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中华肺部疾病杂志(电子版)

中华肺部疾病杂志(电子版) ›› 2017, Vol. 10 ›› Issue (01) : 50 -54. doi: 10.3877/cma.j.issn.1674-6902.2017.01.011

所属专题： 总编推荐； 文献；

论著

心智觉知干预模式对肺癌化疗患者生活质量和心理状况的影响
胥秀1, 冯丹1, 贾罄竹1, 王道晓1, 周俊1, 陈萍1,†()   
  1. 1. 400037　重庆，第三军医大学新桥医院肿瘤科　全军肿瘤研究所
  • 收稿日期:2016-10-23 出版日期:2017-02-25
  • 通信作者: 陈萍
  • 基金资助:
    国家自然科学基金资助项目(30800506)

Effects of mindfulness-based intervention model on the quality of life and psychological status of lung cancer patients during chemotherapy

Xiu Xu1, Dan Feng1, Qingzhu Jia1, Daoxiao Wang1, Jun Zhou1, Ping Chen1,†()   

  1. 1. Cancer Research Institute of XinQiao Hosptial, the Third Military Medical University, Chongqing 400037, China
  • Received:2016-10-23 Published:2017-02-25
  • Corresponding author: Ping Chen
  • About author:
    Corresponding author: Chen Ping, Email:
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引用本文：

胥秀, 冯丹, 贾罄竹, 王道晓, 周俊, 陈萍. 心智觉知干预模式对肺癌化疗患者生活质量和心理状况的影响[J/OL]. 中华肺部疾病杂志(电子版), 2017, 10(01): 50-54.

Xiu Xu, Dan Feng, Qingzhu Jia, Daoxiao Wang, Jun Zhou, Ping Chen. Effects of mindfulness-based intervention model on the quality of life and psychological status of lung cancer patients during chemotherapy[J/OL]. Chinese Journal of Lung Diseases(Electronic Edition), 2017, 10(01): 50-54.

目的

探讨心智觉知干预对肺癌化疗患者生活质量和心理状况的影响。

方法

将118例肺癌化疗患者随机分为观察组和对照组，对照组给予一般常规护理，观察组在常规护理基础上给予心智觉知干预。两组患者在干预前和干预8周后分别采用欧洲癌症研究与治疗组织的生存质量核心量表(EORTC QLQ-30)及焦虑(SAS)、抑郁(SDS)量表进行测评。

结果

干预前，两组患者生活质量比较差异无统计学意义。干预8周后，观察组总体健康评分为59.6±5.0，对照组为29.8±3.4。观察组在疲劳、疼痛、恶心呕吐这三个症状上的得分分别为43.2±2.7，26.2±4.3，30.5±5.6，对照组在三个症状上的得分分别为57.8±4.2，47.8±3.9，51.4±5.6，差异具有统计学意义。观察组生活质量优于对照组(P<0.05)。干预后，两组患者焦虑、抑郁得分均降低，负性情绪得到缓解。其中观察组SAS得分为38.64±5.02，对照组SAS得分为44.06±5.24。观察组SDS为41.26±5.2，对照组SDS为46.89±5.34。观察组心理状况优于对照组(P<0.05)。

结论

心智觉知干预能有效缓解患者不良情绪，提高肺癌化疗患者生活质量和心理状况。

关键词: 支气管肺癌, 化疗, 干预, 心智觉知, 生活质量
Objective

To explore the effects of mindfulness-based intervention model on the quality of life and psychological status of lung cancer patients during chemotherapy.

Methods

A total of 76 patients with lung cancer during chemotherapy were randomly divided into control group and observation group, the control group were given routine nursing. In addition, patients in observation group received mindfulness-based intervention. The EORTC QLQ-30 and SAS scales, SDS scales were used to evaluate the quality of life of the patients before and after the 8-week intervention.

Results

Before intervention, there was no significant difference in quality of life (QOL)between the two groups. After 8 weeks of intervention, the overall health score of observation group was 59.6±5.0, the control group was 59.6±5.0. In fatigue, pain, nausea and vomiting, the score of observation was 43.2±2.7, 26.2±4.3, 30.5±5.6, and the control group was 57.8±4.2, 47.8±3.9, 51.4±5.6, the difference was statistically significant, the QOL of the observation group was better than control group, P<0.05. Two groups of patients with anxiety, depression scores were reduced. The SAS score of observation group was 38.64±5.02, the control group was 44.06±5.24. And the SDS score of observation group was 41.26±5.2, the control group was 46.89±5.34, the psychologic status of observation group was better than the control group, P<0.05.

