认知心理治疗对癌症伴抑郁患者负面情绪和病耻感的改善作用  

Improvement effect of cognitive psychotherapy on negative emotions and shame in patients with cancer and depression

作　　者：刘广华 傅佳萍[2] 段迪 Liu Guanghua;Fu Jiaping;Duan Di(Psychological Measurement and Treatment Room,Shaoxing 7th People's Hospital,Shaoxing 312000,Zhejiang Province,China;Department of Hematology,Shaoxing 7th People's Hospital,Shaoxing 312000,Zhejiang Province,China;Department of Judicial Appraisal,Shaoxing 7th People's Hospital,Shaoxing 312000,Zhejiang Province,China)

机构地区：[1]绍兴市第七人民医院心理测量与治疗室,绍兴312000 [2]绍兴市人民医院血液科,绍兴312000 [3]绍兴市第七人民医院司法鉴定科,绍兴312000

出　　处：《中国基层医药》2024年第3期371-376,共6页Chinese Journal of Primary Medicine and Pharmacy

摘　　要：目的探讨认知心理治疗对癌症伴抑郁患者负面情绪和病耻感的改善作用。方法采取随机对照研究,选取绍兴市第七人民医院2022年2月至2023年5月收治的癌症伴抑郁患者114例,采用随机数字表法分为A组、B组各57例。A组予常规西药治疗,B组予常规西药治疗联合认知心理治疗,均治疗8周。观察两组的负面情绪[汉密尔顿抑郁量表(HAMD)、汉密尔顿焦虑量表(HAMA)评分]、病耻感[社会影响量表(SIS)评分]、自我效能[自我效能量表(BSES)评分]、睡眠质量[匹兹堡睡眠质量指数(PSQI)评分]及临床疗效。结果治疗后,B组HAMD评分[(7.83±2.01)分]、HAMA评分[(9.78±1.94)分]均低于A组[(12.15±2.37)分、(13.06±2.32)分],差异均有统计学意义(t=10.50、8.19,均P<0.001);B组SIS评分为(44.72±4.93)分,低于A组的(51.63±6.10)分,差异有统计学意义(t=6.65,P<0.001);B组BSES评分为(121.65±11.44)分,高于A组的(100.24±10.73)分,差异有统计学意义(t=-10.31,P<0.001);B组PSQI评分为(7.00±0.85)分,低于A组的(9.83±1.10)分,差异有统计学意义(t=15.37,P<0.001);B组总有效率为94.74%(54/57),高于A组的80.70%(46/57),差异有统计学意义(χ^(2)=5.21,P=0.022)。结论认知心理治疗在癌症伴抑郁患者中的应用效果显著,能有效减轻患者的负面情绪和病耻感,且能提高其自我效能,改善睡眠质量,值得推广。Objective To investigate the improvement effect of cognitive psychotherapy on negative emotions and shame in patients with cancer and depression.Methods A total of 114 patients with cancer and depression who received treatment at Shaoxing 7th People's Hospital from February 2022 to May 2023 were included in this randomized controlled study.The patients were randomly divided into two groups:group A and group B,with 57 patients in each group.Group A received routine western medicine treatment,while group B received routine western medicine combined with cognitive psychotherapy.Both groups received treatment for 8 weeks.Various measures were evaluated at the end of the treatment period,including negative emotions(Hamilton Depression Scale score,Hamilton Anxiety Scale score),shame(Social Impact Scale score),self-efficacy(Breastfeeding Self-Efficacy Scale score),sleep quality(Pittsburgh Sleep Quality Index score),and clinical efficacy.Results After treatment,the Hamilton Depression Scale score and Hamilton Anxiety Scale score in group B were(7.83±2.01)points and(9.78±1.94)points,respectively,which were significantly lower than those in group A[(12.15±2.37)points,(13.06±2.32)points,t=10.50,8.19,both P<0.001].The Social Impact Scale score in group B was significantly lower than that in group A[(44.72±4.93)points vs.(51.63±6.10)points,t=6.65,P<0.001].The Breastfeeding Self-Efficacy Scale score in group B was significantly higher than that in group A[(121.65±11.44)points vs.(100.24±10.73)points,t=-10.31,P<0.001].The Pittsburgh Sleep Quality Index score in group B was significantly lower than that in group A[(7.00±0.85)points vs.(9.83±1.10)points,t=15.37,P<0.001].The overall response rate in group B was significantly higher than that in group A[94.74%(54/57)vs.80.70%(46/57),χ^(2)=5.21,P=0.022].Conclusion Cognitive psychotherapy has a significant impact on patients with cancer and depression,effectively alleviating negative emotions and shame,enhancing self-efficacy,and improving sleep quality.Therefore,it deserv

关 键 词：认知疗法 心理疗法 肿瘤 抑郁 焦虑 情绪障碍 睡眠 

分 类 号：R473.73[医药卫生—护理学]