结构式心理干预在围术期乳癌患者治疗中的应用  

Structural psychological intervention in perioperative period of breast cancer

作　　者：于洪鸾[1] 潘芳[2] 毛雪琴[1] 

机构地区：[1]山东大学齐鲁医院心理科,山东济南250012 [2]山东大学医学院心理研究所,山东济南250012

出　　处：《山东大学学报（医学版）》2005年第4期283-286,共4页Journal of Shandong University:Health Sciences

基　　金：山东省科技厅科研基金资助项目(99BBICAA2)

摘　　要：目的:探讨结构式心理干预在围术期乳癌患者治疗中的作用。方法:将60例接受乳癌根治手术的早期(Ⅰ～Ⅱ期)乳癌患者随机分成干预组与未干预组,干预组手术前给予45min的结构式心理干预,未干预组不实行心理干预,用Zung焦虑量表(SAS)、Zung抑郁量表(SDS)、症状自评量表(SCL-90)、自尊量表(SES)、特制应对量表(TCSQ)、皮肤电测试仪,在入院后和手术后对患者心理状况、交感神经紧张度进行测试,并抽取患者清晨空腹血检测氢化可的松(Cortisol)水平。结果:干预后,干预组的SAS、SDS、SCL-90量表得分及消极应对(NC)得分均低于未干预组(P<0.01),SES、积极应对(PC)得分、皮肤电阻(PI)数值明显高于未干预组(P<0.01,P<0.01,P<0.05),Cortisol水平低于未干预组(P>0.05);干预组干预前后Cor-tisol水平呈下降趋势,而未干预组术前术后Cortisol水平呈上升趋势。结论:结构式心理干预可有效改善乳癌患者的心理、行为健康状况。Objective: To exnlore the effect of structural psychological intervention for breast cancer during perioperative period. Methods: Sixty volunteers who were diagnosed as breast cancer with fine needle aspiration were randomly divided into two groups. All the patients received the tests of psychological rating scales (SAS, SDS, SCL-90, SES, TCSQ), electronic skin resistometry,and blood cortisol level before and after operation. The patients in intervention group were given 45 minutes' structural interview before operation. Results: The patients in intervention group had a significantly decreased scores in SAS, SDS, SCL-90,NC, and increased scores in SES, PC, PI compared to the controls (P<0.01, P<0.01, P<0.01, P<0.01, P<0.01, P<0.01, P<0.05, respectively). The intervention group had a lower level of cortisol after intervention and the control group had a higher level of cortisol than that before intervention. Conclusion: Structural psychological intervention can significantly improve patients' psychological and behavioral status.

关 键 词：心理干预 情绪 应对方式 交感神经 氢化可的松 

分 类 号：R737.9[医药卫生—肿瘤] R395.1[医药卫生—临床医学]