階段性認知行為護理對肺癌化療患者情緒及生活質量的影響分析

陳明霞 黃秀蓉 吳云 王卿 陳雪釵

[摘要] 目的 探討給予肺癌化療患者階段性認知行為護理對其生活質量和情緒的影響。 方法 選取2018年1～12月間我院接受化療的肺癌患者70例為研究對象，采取數字表法隨機分成對照組和觀察組，每組35例，對照組行常規護理，觀察組在前者基礎上應用階段性認知行為護理，觀察兩組護理效果。 結果 護理前，兩組SAS、SDS與GQLI-74評分差異無統計學意義（P>0.05）;護理后，觀察組SAS、SDS評分較對照組低，GQLI-74評分較對照組高，差異有統計學意義（P<0.05）。 結論 給予肺癌化療患者階段性認知行為護理能改善其負面情緒，提高其生活質量，值得采用。

[關鍵詞] 化療;肺癌;生活質量;抑郁;焦慮;階段性認知行為護理

[中圖分類號] R473.73? ? ? ? ? [文獻標識碼] B? ? ? ? ? [文章編號] 1673-9701（2019）18-0136-03

[Abstract] Objective To investigate the effects of staged cognitive behavioral care on the quality of life and emotion in the patients with lung cancer undergoing chemotherapy. Methods 70 patients with lung cancer who received chemotherapy in our hospital from January 2018 to December 2018 were selected as the study subjects. The number table method was used to randomly divide the patients into the control group and the observation group， with 35 cases in each group. The control group was given routine care， and the observation group was given staged cognitive behavioral care on the basis of the former. The effects of the two groups were observed. Results There were no statistically significant differences in SAS， SDS and GQLI-74 scores between the two groups before nursing care（P>0.05）; after the nursing care， the SAS and SDS scores in the observation group were lower than those in the control group. The GQLI-74 scores were higher than those in the control group， and the differences were statistically significant（P<0.05）. Conclusion It is worthwhile to give staged cognitive behavioral care for the patients with lung cancer undergoing chemotherapy to improve their negative emotions and improve their quality of life.

[Key words] Chemotherapy;Lung cancer;Quality of life; Depression;Anxiety;Staged cognitive behavioral care

肺癌屬于呼吸系統十分常見的惡性腫瘤，近幾年來其發病率正逐年上升，已對人類生命健康產生嚴重威脅[1]。有資料顯示[2]，長期大量吸煙和肺癌發生之間有著密切關系，且肺部慢性炎癥、結核、環境污染、職業暴露、家族史等均為肺癌的常見病因。臨床治療肺癌時多選擇化療，但化療時多數患者會出現惡心嘔吐和疲勞等癥狀，這些癥狀會給患者帶來較大心理負擔，易使其出現焦慮和抑郁等不良情緒，影響其康復進程[3]。為提高患者生活質量，改善其負面情緒，我院對肺癌化療患者采取階段性認知行為護理，取得了顯著成效，現報道如下。

1 資料與方法

1.1 一般資料

選取2018年1～12月間我院接受化療的肺癌患者70例為研究對象，采取數字表法隨機分成對照組和觀察組，每組35例，對照組中男28例，女7例。年齡35～80歲，平均（58.26±6.25）歲。病理類型：12例小細胞癌，23例非小細胞癌。病理分期：4例局限期，8例廣泛期，6例3期，17例4期。觀察組中男27例，女8例。年齡36～81歲，平均（58.32±6.21）歲。病理類型：11例小細胞癌，24例非小細胞癌。病理分期：2例局限期，9例廣泛期，6例3期，18例4期。兩組一般資料比較差異不明顯（P>0.05），具有可比性。

入選標準：（1）均確診為肺癌;（2）均為首次化療;（3）神志清楚，能進行正常交流和溝通;（4）均取得患者知情同意。排除標準：（1）肝腎心等重要臟器存在嚴重功能障礙者;（2）繼發性肺癌;（3）惡液質和嚴重貧血者。