正念减压疗法减轻同步放化疗肿瘤病人的心理痛苦  

Effect of mindfulness-based decompression therapy in alleviating psychological pain of malignant tumor patients undergoing concurrent chemoradiotherapy

作　　者：李茸[1] 雷叡 刘璇 朱丽[1] 王玲[1] 邢舒 王皎[1] 刘东阳[1] 李潇 李珊珊[1] 马卫平 姚晚侠 LI Rong;LEI Rui;LIU Xuan;ZHU Li;WANG Ling;XING Shu;WANG Jiao;LIU Dongyang;LI Xiao;LI Shanshan;MA Weiping;YAO Wanxia(Department of Radiotherapy,The First Affiliated Hospital of Xi'an Jiaotong University,Xi'an,Shaanxi 710061,China;Department of Critical Care Medicine,Shaanxi Provincial Fourth People's Hospital,Xi'an,Shaanxi 710061,China;Endoscopy Center for Gastroenterology,Ankang Central Hospital,Ankang,Shaanxi 725029,China;Department of Health Management,Shenzhen Samii Medical Center,Shenzhen,Guangdong 518118,China)

机构地区：[1]西安交通大学第一附属医院肿瘤放疗科,陕西西安710061 [2]陕西省第四人民医院重症医学科,陕西西安710061 [3]安康市中心医院消化内科内镜中心,陕西安康725000 [4]深圳市萨米医疗中心健康管理部,广东深圳518118

出　　处：《安徽医药》2023年第7期1426-1432,共7页Anhui Medical and Pharmaceutical Journal

基　　金：陕西省自然科学基础研究计划(2022JM-597);陕西省重点研发计划(2022SF-562)。

摘　　要：目的探讨正念减压疗法在减轻同步放化疗恶性肿瘤病人心理痛苦时的作用。方法选取2020年1月至2021年6月西安交通大学第一附属医院收治的120例恶性肿瘤病人,分为观察组和对照组,每组各60例。对照组病人行常规护理,观察组病人在常规护理的基础上辅以为期8周的正念减压疗法。观察并对比两组病人心理状态、心理痛苦方面以及生活质量的状况。结果心理痛苦方面:心理痛苦评分,干预前、后痛苦评分[观察组:(5.49±1.88)分、(4.11±1.62)分;对照组:(5.36±1.78)分、(4.71±1.24)分],观察组下降得更为明显(P<0.05)。痛苦程度占比,两组均以中度痛苦为主,两组干预后痛苦程度均趋轻变化,但仅观察组前后差异有统计学意义(P<0.05);焦虑和抑郁评分:组内比较,干预前、后焦虑和抑郁评分,干预后均比干预前有明显下降,干预后观察组下降得更为明显(P<0.05)。心理健康方面,观察组和对照组在活力(VT)、情感职能(RE)、社会功能;(SF)和精神健康(MH)各维度得分[VT:(79.51±16.42)分、(71.84±20.82)分;RE:(84.72±19.87)分、(77.29±18.51)分;SF:(85.19±20.15)分、(77.24±19.39)分;MH:(87.44±17.94)分、(80.88±17.57)分],观察组在各维度得分均低于对照组,差异有统计学意义(P<0.05)。到8周结束正念减压干预时,观察组病人的CD3^(+)、CD4^(+)、CD8^(+)、NK细胞和白细胞介素-6表达水平显著增高,皮质醇的表达水平显著下降,差异有统计学意义(P<0.05)。两组各指标比较亦均差异有统计学意义(P<0.05)。结论正念减压疗法能够显著减轻同步放化疗恶性肿瘤病人的心理痛苦,改善病人的焦虑和抑郁状态,提升生活质量。Objective To explore the effect of mindfulness-based decompression therapy(MBSR)on alleviating the psychological pain of malignant tumor patients undergoing concurrent chemoradiotherapy.Methods A total of 120 malignant tumor patients admitted to The First Affiliated Hospital of Xi'an Jiaotong University from January 2020 to June 2021 were selected and divided into an observation group and a control group,with 60 patients in each group.The control group received routine nursing,and the observation group received MBSR for 8 weeks on the basis of routine nursing.The psychological distress score,psychological state and quality of life were observed and compared between the two groups.Results Psychological pain scores:observation group:(5.49±1.88)points,(4.11±1.62)points;control group:(5.36±1.78)points,(4.71±1.24)points,the observation group decreased more obviously after intervention(P<0.05).The pain degree in both groups was moderate,and the pain degree in both groups eases slightly after intervention,but there was significant difference between the observation group and the observation group(P<0.05).Scores of anxiety and depression:Compared with before intervention,both groups were significantly lower after intervention,with statistical significance(P<0.05),the decrease was more obvious in the observation group after intervention,there was significant difference between the two groups(P<0.05);Quality of life score:Scores of physical health[VT:(79.51±16.42)points,(71.84±20.82)points;RE:(84.72±19.87)points,(77.29±18.51)points;SF:(85.19±20.15)points,(77.24±19.39)points;MH:(87.44±17.94)points,(80.88±17.57)points],the dimensions of physical function(PF),physical function(RP)and overall self-assessment of health(GH)were slightly improved in the two groups,while the dimensions of body pain(BP)were decreased,but the differences were not statistically significant.In terms of mental health,the scores of vitality(VT),social function(SF),emotional function(RE)and mental health(MH)in the observation group were lower

关 键 词：正念减压 放化疗病人 心理痛苦 人文关怀 

分 类 号：R473.73[医药卫生—护理学]