胃癌化疗患者心理护理方法研究

Study of psychological nursing measures for gastric tumor patients with chemotherapy

目的对胃癌化疗患者实施认知一行为疗法、健康教育和音乐疗法相结合心理护理，探讨此方法对减轻患者焦虑、抑郁情绪及改善生活质量是否有效。方法收集胃癌化疗患者（化疗次数进行第2次及以上者）45例，对所惠疾病已知情。实验组与对照组一般情况无明显差异。实验组患者在化疗期间实施心理护理，对照组进行常规护理。2组患者分别于第1天和第21天进行量表评分。比较2组患者焦虑、抑郁及生活质量是否有差别。结果心理护理之后实验组患者焦虑、抑郁评分低于对照组患者焦虑、抑郁评分（P〈0.05）。生活质量中部分功能（躯体功能、角色功能、情绪功能、疲乏、恶心呕吐、失眠）得到改善（P〈0.05）。结论本研究中采用的心理护理方法，可使患者焦虑、抑郁得到缓解，躯体功能、角色功能、情绪功能明显增强，疲乏、恶心呕吐、失眠症状缓解，说明此方法是可行、有效的。

Objective To practice the psychological nursing of cognitive behavior therapy, health education in combination with music therapy for gastric cancer patients with chemotherapy, and to investigate the effect of such psychological nursing to reduce the anxiety and depression, and improve the life quality of these patients. Methods 45 gastric cancer patients with chemotherapy were divided into two groups of the control group and the treatment group. All the patients had received two or more times of chemotherapy, and had known their illness. There was no significant difference in the general data between the two groups, such as KPS point, age, gender, and educational degree. The treatment group accepted the procedure of psychological nursing while they were receiving the chemotherapy. The control group received the routine nursing care. Patients of the two groups were scored on the first day and the 21st day, and compared whether there were differences in anxiety, depression and quality of life by t--test. Results After the psychological nursing, the scores of anxiety and depression of the treatment group were lower than those of the control group （P〈0.05）, and parts of the functions in quality of life were improved （P〈0.05）, such as somatic function, role function, emotional function, fatigue, nausea and vomit, insomnia. Conclusions The psychological nursing, which was used to care for the gastric cancer patients with chemotherapy in this study, can reduce patients＇ anxiety and depression, improve their somatic function, role function, and emotional function significantly, and also can remit the symptoms of fatigue, nausea and vomit, insomnia. Thus, the psychological nursing measures are feasible and effective.