宫颈癌患者自杀风险短程认知行为干预方案的构建与初步验证  

Development and preliminary validation of a brief cognitive behaviour intervention program for suicide prevention in cervical cancer patients

作　　者：丁小萍 饶贞丽 张垠莹 何春燕 李岚[1] 胡德英[2] Ding Xiaoping;Rao Zhenli;Zhang Yinying;He Chunyan;Li Lan;Hu Deying(Department of Nursing,Wuhan Mental Health Center,Wuhan 430012,China)

机构地区：[1]武汉市精神卫生中心护理部,湖北武汉430012 [2]华中科技大学同济医学院附属协和医院肿瘤中心 [3]南华大学护理学院 [4]华中科技大学同济医学院护理学院

出　　处：《护理学杂志》2025年第2期70-74,共5页Journal of Nursing Science

基　　金：国家自然科学基金青年项目(72404095)。

摘　　要：目的构建宫颈癌患者自杀风险短程认知行为干预方案并进行初步验证,为癌症患者自杀预防和管理提供参考。方法以吉利汉博士开发的7周认知行为疗法为理论框架,结合证据总结和专家会议,构建宫颈癌患者自杀风险短程认知行为干预方案。采用非随机同期对照设计,将2023年5-6月在某三甲医院妇科肿瘤科就诊的26例宫颈癌患者按病区分为干预组和对照组各13例。对照组给予常规护理,干预组在常规护理基础上接受短程认知行为干预,包括设定目标并计划行动、建立新的思维模式、恢复生机、提升生活质量、直面癌症复发恐惧、制订安全计划以及融会贯通7个单元,总干预时长不超过7 h。收集干预前、干预后即刻、干预后1个月两组的自杀意念、抑郁、消化系统不良反应、泌尿系统不良反应及生活质量。结果干预组留存率为100%,接受度为100%,家庭作业依从率为30.77%~100%。干预后干预组自杀意念、抑郁、消化系统不良反应得分显著低于干预前及对照组,而生活质量得分显著高于干预前及对照组(均P<0.05)。结论宫颈癌患者自杀风险短程认知行为干预方案具有可行性,接受度好。应用该方案能有效降低宫颈癌患者自杀风险,提高生活质量,为临床心理护理实践提供参考。Objective To develop and preliminarily validate a brief cognitive behaviour intervention program for suicide prevention tailored to cervical cancer patients,so as to provide references for prevention and management of suicide in cancer patients.Methods A brief cognitive behaviour intervention program for suicide prevention in cervical cancer patients was developed based on Dr.Gillihan′s 7-week cognitive behaviour therapy,supplemented by a summary of evidence and expert meeting.A non-randomized controlled design was used.A total of 26 cervical cancer patients from the gynecological oncology department of a tertiary hospital from May to June 2023 were assigned to an intervention group(n=13)or a control group(n=13)based on ward allocation.The control group received routine nursing care along with general psychological interventions,while the intervention group additionally received the brief cognitive behaviour intervention program,which included setting goals and planning actions,establishing new thinking patterns,regaining vitality,improving quality of life,facing the fear of recurrence,making a safety plan,and integrating all elements into daily life,with a total duration of less than 7 hours.Data on suicidal ideation,depression,gastrointestinal system adverse reactions,urinary system adverse reactions,and quality of life were collected at three time points:pre-intervention,post-intervention,and 1 month after the intervention.Results In the intervention group,the retention rate was 100%,acceptability was 100%,adherence to assigned homework ranged from 30.77%to 100%.After the intervention,in the intervention group,the scores of suicidal ideation,depression,adverse digestive system reactions were significantly lower than those before the intervention and in the control group,while its scores of quality of life were significantly higher than those before the intervention and in the control group(all P<0.05).Conclusion The brief cognitive behaviour intervention program for suicide prevention in cervical cancer pati

关 键 词：宫颈癌 自杀预防 短程认知行为疗法 自杀意念 抑郁 不良反应 生活质量 心理护理 

分 类 号：R473.73[医药卫生—护理学]