Effects of relaxation training combined with guided imagery audio on lymphoma patients undergoing chemotherapy

doi:10.3761/j.issn.0254-1769.2022.15.002

Abstract

Abstract:

Objective To investigate the effect of relaxation training combined with guided imagery on the adverse subjective experience of nausea and vomiting,anxiety levels as well as quality of life in lymphoma patients undergoing chemotherapy. Methods A total of 100 lymphoma patients undergoing initial chemotherapy were divided into an intervention group and a control group using random number table method. Each group contains 50 cases. The intervention group was given relaxation training combined with guided imagery audio based on routine chemotherapy nursing care. The patients in the control group were given routine chemotherapy nursing care,including chemotherapy diet education,accurate implementation of standardized antiemetic programs,and online follow-up during chemotherapy interval. The Index of Nausea and Vomiting and Retching（INVR）,Self-Rating Anxiety Scale（SAS）,and the Functional Assessment of Cancer Therapy-General（FACT-G） were utilized for evaluation. Results At the times of 24 hours before chemotherapy,and 24 hours,7 days,and 14 days after the first,third,and sixth cycle of chemotherapy,the scores of INVR and SAS in the intervention group were lower than those in the control group. The 4 dimensions of physical status,social status,emotional status,and functional status in the FACT-G of cancer patients and the total quality of life score were higher than those in the control group,with statistical significance（P<0.05）. Repeated measures ANOVA results showed that the time effect,the between-group effect and the interaction effect were all statistically significant（P<0.05）. Conclusion Relaxation training combined with guided imagery audio intervention can effectively mitigate the degree of nausea and vomiting,reduce anxiety and improve the quality of life in patients with lymphoma.

Key words: Relaxation Training, Guided Imagery, Nausea and Vomiting, Lymphoma Chemotherapy, Cancer, Quality of Life, Nursing Care

摘要：

目的探讨放松训练联合意象引导音频干预对淋巴瘤化疗患者恶心呕吐、焦虑水平及生命质量的影响。方法采用方便抽样法,选取2020年6月—12月在天津市某三级甲等肿瘤专科医院住院的淋巴瘤初治患者100例作为研究对象,通过随机数字表法将其随机分为试验组和对照组,每组50例。试验组在化疗常规护理基础上接受放松训练联合意象引导音频干预,对照组接受化疗常规护理,包括化疗宣教、准确执行标准化止吐方案以及化疗间歇期线上随访。两组分别于化疗前24 h,第1、3、6周期化疗后24 h、7 d、14 d,采用中文版恶心呕吐干呕症状评估量表（Index of Nausea and Vomiting and Retching,INVR）、焦虑自评量表（Self-Rating Anxiety Scale,SAS）、癌症患者生命质量测定量表（The Functional Assessment of Cancer Therapy-General,FACT-G）进行评定。结果试验组第1、3、6周期化疗后24 h、7 d、14 d,INVR评分、SAS评分均低于对照组,FACT-G总分均高于对照组,差异有统计学意义（P<0.05）。重复测量方差分析结果显示,INVR评分、SAS评分、FACT-G总分的时间效应、组间效应及交互效应均有统计学意义（P<0.05）。结论放松训练联合意象引导音频干预能有效缓解淋巴瘤化疗患者恶心呕吐及干呕症状,减轻其焦虑水平,提高其生命质量。

关键词: 放松训练, 意象引导, 恶心呕吐, 淋巴瘤化疗, 癌症, 生命质量, 护理

CHANG Qing, XIE Yating, WANG Huan, WANG Jianmei, QIANG Wanmin. Effects of relaxation training combined with guided imagery audio on lymphoma patients undergoing chemotherapy[J]. Chinese Journal of Nursing, 2022, 57(15): 1804-1810.

常青, 谢雅婷, 王欢, 王建美, 强万敏. 放松训练联合意象引导音频对淋巴瘤化疗患者影响的研究[J]. 中华护理杂志, 2022, 57(15): 1804-1810.

Figures/Tables 6

Table 1 Contents of audio instructions for relaxation training combined with guiding intention

Table 2 Essentials of relaxation training combined with guided intention audio training

Table 3 Comparison of the general data of 2 groups[case（percentage,%）]

Table 4 Comparison of scores of nausea and vomiting between the 2 groups at each time point（scores,$\bar{x} \pm s$）

Table 5 Comparison of anxiety scores between the 2 groups at each time point（scores,$\bar{x} \pm s$）

Table Comparison of the total score of quality of life between the 2 groups at each time point（scores,$\bar{x} \pm s$）

