“一核多元”安宁疗护模式对肺癌晚期患者癌因性疲乏、希望水平及抑郁情绪的影响  

Effects of one-core-multiple hospice care on cancer-induced fatigue, hope level,and depression in advanced patients with lung cancer

作　　者：杜晓霞[1] 孙媛媛 鲁德玕[2] 赵新月 徐焕毓 苏淑芬[1] DU Xiaoxia;SUN Yuanyuan;LU Degan;ZHAO Xinyue;XU Huanyu;SU Shufen(Department of Nursing,the First Affiliated Hospital of Shandong First Medical University(Shandong Qianfoshan Hospital),Jinan,Shandong 250014,China;不详)

机构地区：[1]山东省第一医科大学第一附属医院(山东省千佛山医院)护理部,山东济南250014 [2]山东省第一医科大学第一附属医院(山东省千佛山医院)保健呼吸内科

出　　处：《中华全科医学》2025年第2期335-339,共5页Chinese Journal of General Practice

基　　金：山东省自然科学基金项目(ZR2021MH379)。

摘　　要：目的 在肺癌晚期患者中应用“一核多元”安宁疗护模式,探究患者癌因性疲乏、希望水平及抑郁情绪的变化。方法 选取2021年9月—2023年9月山东省第一医科大学第一附属医院收治的60例晚期肺癌患者,采用随机数表法均分为观察组(“一核多元”安宁疗护)及对照组(常规安宁疗护),各30例。比较2组干预前及干预6周后癌因性疲乏[癌症疲乏量表(CFS)]、希望水平[Herth希望量表(HHI)]、焦虑抑郁情绪[汉密尔顿抑郁量表评分(HAMD),汉密尔顿焦虑量表评分(HAMA)]、生命意义[生命意义量表(MiLS)]、生活质量[国际肿瘤患者生命质量测定表(QOL-C30)]。结果 2组干预6周后CFS、HAMD、HAMA均低于干预前,观察组MiLS高于干预前(P<0.01),干预6周后观察组CFS低于对照组,MiLS高于对照组,调整干预前各指标水平后,2组比较差异有统计学意义(P<0.01);干预6周后,观察组希望水平中高水平比例为66.67%(20/30),对照组为36.67%(11/30),观察组生命意义中高水平比例为53.33%(16/30),对照组为26.67%(8/30),观察组希望水平、生命意义中高水平比例均高于对照组(Z=2.237、4.444,P=0.025、0.035)。结论 “一核多元”安宁疗护用于肺癌晚期患者能够降低患者癌因性疲乏及焦虑抑郁情绪水平,提升希望水平、生命意义及生活质量水平。Objective To investigate the effects of one-core-multiple hospice care on cancer-induced fatigue,hope level,and depression in patients with advanced lung cancer.Methods From September 2021 to September 2023,60 patients with advanced lung cancer were enrolled at the First Affiliated Hospital of Shandong First Medical University.They were randomly assigned to the observation group(n=30,receiving one-core-multiple hospice care)and the control group(n=30,receiving routine care).Cancer-induced fatigue(cancer fatigue scale,CFS),hope level(Herth hope inventory,HHI),anxiety and depression(Hamilton depression scale score,HAMD;Hamilton anxiety scale score,HAMA),meaning of life(meaning of life scale,MiLS),and quality of life(international quality of life for cancer patients,QOL-C30)were compared between the two groups before and 6 weeks after intervention.Results After 6 weeks of intervention,both groups showed reduced CFS,HAMD,and HAMA scores.The observation group had a significant increase in MiLS scores after intervention than before(P<0.01).CFS in the observation group was lower than that in the control group,while MiLS was higher after 6 weeks of intervention,after adjustment for baseline values(P<0.01).After 6 weeks of intervention,the medium to high level proportion of hope and life meaning in the observation group was 66.67%(20/30)and 53.33%(16/30),respectively.In contrast,the control group had 36.67%(11/30)for hope and 26.67%(8/30)for life meaning.The medium to high level proportion of hope and life meaning in the observation group were higher than those in the group(Z=2.237,4.444,P=0.025,0.035).Conclusion One-core-multiple hospice care for advanced lung cancer patients can reduce the level of cancer-related fatigue,anxiety and depression,while improving the level of hope,life meaning,and life quality.

关 键 词：肺癌 晚期 一核多元 安宁疗护 癌因性疲乏 希望水平 抑郁 

分 类 号：R734.2[医药卫生—肿瘤] R473.73[医药卫生—临床医学]