Conclusions

Mindfulness-based intervention can effectively improve the psychological status and quality of life of lung cancer patients during chemotherapy.

Key words: Bronchiogenic cancer, Chemotherapy, Intervention, Mindfulness level, Quality of life
表1 两组患者基线资料比较[n(%)]
临床资料 观察组 对照组 t/χ2值 P值
性别 ? ? ? ?
男 32(53.33) 34(58.62) 0.1544 0.6944
女 28(46.67) 24(41.38) ? ?
年龄(±s，岁) 58.95±6.46 59.41±5.76 0.1025 0.8977
肿瘤分期(例) ? ? ? ?
ⅡB 35(58.33) 32(55.17) 0.0258 0.8724
Ⅳ 25(41.67) 26(44.83) ? ?
病理分型 ? ? ? ?
小细胞肺癌 22(36.67) 20(34.48) 0.0031 0.9558
非小细胞肺癌 38(63.33) 38(65.52) ? ?
文化程度 ? ? (0) (1.000)
中上(大学/高中) 52(86.67) 50(86.21) ? ?
初等(小学/文盲) 8(13.33) 8(13.79) ? ?
肿瘤并发症 2 3 0.214 0.644
表2 两组肺癌化疗患者干预前后EORTC QLQ-30生活质量评分变化量比较
变量及分组 观察组(n＝60) 对照组(n＝58) t值 P值
干预前 干预后 差值1 干预前 干预后 差值2
总体健康 66.8±5.0 59.6±3.4 7.2±1.0 67.2±4.9 29.8±3.4 36.8±2.0 102.540 <0.01
功能 ? ? ? ? ? ? ? ?
? 躯体 68.8±2.8 59.3±3.5 10.8±1.8 67.6±2.6 30.2±2.7 34.2±2.46 59.111 <0.01
? 角色 64.8±3.2 58.6±2.4 12.2±1.4 63.8±2.8 23.6±1.8 40.2±1.8 94.503 <0.01
? 情绪 57.4±3.8 49.8±2.4 8.4±1.2 54.6±4.3 32.6±2.9 22.1±2.6 36.950 <0.01
? 认知 66.2±2.5 61.6±2.8 6.6±1.8 67.1±2.8 42.6±2.8 25.8±3.2 40.343 <0.01
? 社会 74.2±5.4 67.8±2.2 7.0±1.0 75.2±6.4 33.6±2.8 34.5±3.2 63.447 <0.01
症状 ? ? ? ? ? ? ? ?
? 疲劳 34.2±2.7 43.2±2.8 9.6±2.0 33.6±1.8 57.8±4.2 24.6±3.2 30.644 <0.01
? 疼痛 20.8±6.5 26.2±4.3 6.8±1.2 21.5±5.8 47.8±3.9 27.8±2.5 58.476 <0.01
? 恶心呕吐 20.8±4.2 30.5±5.6 9.0±1.4 21.2±3.2 51.4±5.6 31.2±3.6 44.423 <0.01
特异性 ? ? ? ? ? ? ? ?
? 气促 26.8±4.9 36.2±5.6 10.2±1.6 28.4±4.2 38.6±4.3 10.5±1.7 0.987 0.325
? 失眠 29.2±3.2 36.2±5.8 8.6±1.2 28.4±3.6 56.2±5.6 27.6±1.6 73.137 <0.01
? 食欲 30.2±2.6 48.6±5.2 8.0±1.5 31.2±3.2 59.5±5.2 29.6±2.8 52.475 <0.01
? 便秘 26.3±3.2 32.6±3.8 8.2±1.6 25.2±5.6 60.2±2.8 33.2±1.8 79.805 <0.01
? 腹泻 34.2±4.8 40.6±7.2 7.1±2.6 32.8±4.2 39.8±6.2 8.1±1.8 2.421 0.017
? 经济状况 51.4±3.5 56.8±6.8 6.4±0.8 50.6±3.9 60.6±6.8 10.2±3.5 8.193 <0.01
表3 两组患者干预前后SAS、SDS评分
组　别 例数 SAS SDS
观察组 60 ? ?
? 干预前 30 52.82±5.16 53.76±6.42
? 干预后 30 38.64±5.02ab 41.26±5.2ab
对照组 58 ? ?
? 干预前 30 53.11±5.26 53.84±6.56
? 干预后 28 44.06±5.24a 46.89±5.34a
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