心理弹性对乳腺癌化疗患者疲劳状况、依从性和生活质量的影响

Effects of mental resilience on fatigue,compliance and quality of life in breast cancer chemotherapy patients

目的 探讨乳腺癌化疗患者心理弹性对其疲劳状况、服药依从性和生活质量的影响.方法 选取2014年6月~2015年12月该院肿瘤二科收治的乳腺癌术后化疗患者186例作为研究对象.随机分为对照组89例和实验组97例.对照组仅接受常规内分泌治疗,实验组则在常规内分泌治疗基础上进行为期4周的心理弹性训练.采用Conner-Davidson心理弹性量表( Conner-Davidson Resilience Scale,CD-RISC) 、Piper疲劳修订量表( The Revised Piper Fatigue Scale,PFS-R) 、依从性量表和乳腺癌患者生活质量测定量表( Functional Assessment of Cancer Therapy-Breast,FACT-B) 对两组患者进行调查评估.结果 治疗6个月后实验组乳腺癌患者心理弹性CD-RISC量表、PFS-R量表的各维度得分和总分均高于治疗前和对照组,差异有统计学意义(均P<0.05).治疗1个月和3个月时,两组乳腺癌患者MPR值比较,差异无统计学意义( P>0.05) ;治疗6个月时,实验组乳腺癌患者MPR值高于对照组,差异有统计学意义( P<0.05) .生活质量方面,治疗前两组乳腺癌患者FACT-B量表各维度得分和总分比较,差异均无统计学意义(均P>0.05) ;治疗6个月后,除社会/家庭状况和附加关注这两个维度外,实验组患者FACT-B其余维度得分和总分均高于治疗前,差异有统计学意义(均P<0.05) ;治疗6个月后,实验组患者FACT-B量表中生理状况、情感状况得分和总分均高于对照组,差异有统计学意义(均P<0.05) .结论 增强乳腺癌化疗患者心理弹性,能有效改善疲劳状况,提高患者的服药依从性和生活质量.

Objective To investigate the effects of mental resilience on fatigue, medication compliance and quality of life in breast cancer patients undergoing chemotherapy. Methods A total of 186 cases of postoperative chem-otherapy for breast cancer patients admitted by the second department of tumor in the hospital from June 2014 to Decem-ber 2015 were selected as the study objects. There were 89 cases in the control group and 97 cases in the experimental group. The control group received only conventional endocrine therapy, while the experimental group received four weeks of mental resilience training on the basis of conventional endocrine therapy. Conner-davidson Resilience Scale ( CD-RISC) , The Revised Piper Fatigue Scale ( PFS-R) , compliance scale and Functional Assessment of Cancer Ther-apy-Breast ( FACT-B) were adopted to investigate and evaluate the two groups of patients. Results After 6 months of treatment, the dimensions and total scores of the CD-RISC scale and the PFS-R scale of breast cancer patients in the ex-perimental group were higher than those in the control group and the pre-treatment group, and the differences were sta-tistically significant ( P<0.05) . At 1 and 3 months of treatment, the MPR value of breast cancer patients in the two groups was compared, and the difference was not statistically significant ( P>0.05) . At 6 months of treatment, the MPR value of breast cancer patients in the experimental group was higher than that in the control group, and the differ-ence was statistically significant (P<0.05). In terms of quality of life, the scores and total scores of FACT-B scale of breast cancer patients in the two groups before treatment were not statistically significant ( P>0.05) . After 6 months of treatment, the scores and total scores of the other dimensions of FACT-B in the experimental group were higher than those before treatment, except for the two dimensions of social/family status and additional attention. The differences were statistically significant (P<0.05). After 6 months of treatment, the physiological status, emotional status and to-tal score of the experimental group were higher than those of the control group, and the differences were statistically sig-nificant ( P<0.05) . Conclusions Enhancing the mental resilience of breast cancer chemotherapy patients can effec-tively improve the fatigue condition, improve the patient's medication compliance and quality of life.