归因心理调适联合渐进性肌肉放松训练对乳腺癌化疗伴失眠患者身心健康的影响  

Effect of attributed psychological adjustment combined with progressive muscle relaxation training on physical and mental health of patients with breast cancer chemotherapy and insomnia

作　　者：刘海凤 戴晓燕[1] 桑娟[1] 马英芝 蔺波[1] 候燕[1] LIU Haifeng;DAI Xiaoyan;SANG Juan;MA Yingzhi;LIN Bo;HOU Yan(Radiotherapy Center,People's Hospital of Xinjiang Uygur Autonomous Region,Urumqi,Xinjiang 830000,China;不详)

机构地区：[1]新疆维吾尔自治区人民医院放疗中心,新疆乌鲁木齐830000 [2]新疆维吾尔自治区人民医院重症医学科

出　　处：《中华全科医学》2024年第4期704-708,共5页Chinese Journal of General Practice

基　　金：新疆维吾尔自治区自然科学基金面上项目(2020311A054)。

摘　　要：目的乳腺癌化疗易出现失眠等多种不良反应,需予以高度重视。本研究旨在探讨归因心理调适联合渐进性肌肉放松训练(PMR)对乳腺癌化疗伴失眠患者的应用效果。方法选取新疆维吾尔自治区人民医院2022年1月—2023年8月收治的乳腺癌化疗伴失眠患者共325例,采用随机数表法分为对照组(162例)和研究组(163例)。在常规护理基础上,对照组接受PMR,研究组接受归因心理调适联合PMR,均干预6周,并比较2组匹兹堡睡眠质量指数(PSQI)、心理弹性量表(CD-RISC)、癌因性疲乏量表(CFS)和乳腺癌生命质量量表(FACT-B)变化情况。结果对照组、研究组分别有117、132例成功完成研究。干预6周后,2组PSQI评分均较干预前明显下降(P<0.05),但研究组PSQI评分[(7.70±2.08)分vs.(9.81±3.10)分]、睡眠障碍发生率[41.67%(55/132)vs.55.56%(65/117)]低于对照组,差异均有统计学意义(P<0.05)。干预6周后,2组CD-RISC、CFS、FACT-B评分均有明显改善(P<0.05),且研究组CD-RISC、FACT-B评分明显高于对照组,CFS评分显著低于对照组,差异均有统计学意义(P<0.05)。结论归因心理调适联合PMR能有效缓解乳腺癌化疗伴失眠患者的睡眠障碍,提高心理弹性水平和减轻癌因性疲乏,改善患者化疗期间的生活质量。Objective Breast cancer chemotherapy is prone to insomnia and other adverse reactions,necessitating close attention.This study investigated the effect of attributive psychological adjustment combined with progressive muscle relaxation(PMR)on breast cancer patients undergoing chemotherapy and experiencing insomnia.Methods A total of 325 breast cancer patients with chemotherapy and insomnia admitted to the People's Hospital of Xinjiang Uygur Autonomous Region from January 2022 to August 2023 were selected and divided into control group(162 cases)and study group(163 cases)by random number table method.On the basis of routine care,the control group received PMR,and the study group received attributional psychological adjustment combined with PMR.The intervention lasted for 6 weeks,and the changes of Pittsburgh sleep quality index(PSQI),Connor-Davidson resilience scale(CD-RISC),cancer fatigue scale(CFS)and functional assessment of cancer therapy-breast(FACT-B)were compared between the two groups.Results A total of 117 cases in control group and 132 cases in study group successfully completed the study.After 6 weeks of intervention,both groups showed significant decrease in PSQI scores after intervention(P<0.05).The study group exhibited significantly lower PSQI scores[(7.70±2.08)points vs.(9.81±3.10)points]and a lower incidence of sleep disorders[41.67%(55/132)vs.55.56%(65/117)]compared to the control group,with statistically significant differences(P<0.05).After 6 weeks of intervention,the scores of CD-RISC,CFS and FACT-B in both groups were significantly improved(P<0.05),and the scores of CD-RISC and FACT-B in the study group were significantly higher than those in the control group,while the CFS scores were significantly lower than those in the control group,with statistical significance(P<0.05).Conclusion Attributive psychological adjustment combined with PMR can effectively alleviate sleep disorders,improve mental resilience,reduce cancer-related fatigue,and improve patients'quality of life during chemotherapy.

关 键 词：乳腺癌 化疗 失眠 归因心理调适 渐进性肌肉放松训练 

分 类 号：R737.9[医药卫生—肿瘤] R473.73[医药卫生—临床医学]