术前焦点导向型心理干预对高位胆管癌切除术患者心理压力、应激反应及生活质量的影响  

Effect of Preoperative Focus-oriented Psychological Intervention on Psychological Stress,Stress Response and Quality of Life of Patients Undergoing Resection for High Grade Cholangiocarcinoma

作　　者：王迁 王珣 刘爽 Wang Qian;Wang Xun;Liu Shuang(Department of Hepatobiliary and Pancreatic Surgery,Affiliated Cancer Hospital of Zhengzhou University(Henan Provincial Cancer Hospital),Zhengzhou,Henan,450003,China)

机构地区：[1]郑州大学附属肿瘤医院·河南省肿瘤医院肝胆胰腺外科,河南郑州450003

出　　处：《黑龙江医学》2024年第8期989-991,995,共4页Heilongjiang Medical Journal

摘　　要：目的:研究术前焦点导向型心理干预对改善高位胆管癌切除术患者心理压力、应激反应及生活质量的影响。方法:选取2019年5月—2021年5月河南省肿瘤医院肝胆胰腺外科接受高位胆管癌切除术的82例患者作为研究对象,采用随机数表法分为对照组和观察组,每组各41例。对照组患者采取常规护理措施,观察组患者在常规护理基础上采取焦点导向型心理护理干预。分别于干预前后比较两组患者焦虑自评量表(SAS)评分及抑郁自评量表(SDS)评分、应激反应指标[去甲肾上腺素(NE)、肾上腺素(E)]、生活质量(皮质醇水平、心理功能、社会功能及躯体功能评分)情况。结果:干预后,两组患者SAS评分、SDS评分均显著下降,且观察组患者显著低于对照组,差异有统计学意义(t=15.960、23.871,P<0.05);观察组患者NE、E、皮质醇水平在T2时上升,在T3时下降,且T2、T3时患者的NE、E、皮质醇水平较对照组低,差异有统计学意义(t=26.709、13.461、10.976;t=15.979、12.149、6.260,P<0.05);干预后,两组患者的心理功能、社会功能维度评分较干预前显著提高,其中观察组患者干预后上述评分显著高于对照组(t=23.118、7.400,P<0.05),但两组患者干预前后躯体功能维度评分比较,差异无统计学意义(t=1.215,P>0.05)。结论:术前焦点导向型心理干预能有效缓解高位胆管癌切除术患者心理压力,减轻术后应激反应,改善患者术后生活质量。Objective:To investigate the effects of a preoperative focus-oriented psychological intervention on improving psychological stress,stress response,and quality of life in patients undergoing resection for high-grade cholangiocarcinoma.Methods:82 patients who underwent high cholangiocarcinoma resection in the hospital from May 2019 to May 2021 were selected and divided into the control group and observation group using the random number table method,with 41 cases in each group.The control group adopted conventional nursing measures,and the observation group adopted focus-oriented psychological nursing intervention on the basis of the control group.Anxiety self-assessment scale(SAS)scores and depression self-assessment scale(SDS)scores,norepinephrine(NE),epinephrine(E)and cortisol levels,psychological functioning,social functioning,and somatic functioning scores were compared before and after the interventions,respectively.Results:After the intervention,SAS scores and SDS scores decreased significantly in both groups,and the appeal scores of the observation group were significantly lower than those of the control group after the intervention,and the difference was statistically significant(t=15.960,23.871;P<0.05).The patients in the observation group increased at T2 and decreased at T3,and the NE,E,and cortisol levels of the patients at T2 and T3 were lower than those of the patients in the control group,and the difference was statistically significant(t=26.709,13.461,10.976;t=15.979,12.149,6.260;P<0.05).The psychological and social functions of the patients in the two groups were significantly improved after the intervention compared with the pre-intervention period,in which the above scores of the observation group were significantly higher than those of the control group after the intervention(t=23.118,7.400;P<0.05),but there was no statistically significant difference in the comparison of the somatic functions before and after the intervention in the two groups(t=1.215,P>0.05).Conclusion:Preoperative focus-orien

关 键 词：高位胆管癌切除术 焦点导向型心理干预 心理压力 应激反应 生活质量 

分 类 号：R47[医药卫生—护理学]