认知图式教育对中重度癌痛患者疼痛程度和生活质量的影响  

Effects of cognitive schema education on pain degree and quality of life in patients with moderate to severe cancer pain

作　　者：韦程敏 徐炜[1] 杜梦迪 WEI Chengmin;XU Wei;DU Mengdi(Department of Integrated Traditional Chinese and Western Medicine Oncology,Hangzhou Cancer Hospital,Hangzhou 311100,Zhejiang,China;Department of Oncology,Linping Campus,the Second Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 311100,Zhejiang,China)

机构地区：[1]杭州市肿瘤医院中西医结合肿瘤科,浙江杭州311100 [2]浙江大学医学院附属第二医院临平院区肿瘤科,浙江杭州311100

出　　处：《护士进修杂志》2025年第5期503-507,515,共6页Journal of Nurses Training

基　　金：浙江省中医药科技计划项目(编号:81670567)。

摘　　要：目的探讨认知图式教育对中重度癌因性疼痛(癌痛)患者疼痛程度和生活质量的影响。方法采用便利抽样法选取某医院在2023年1—6月收治住院的中重度癌痛的患者为对照组(予以常规健康教育联合多模式镇痛干预),选取2023年7—12月收治住院的中重度癌痛的患者为观察组(予以认知图式教育联合多模式镇痛干预),每组各43例。观察2组患者疼痛认知、疼痛控制结局、生活质量方面的差异。结果干预后,观察组恶性肿瘤患者疼痛认知量表(cancer pain inventory,CPI)(中文版)各维度评分均低于对照组(P<0.05);美国疼痛协会患者结局问卷修订版(American Pain Society patient outcome questionnaire modified,APS-POQ-Modified)中疼痛程度、疼痛的影响均低于对照组,疼痛信念优于对照组,对疼痛治疗结果、对护士处理方法的满意度高于对照组(P<0.05);观察组癌症患者生命质量量表各维度评分均高于对照组(P<0.05)。结论认知图式宣教方式有利于中重度癌痛患者疼痛认知程度的提高,可帮助患者转变应对方式,提高疼痛信念,进一步降低对疼痛的反应,提升生活质量。Objective To explore the effects of cognitive schema education on pain degree and quality of life in patients with moderate to severe cancer pain.Methods By convenient sampling method,cancer patients with moderate to severe cancer pain admitted to a hospital from January to June 2023 were selected as the control group(given routine health education combined with multi-modal analgesia),and cancer patients with moderate to severe cancer pain admitted from July to December 2023 were selected as the observation group(given cognitive schema education combined with multi-modal analgesia),with 43 cases in each group.The differences of pain cognition,pain control outcomes,and quality of life between 2 groups were observed.Results After intervention,scores of Chinese pain inventory in observation group were lower than those in control group(P<0.05);After intervention,pain degree and effect in American Pain Society patient outcomes questionnaire-modified(APS-POQ-Modified)in observation group were lower than those in control group,and pain belief in APS-POQ-Modified in observation group was better than that in control group,and satisfaction with pain treatment outcomes and nurses'treatment methods in observation group was higher than those in control group(P<0.05).The each dimension scores of functional assessment of cancer therapy-G in observation group were higher than those in control group(P<0.05).Conclusion Cognitive schema education is beneficial to improve pain cognition in patients with moderate to severe cancer pain,help patients change their coping styles,enhance their pain beliefs,further relieve their reaction to pain and improve the quality of life.

关 键 词：认知图式 健康教育 中重度癌痛 疼痛认知 生活质量 护理 

分 类 号：R473.73[医药卫生—护理学]