基于接纳承诺疗法的心理护理方案在终末期癌症患者中的应用研究

doi:10.3761/j.issn.0254-1769.2024.15.006

摘要/Abstract

摘要：

目的探讨基于接纳承诺疗法的心理护理方案对终末期癌症患者的影响。方法采用便利抽样法，选取2021年6月—2022年12月在山西省运城市某三级甲等综合医院放射治疗科住院的120例终末期癌症患者作为研究对象。利用Research Randomizer软件随机分为试验组和对照组，各60例。住院期间，试验组在常规护理的基础上接受基于接纳承诺疗法的心理护理干预，对照组接受常规心理护理，采用简化版心理弹性量表、心理痛苦温度计、接纳与行动问卷第2版、癌症患者生存质量测定量表，评估两组干预前后心理弹性、心理痛苦程度、经验性回避水平、生存质量，并进行比较。结果研究期间，试验组脱落3例，对照组脱落2例，最终试验组57例、对照组58例完成研究。干预后试验组简化版心理弹性量表得分为（35.14±4.76）分，对照组为（33.17±2.97）分，两组比较，差异具有统计学意义（t=2.664，P=0.009）；干预后试验组心理痛苦温度计得分为（4.14±1.88）分，对照组为（5.69±2.13）分，两组比较，差异具有统计学意义（t=-4.138，P<0.001）；干预后试验组接纳与行动问卷第2版得分为（16.19±3.80）分，对照组为（23.93±2.46）分，两组比较，差异具有统计学意义（t=-13.002，P<0.001）；干预后试验组癌症患者生存质量测定量表得分为（117.00±8.50）分，对照组为（101.45±11.88）分，两组比较，差异具有统计学意义（t=8.066，P<0.001）。结论实施基于接纳承诺疗法的心理护理方案能有效降低终末期癌症患者的心理痛苦程度、经验性回避水平，提高心理弹性，改善生存质量。

关键词: 终末期, 癌症, 接纳承诺疗法, 心理弹性, 生存质量, 心理护理

Abstract:

Objective To explore the effects of a psychological nursing programme based on acceptance and commitment therapy on patients with end-stage cancer. Methods The convenience sampling method was adopted to select 120 patients with end-stage cancer who were hospitalized in the radiotherapy department of a tertiary A maternity and general hospital in Yuncheng from June 2021 to December 2022 as the research subjects. The Research Randomizer was used to divide them into an experimental group and a control group，with 60 cases in each group. The experimental group adopted the psychological nursing programme based on acceptance and commitment therapy，and the control group received the routine psychological nursing. The differences of psychological resilience，psychological pain，experiential avoidance level and quality of life before and after intervention were compared between the 2 groups. Results 57 cases in the experimental group and 58 cases in the control group completed the study. The scores of the 10-item Connor-Davidson Resilience Scale were（35.14±4.76） points in the experimental group and（33.17±2.97） points in the control group，and the difference between the 2 groups was statistically significant（t=2.664，P=0.009）. After intervention，the scores of the Distress Thermometer in experimental group and control group were（4.14±1.88） points and（5.69±2.13） points，and the difference between the 2 groups was statistically significant（t=-4.138，P<0.001）. The scores of the Acceptance and Action Questionnaire-Ⅱ were（16.19±3.80） points in the experimental group and（23.93±2.46） points in the control group，and the difference between the 2 groups was statistically significant（t=-13.002，P<0.001）. The EORTC QLQ-C30 score in the experimental group was（117.00±8.50） points，and that in the control group was（101.45±11.88） points，and the difference between the 2 groups was statistically significant（t=8.066，P<0.001）. Conclusion The psychological nursing programme based on acceptance and commitment therapy can effectively reduce the level of psychological pain and experiential avoidance，improve psychological resilience and improve the quality of life of patients.

Key words: End Stage, Tumor, Acceptance and Commitment Therapy, Psychological Resilience, Quality of Life, Psychological Nursing

薛蓉, 王雪静, 杨润平, 杜巧红, 张晶, 何海燕. 基于接纳承诺疗法的心理护理方案在终末期癌症患者中的应用研究[J]. 中华护理杂志, 2024, 59(15): 1832-1839.

XUE Rong, WANG Xuejing, YANG Runping, DU Qiaohong, ZHANG Jing, HE Haiyan. The application of a psychological nursing programme based on acceptance and commitment therapy in end-stage cancer patients[J]. Chinese Journal of Nursing, 2024, 59(15): 1832-1839.

图/表 3

表1 基于接纳承诺疗法的心理护理方案

Table 1 The psychological nursing programme based on acceptance and commitment therapy

表2 两组一般资料的比较

Table 2 Comparison of general data in the 2 groups

表3 两组干预前后心理弹性、心理痛苦程度、经验性回避水平、生存质量比较（分，$ \bar{x} \pm s$）

Table 3 Comparison of the degree of psychological resilience, psychological pain, experiential avoidance level and quality of life before and after intervention between the 2 groups（scores，$ \bar{x} \pm s$）

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