017,14(8):171-174.
[14]郑希.浅谈内观疗法对精神分裂症患者康复效果的研究[J].中国民康医学,2016,28(14):7-9.
[15]张永艳,赵景新,王秀梅,等.药物联合改良式森田疗法及内观疗法治疗慢性精神分裂症的临床疗效[J].国际精神病学杂志,2016,43(6):999-1001;1010.
[16]杨玉婷.内观认知疗法对抑郁症患者临床症状与生活质量的影响探讨[J].基层医学论坛,2018,22(1):56-57.
[17]唐晨曦,刘小红,宋燕.恶性肿瘤住院患者癌因性疲乏与心理弹性的关系[J].中国健康心理学杂志,2018,26(12):1813-1816.
[18]杨柳.乳腺癌患者术后生活质量与自我效能的相关性研究[J].锦州医科大学学报,2018,39(5):68-71.