乳腺疾病护理门诊对乳腺癌患者术后焦虑和抑郁情绪的干预效果  

Outpatient nursing for intervention treatment against postoperative anxiety and depression in breast cancer patients

作　　者：陈显春[1] 宗贝歌[1] 谭璇妮[1] 陈庆秋[1] 蒋成刚[2] 

机构地区：[1]第三军医大学西南医院乳腺外科,重庆400038 [2]第三军医大学大坪医院野战外科研究所睡眠心理中心,重庆400042

出　　处：《中华乳腺病杂志（电子版）》2016年第5期287-290,共4页Chinese Journal of Breast Disease(Electronic Edition)

基　　金：第三军医大学西南医院护理科技创新基金课题

摘　　要：目的 探讨乳腺疾病护理门诊对乳腺癌患者术后焦虑、抑郁情绪的干预效果。方法 本研究为前瞻性研究,按照入组和排除标准收集2014年1~6月在第三军医大学西南医院确诊并行手术治疗的乳腺癌患者240例,采用随机数字表法将其分为两组：一组患者坚持每1~2周接受1次乳腺疾病护理门诊心理疏导（干预组,120例）,另一组患者未到乳腺疾病护理门诊进行心理疏导（对照组,120例）。干预组患者在护理门诊接受专业护师、康复师或心理医师的指导和帮助,之后患者之间进行自由交流,相互鼓励。6个月后采用汉密尔顿抑郁和焦虑量表对两组患者的焦虑和抑郁状态进行评分,并采用t检验比较两组之间的差异。结果 收集有效调查问卷共212份,干预组116份,对照组96份。干预组患者有效问卷回收率为93.3%（112/120）,明显高于对照组的80.0%（96/120）（χ2=9.231,P=0.004）。干预组患者焦虑和抑郁评分分别为（20.9±8.0）分和（24.7±10.5）分,均低于对照组患者的（26.8±8.7）分和（32.1±8.0）分（t=-5.086、-5.803,P均〈0.001）。结论 乳腺疾病护理门诊对患者的健康教育和心理疏导能够很好地缓解患者的焦虑和抑郁情绪,提高患者的生活质量,是一种可持续进行的患者自助互助途径。Objective To study the intervention effect of outpatient nursing for the postoperative anxiety and depression in patients with breast cancer. Methods This study was a prospective study. According to the inclusion and exdusion criteria, we enrolled 240 breast cancer patients diagnosed and operated in Southwest Hospital from January 2014 to June 2014. They were divided into two groups by random number table： intervention group receiving psychological support in outpatient nursing service 1 to 2 times per week, and control group receiving no outpatient nursing service. The patients had health consultation with professional nurses, rehabilitation physicians and psychologists, and then they communicated with other patients and encouraged each other. Hamilton anxiety scale and Hamilton depression scale were used to evaluate patients＇ anxiety and depression 6 months later, t test was used to compare the anxiety and depression scores between two groups. Results Totally 212 copies of effective questionnaires were collected, 116 in intervention group and 96 in control group. The recovery rate of questionnaires was 93.3% （ 112/120）, significantly higher than 80. 0% （96/120） in control group （χ2= 9. 231, P = 0. 004）. The anxiety and depression scores in intervention group were significantly lower than those in control group （20. 9± 8. 0 vs 26. 8± 8. 7, 24. 7 ± 10. 5 vs 32. 1 ±8.0; t =-5. 086, -5. 803, both P〈0. 001 ）. Conclusion Health education and psychological counseling in outpatient nursing service can relieve patients＇ anxiety and depression and improve quality of life to a great extent, regarded as a good way for self-support and mutual assistance of breast cancer patients.

关 键 词：乳腺肿瘤 焦虑 抑郁 护理 生活质量 

分 类 号：R473.73[医药卫生—护理学]