正念联合自我洞察疗法对头颈部肿瘤老年放疗患者癌症宿命及希望水平的影响

Effects of mindfulness combined with self-insight therapy on cancer fate and hope levels in elderly radiotherapy patients with head and neck tumors

目的探讨正念联合自我洞察疗法对头颈部肿瘤老年放疗患者癌症宿命及希望水平的影响。方法选取116例在南阳市某三甲医院接受放射性治疗的老年头颈部肿瘤患者,采用随机数字表法将其分为对照组与观察组,每组58例,对照组实施放疗常规干预,观察组在常规干预基础上实施正念联合自我洞察疗法,干预3个月,分别在干预前后应用癌症宿命论量表(FSC)与希望水平量表(HHI)评价并比较两组患者干预前后癌症宿命及希望水平。结果干预前,2组患者FSC与HHI总分及各维度得分比较,差异均无统计学意义(t_(FSC总分)=0.006,P_(FSC总分)=0.995;t_(HHI总分)=0.082,P_(HHI总分)=0.935),干预后,观察组患者FSC总分及先定、运气、悲观各维度得分均明显低于对照组,差异有统计学意义(t_(FSC总分)=9.351,P_(FSC总分)<0.001;t_(先定)=5.475,P_(先定)<0.001;t_(运气)=4.331,P_(运气)<0.001;t_(悲观)=6.883,P_(悲观)<0.001);观察组患者HHI总分及亲密关系、积极行为、行为态度各维度得分明显高于对照组,差异有统计学意义(t_(HHI总分)=7.519,P_(HHI总分)<0.001;t_(亲密关系)=6.012,P_(亲密关系)<0.001;t_(积极行为)=6.114,P_(积极行为)<0.001;t_(行为态度)=3.684,P_(行为态度)<0.001)。结论正念联合自我洞察疗法干预可有效降低老年头颈部肿瘤放疗患者癌症宿命水平,提升其希望水平。

Objective To investigate the effect of mindfulness combined with self-insight therapy on cancer fate and hope level in elderly patients with head and neck tumors undergoing radiotherapy.Methods A total of 116 elderly patients with head and neck tumors who received radiation therapy in a tertiary hospital in Nanyang City were selected and divided into a control group and an observation group by random number table method,with 58 cases in each group.The control group received routine radiotherapy intervention,and the observation group implemented mindfulness combined with self-insight therapy on the basis of the conventional intervention for 3 months.The cancer fatalism scale(FSC)and herth hope inder(HHI)were used before and after the intervention to evaluate and compare the cancer fate and hope levels before and after the intervention.Results Before the intervention,there was no significant difference between the total scores of FSC and HHI and the scores of each dimension between the two groups(t_(FSC total score)=0.006,P_(FSC total score)=0.995;t_(HHI total score)=0.082,Total score of P_(HHI)=0.935).After the intervention,the total score of the FSC and the scores of predetermined,luck,and pessimism of the observation group patients were significantly lower than those of the control group patients,and the dif-ferences were statistically significant(t_(FSC score)=9.351,P_(FSC score)<0.001,t_(Predetermined)=5.475,P_(Predetermined)<0.001,t_(luck)=4.331,P_(luck)<0.001,t_(gloomy)=6.883,P_(gloomy)<0.001).The total score on the HHIe and the scores of the intimacy,positive behavior,and behavioral attitude in the observation group were significantly higher than those in the control group,and the differences were statistically significant(t_(HHI total score)=7.519,P_(HHI total score)<0.001;t_(intimacy)=6.012,P_(intimate relationship)<0.001;t_(positive behavior)=6.114,P_(positive behavior)<0.001;t_(behavior attitude)=3.684,P_(behavior attitude)<0.001).Conclusion The intervention of mindfulness combined with self-insight therapy can effectively reduce the level of cancer fate and improve the level of hope in elderly patients with head and neck cancer radiotherapy.