整合心理行为治疗配合放化疗对乳腺癌术后患者整体心身变化及睡眠质量的影响  

Effects of integrated psychobehavioral therapy combined with radiotherapy and chemotherapy on overall psychosomatic changes and sleep quality in patients with breast cancer after surgery

作　　者：裴方方 亢崇照[1] 杨宁波 PEI Fang-fang;KANG Chong-zhao;YANG Ning-bo(Department of Radiotherapy,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 470001,Henan,CHINA;Department of Psychology,the First Affiliated Hospital of Henan University of Science and Technology,Luoyang 470001,Henan,CHINA)

机构地区：[1]河南科技大学第一附属医院放疗科,河南洛阳470001 [2]河南科技大学第一附属医院心理科,河南洛阳470001

出　　处：《海南医学》2024年第9期1252-1257,共6页Hainan Medical Journal

基　　金：2022年河南省医学科技攻关计划(联合共建)项目(编号:LHGJ20220204)。

摘　　要：目的探讨整合心理行为治疗配合放化疗对乳腺癌术后患者整体心身变化及睡眠质量的影响。方法选取2019年1月至2023年1月河南科技大学第一附属医院收治的289例乳腺癌术后患者作为研究对象,按随机数表法分为研究组145例和常规组144例。两组患者均给予4~8个周期的化疗,每个周期3周(21 d),化疗完成后放疗。期间常规组患者给予常规心理治疗,研究组患者在常规组基础上给予整合心理行为治疗。靶向维持及内分泌治疗期间不进行心理治疗。比较两组患者治疗前后的整体心身变化、90项症状自评量表(SCL-90)评分和睡眠质量[匹兹堡睡眠治疗指数(PSQI)]。结果研究组患者治疗期间脱落率为2.76%(4/145),明显低于常规组的14.58%(21/144),差异有统计学意义(P<0.05);治疗后,研究组患者的压力指数、疲劳指数分别为(45.20±5.24)分、(78.52±4.39)分,明显低于常规组的(52.61±6.08)分、(83.44±4.58)分,放松指数、稳定指数分别为(67.82±3.92)分、(88.54±3.16)分,明显高于常规组的(63.10±4.75)分、(85.17±3.04)分,差异均有统计学意义(P<0.05);治疗后,研究组患者的躯体化、精神病性、人际关系敏感、强迫症状、焦虑、抑郁、偏执、恐怖、敌对及SCL-90总分明显低于常规组,差异均有统计学意义(P<0.05);治疗后,研究组患者的主观睡眠质量、睡眠潜伏期、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍、夜间功能障碍维度评分及PSQI总分分别为(0.95±0.10)分、(0.83±0.14)分、(0.76±0.23)分、(0.85±0.19)分、(0.93±0.20)分、(0.65±0.11)分、(0.72±0.14)分、(5.69±1.13)分,明显低于常规组(1.10±0.11)分、(0.96±0.17)分、(1.04±0.26)分、(1.06±0.22)分、(1.12±0.25)分、(0.81±0.13)分、(0.93±0.18)分、(7.02±1.25)分,差异均有统计学意义(P<0.05)。结论整合心理行为治疗配合放化疗应用于乳腺癌术后患者能减少治疗期间脱落病例,改善患者整体心身状况Objective To explore the effect of integrated psychobehavioral therapy combined with radiotherapy and chemotherapy on the overall psychosomatic changes and sleep quality of patients with breast cancer after surgery.Methods A total of 289 cases of postoperative breast cancer patients admitted to the First Affiliated Hospital of Henan University of Science and Technology from January 2019 to January 2023 were selected and divided into the study group of 145 cases and the conventional group of 144 cases according to the random number table.Both groups of patients were given 4-8 cycles of chemotherapy,each lasting 3 weeks(21 days),followed by radiation therapy.During this period,patients in the conventional group received routine psychological therapy,while patients in the study group received integrated psychobehavioral therapy on the basis of the conventional group.No psychotherapy is performed during targeted maintenance and endocrine therapy.The overall psychosomatic changes,SCL-90 scores,and sleep quality[Pittsburgh Sleep Quality Index(PSQI)]were compared between the two groups of patients before and after treatment.Results The dropout rate of patients in the study group during treatment was 2.76%(4/145),which was significantly lower than 14.58%(21/144)of the conventional group(P<0.05).After treatment,the stress index and fatigue index of patients in the study group were(45.20±5.24)points and(78.52±4.39)points,respectively,which were significantly lower than(52.61±6.08)points and(83.44±4.58)points of the conventional group;the relaxation index and stability index were(67.82±3.92)points and(88.54±3.16)points,respectively,which were significantly higher than(63.10±4.75)points and(85.17±3.04)points of the conventional group;the differences were statistically significant(P<0.05).After treatment,the somatization,psychosis,interpersonal sensitivity,obsessive-compulsive symptoms,anxiety,depression,paranoia,phobia,hostility,and SCL-90 total scores in the study group were significantly lower than those in the con

关 键 词：乳腺癌 整合心理行为治疗 放化疗 整体心身变化 睡眠质量 

分 类 号：R737.9[医药卫生—肿瘤]