基于接纳承诺疗法的心理治疗模型对胰腺癌患者疼痛的影响  

The application of psychotherapy model based on acceptance commitment therapy in the pain of pancreatic cancer patients

作　　者：徐英萍[1,2] 董锐增 陈伟琴[1,2] 盛华英 郭安阳[1,2] XU Yingping;DONG Ruizeng;CHEN Weiqin;SHENG Huaying;GUO Anyang(Department of Hepatobiliary,Pancreatic and Gastrointestinal Surgery,Zhejiang Cancer Hospital,Hangzhou 310022,China;Hangzhou Institute of Medicine,Chinese Academy of Sciences,Hangzhou 310018,China)

机构地区：[1]浙江省肿瘤医院肝胆胰胃外科,浙江杭州310022 [2]中国科学院杭州医学研究所,浙江杭州310018

出　　处：《健康研究》2024年第2期172-176,共5页Health Research

基　　金：浙江省医药卫生科技计划项目(2023KY584)。

摘　　要：目的 了解胰腺癌患者的疼痛、睡眠状况,探讨接纳承诺疗法对患者心理灵活性的影响,为改善患者生活质量提供思路。方法 62例胰腺癌患者随机分为对照组(30例)和观察组(32例),对照组接受常规肿瘤护理,观察组在对照组的基础上接受接纳承诺疗法。分别采用疼痛数字评分表(NRS)、匹兹堡睡眠指数量表(PSQI)、接纳与行动问卷第二版(AAQ-Ⅱ)和认知融合问卷(CFQ)进行问卷调查,比较2组患者干预前后的疼痛、睡眠状况及心理灵活性。结果 干预前,患者NRS、PSQI、AAQ-Ⅱ和CFQ评分分别为(2.3±0.7)分、(11.4±3.2)分、(20.2±7.8)分和(31.8±11.8)分,2组间差异无统计学意义(均P>0.05)。干预后,观察组各量表评分均低于干预前,且观察组低于对照组,差异有统计学意义(均P<0.05);对照组干预前后各项评分比较,差异无统计学意义(均P>0.05)。胰腺癌患者的NRS评分与PSQI、AAQ-Ⅱ、CFQ评分显著正相关(r=0.790、0.925、0.898,P<0.05)。结论 胰腺癌患者存在一定的疼痛和睡眠困扰,接纳承诺疗法可提高其心理灵活性,改善疼痛程度和睡眠质量。Objective To examine the pain and sleep status of pancreatic cancer patients and explores the impact of acceptance and commitment therapy on their psychological flexibility,aiming to provide insights for improving their quality of life.Methods A total of 62 pancreatic cancer patients were randomly assigned into a control group(n=30) and an observation group(n=32).The control group received routine oncology care,while the observation group received acceptance and commitment therapy in addition to routine care.Pain numeric rating scale(NRS),Pittsburgh sleep quality index(PSQI),acceptance and action questionnaire Ⅱ(AAQ-Ⅱ),and cognitive fusion questionnaire(CFQ) were used to assess pain,sleep status,and psychological flexibility of the patients before and after the intervention.Results Before the intervention,the NRS,PSQI,AAQ-II,and CFQ scores of the patients were(2.3±0.7)points,(11.4±3.2)points,(20.2±7.8)points,and(31.8±11.8)points respectively,with no significant differences between the two groups(all P>0.05).After the intervention,the scores on all scales in the observation group were lower than before the intervention,and the scores in the observation group were lower than those in the control group,with statistically significant differences(all P<0.05).There were no significant differences in the scores on each scale before and after the intervention in the control group(all P>0.05).The NRS scores of pancreatic cancer patients were significantly positively correlated with the PSQI,AAQ-Ⅱ,and CFQ scores(r=0.790,0.925,0.898;P<0.05).Conclusions Pancreatic cancer patients experience significant pain and sleep disturbances.Acceptance and commitment therapy can enhance their psychological flexibility and improve the severity of pain and sleep quality.

关 键 词：胰腺癌 接纳承诺疗法 心理灵活性 疼痛 睡眠质量 

分 类 号：R-4[医药卫生]