References 19

[1]	贺瑾, 冯丽娜, 朱晓萌, 等. 症状管理动态模型在淋巴瘤化疗患者全程管理中的应用研究[J]. 中国护理管理, 2022, 22(1):111-117.
	He J, Feng LN, Zhu XM, et al. Application of symptom management dynamic model in the whole management of lymphoma patients with chemotherapy[J]. Chin Nurs Manag, 2022,22(1):111-117.
[2]	倪宏, 刘玉, 覃惠英, 等. 化疗相关性恶心呕吐的非药物干预研究进展[J]. 护理研究, 2020, 34(20):3674-3677.
	Ni H, Liu Y, Qin HY, et al. Research progress on non-pharmacological interventions of chemotherapy induced nausea and vomiting[J]. Chin Nurs Res, 2020, 34(20):3674-3677.
[3]	褚彦香, 王颖, 熊欢. 分级管理方案在乳腺癌患者化疗所致恶心呕吐中的应用[J]. 中华护理杂志, 2019, 54(12):1815-1819. DOI
	Chu YX, Wang Y, Xiong H. Clinical practice of grading management scheme for chemotherapy induced nausea and vomiting in breast cancer patients[J]. Chin J Nurs, 2019, 54(12):1815-1819.
[4]	Einhorn LH, RaPoPort B, Navari RM, et al. 2016 updated MASCC/ESMO consensus recommendations:prevention of nausea and vomiting following multiple-day chemotherapy,high-dose che-motherapy,and breakthrough nausea and vomiting[J]. Support Care Cancer,2017, 25(1):303-308. DOI URL
[5]	杨漫丽, 万艳平, 陈狮, 等. 渐进式肌肉放松训练在癌症患者中的应用进展[J]. 中华护理教育, 2020, 17(5):415-418.
	Yang ML, Wan YP, Chen S, et al. A review of progressive muscle relaxation training in cancer patients[J]. Chin J Nurs Educ, 2020, 17(5):415-418.
[6]	Vuttanon N, Finnegan L, Lojanapiwat B, et al. Effect of progressive muscle relaxation on symptom clusters in breast cancer patients receiving chemotherapy:a quasi-experimental controlled trial[J]. Complement Ther Clin Pract, 2019, 37:27-31. DOI URL
[7]	Samami E, Shahhosseini Z, Hamzehgardeshi Z, et al. Psychological interventions in chemotherapy induced nausea and vomiting in women with breast cancer:a systematic review[J]. Iran J Med Sci, 2022, 47(2):95-106.
[8]	郑亚萍, 傅圆圆, 徐晶. 穴位按压缓解胃肠道肿瘤化疗患者恶心呕吐的效果观察[J]. 中华护理杂志, 2010, 45(2):118-119.
	Zheng YP, Fu YY, Xu J. Effect of acupressure on chemotherapy induced nausea and vomiting in patients with gastrointestinal cancer[J]. Chin J Nurs, 2010, 45(2):118-119.
[9]	杜佳雪. 基于Zung焦虑抑郁自评量表研究难治性胃食管反流病与情志因素的相关性[D]. 北京: 北京中医药大学,2021.
	Du JX. Correlation between refractory gastroesophageal reflux disease and emotional factors based on Zung Self-Rating Anxiety and Depression Scale[D]. Beijing: Beijing University of Chinese Medicine,2021.
[10]	Li H, Jin D, Qiao F, et al. Relationship between the Self-Rating Anxiety Scale score and the success rate of 64-slice computed tomography coronary angiography[J]. Int J Psychiatry Med, 2016, 51(1):47-55. DOI URL
[11]	Cella DF, Tulsky DS, Gray G. The Functional Assessment of Cancer Therapy Scale:development and validation of the general measure[J]. J Clin Oncol, 1993, 11(3):570-579. PMID
[12]	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.
	Wan CH, Meng Q, Tang XL, et al. A review of the Chinese version of the FACT-G scale for measuring the quality of life of cancer patients[J]. J Pract Oncol, 2006, 21(1):77-80.
[13]	吴玉萍, 王芹, 王雪辉. 渐进式肌肉放松训练结合人文关怀护理改善乳腺癌患者化疗所致胃肠道反应的效果[J]. 中国医学创新, 2021, 18(28):94-97.
	Wu YP, Wang Q, Wang XH. Effect of progressive muscle relaxation training combined with humanistic care nursing in improving gastrointestinal reaction induced by chemotherapy in patients with breast cancer[J]. Med Innovat China, 2021,18(28):94-97.
[14]	黄妹妹, 罗瑞君. 放松训练对化疗患者预期性恶心呕吐的效果观察[J]. 护士进修杂志, 2019, 34(2):171-172.
	Huang MM, Luo RJ. Effect of relaxation training on anticipatory nausea and vomiting in chemotherapy patients[J]. J Nurses Training, 2019, 34(2):171-172.
[15]	Tian X, Tang RY, Xu LL, et al. Progressive muscle relaxation is effective in preventing and alleviating of chemotherapy-induced nausea and vomiting among cancer patients:a systematic review of six randomized controlled trials[J]. Support Care Cancer, 2020, 28(9):4051-4058. DOI PMID
[16]	Kapogiannis A, Tsoli S, Chrousos G. Investigating the effects of the progressive muscle relaxation-guided imagery combination on patients with cancer receiving chemotherapy treatment:a systematic review of randomized controlled trials[J]. Explore(NY), 2018, 14(2):137-143.
[17]	陶风英, 黄平, 禹琦. 引导想象放松训练对妇科恶性肿瘤患者疼痛自我效能和生命质量的影响[J]. 中国实用护理杂志, 2020, 36(22):1689-1694.
	Tao FY, Huang P, Yu Q. Effects of guided imagination relaxation training on pain self-efficacy and quality of life in patients with gynecological malignant tumors[J]. Chin J Pract Nurs, 2020, 36(22):1689-1694.
[18]	宋艳品, 杨海燕, 路萍. 集束化护理对宫颈癌化疗患者心理状态及生活质量的影响[J]. 护理实践与研究, 2020, 17(3):114-116.
	Song YP, Yang HY, Lu P. Influence of cluster nursing on mental state and quality of life of patients with cervical cancer chemotherapy[J]. Nurs Pract Res, 2020, 17(3):114-116.
[19]	Dikmen HA, Terzioglu F. Effects of reflexology and progressive muscle relaxation on pain,fatigue,and quality of life during chemotherapy in gynecologic cancer patients[J]. Pain Manag Nurs, 2019, 20(1):47-53. DOI PMID