疼痛教育联合心理干预对原发性肝癌患者术后心理弹性状况及应激激素水平的影响  

Effects of pain education combined with psychological intervention on postoperative mental resilience and stress hormone levels in patients with primary liver cancer

作　　者：刘金华[1] 黄冰[1] LIU Jinhua;HUANG Bing(Department of Oncology Nursing,Jingzhou First People's Hospital,Jingzhou 434000,China)

机构地区：[1]湖北省荆州市第一人民医院肿瘤科护理,434000

出　　处：《中国健康心理学杂志》2023年第3期387-392,共6页China Journal of Health Psychology

摘　　要：目的:分析疼痛教育联合心理干预对原发性肝癌患者术后心理弹性状况及应激激素水平的影响。方法:选取2019年1月-2022年1月某院收治的98例原发性肝癌患者,所有患者均采取经导管肝动脉化疗栓塞术治疗;按照入院先后分为对照组和研究组,每组各49例。对照组采取心理干预,研究组在此基础上采取疼痛教育。对比两组患者干预前后夜间睡眠时间、心理弹性状况[心理弹性量表(CD-RISC)]、应激激素水平[皮质醇(Cor)、肾上腺素(E)]、疼痛等级[视觉模拟评分法(VAS)]及护理满意度。结果:手术当天、术后1d、术后2d及术后3d夜间睡眠时间对比,研究组均高于对照组(t=17.813,11.471,4.267,3.661;P<0.05);干预前,两组CD-RISC量表各维度评分及总分差异对比均无统计学意义;干预后,两组坚韧、乐观、自强及CD-RISC量表总分均升高,且研究组均高于对照组(t=6.759,5.248,6.622,6.903;P<0.05);干预前,两组血清中Cor、E水平差异对比均无统计学意义;术前2h,两组患者Cor、E水平均高于干预前,但研究组均低于对照组(t=-6.082,-6.294;P<0.05);术后3d,两组Cor、E水平均较术前2h、干预前降低,且研究组均低于对照组(t=-4.864,-12.512;P<0.05);研究组77.55%患者为轻度疼痛,4.08%为重度疼痛,而对照组20.41%患者为重度疼痛,两组间疼痛等级差异比较有统计学意义(χ^(2)=7.623,P<0.05);研究组满意度为97.96%,高于对照组的83.67%(χ^(2)=5.844,P<0.05)。结论:疼痛教育联合心理干预有利于增加原发性肝癌患者夜间睡眠时间,改善术后负性情绪,增强其心理弹性,减轻生理应激反应,提高护理满意度,值得临床推广使用。Objective:To analyze the effects of pain education combined with psychological intervention on postoperative mental resilience and stress hormone levels of patients with primary liver cancer.Methods:A total of 98 patients with primary liver cancer admitted to our hospital from January 2019 to January 2022 were selected.All patients were treated with transcatheter arterial chemoembolization.The patients were divided into control group and study group according to the time of admission,with 49 cases in each group.The control group took psychological intervention,and the research group took pain education on this basis.Sleep time at night,mental resilience scale(CD-RISC),stress hormone level(cortisol(Cor),adrenaline(E)),pain level(visual analogue scale)and nursing satisfaction were compared between 2 groups before and after intervention.Results:On the day of operation,1d after operation,2d after operation and 3d after operation,the sleep time of the study group was higher than that of the control group(t=17.813,11.471,4.267,3.661;P<0.05).Before intervention,there was no statistical significance in the score and total score of CD-RISC scale between the two groups(P>0.05).After intervention,the total scores of tenacity,optimism,self-strengthening and CD-RISC scale were increased in both groups(P<0.05),and those in the study group were higher than those in the control group(t=6.759,5.248,6.622,6.903;P<0.05).Before intervention,there was no statistical significance in serum Cor and E levels between the two groups(P>0.05).At 2h preoperatively,the levels of Cor and E in 2 groups were higher than before intervention(P<0.05),but in study group they were lower than control group(t=-6.082,-6.294;P<0.05).3 days after surgery,Cor and E levels in both groups were lower than those at 2 hours before surgery and before intervention(P<0.05),and those in the study group were lower than those in the control group(t=-4.864,-12.512;P<0.05).In the study group,77.55%of patients had mild pain,4.08%had severe pain,while 20.41%of patients in

关 键 词：疼痛教育 心理干预 原发性肝癌 心理弹性状况 应激激素水平 

分 类 号：R749.92[医药卫生—神经病学与精神病学]