压力与应激理论的心理干预对肺癌患者围术期心理状态、应激反应及认知水平的影响  

Effects of psychological intervention based on stress and stress theory on perioperative mental state,stress response and cognitive level of lung cancer patients

作　　者：杨金梅[1] YANG Jinmei(Bozhou City People's Hospital Thoracic Surgery,Bozhou 236831,China)

机构地区：[1]安徽省亳州市人民医院胸外科,236831

出　　处：《中国健康心理学杂志》2024年第11期1698-1702,共5页China Journal of Health Psychology

基　　金：安徽省自然科学基金(编号:2208085MH290)。

摘　　要：目的:探讨基于压力与应激理论的心理干预对肺癌患者围术期心理状态、应激反应及认知水平的影响。方法:结合入院先后顺序将2022年6月-2023年7月某院收治的82例肺癌患者分为对照组(n=41,常规干预)和观察组(n=41,常规干预+基于压力与应激理论的心理干预);从干预前、干预后两组患者心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、应激反应[促肾上腺皮质激素(ACTH)、皮质醇(Cor)、总甲状腺素(TT4)]、认知水平、希望水平[Herth希望量表(HHS)]和生活质量[生活质量调查表(QLQ-C30)]方面评估其干预效果。结果:与干预前比较,观察组干预后SAS评分和SDS评分均低于对照组(t=-4.288,-3.624;P<0.05)。术后3 d,两组ACTH、Cor、TT4均升高(P<0.05),且对照组高于观察组(t=-5.659,-2.125,-3.568;P<0.05)。干预后,观察组认知水平知识、信念、行为维度评分,HHI各维度评分及QLQ-C30中躯体、角色、情绪、社会、认知等5大功能评分均升高(P<0.05),且观察组均高于对照组(t=4.528,2.913,5.533,5.600,9.056,3.768,2.959,2.470,2.378,2.027,2.649;P<0.05)。结论:对肺癌患者围术期采用基于压力与应激理论的心理干预效果显著,可减轻焦虑、抑郁情绪,缓解应激反应,还可提高认知水平、希望水平,提升生活质量。Objective:To explore the effects of psychological intervention based on stress and stress theory on perioperative mental state,stress response and cognitive level of lung cancer patients.Methods:According to the order of admission,82 patients with lung cancer admitted to our hospital from June 2022 to July 2023 were divided into control group(n=41,conventional intervention)and observation group(n=41,conventional intervention+psychological intervention based on stress and stress theory).Psychological state[Self-rating Anxiety Scale(SAS),self-rating Depression Scale(SDS)],stress response[ACTH),cortisol(Cor),total thyroxine(TT4)],cognitive level,hope level[Herth Hope Scale(HHS)]and quality of life[quality of life survey]of patients in both groups before and after intervention Table(QLQ-C30)]to evaluate the effect of the intervention.Results:Compared with before intervention,SAS scores and SDS scores in the observation group were lower than those in the control group(t=-4.288,-3.624;P<0.05).3 days after surgery,ACTH,Cor and TT4 in both groups were increased(P<0.05),and the control group was higher than the observation group(t=-5.659,-2.125,-3.568;P<0.05).After the intervention,the cognitive scores of the observation group were increased in knowledge,belief,behavior dimension,hope level,keeping close relationship with others,taking positive actions,positive attitude towards reality and future dimension,and the 5 functional scores of QLQ-C30,such as body,role,emotion,society and cognition(P<0.05).The observation group was higher than the control group(t=4.528,2.913,5.533,5.600,9.056,3.768,2.959,2.470,2.378,2.027,2.649;P<0.05).Conclusion:Psychological intervention based on stress and stress theory is effective in patients with lung cancer during perioperative period,which can reduce anxiety and depression,relieve stress response,improve cognition level,hope level and improve life quality.

关 键 词：压力与应激理论 肺癌 心理状态 应激反应 认知水平 

分 类 号：R395.5[哲学宗教—心理学] R749.92[医药卫生—医学心理学]