心理干预对肺癌化疗患者焦虑抑郁及生存质量的影响

Effects of psychological intervention on anxiety,depression and quality of life in lung cancer patients undergoing chemotherapy

目的探讨综合心理干预对肺癌化疗患者焦虑、抑郁及生存质量的影响。方法将72例肺癌化疗患者随机分为对照组(35例)和心理干预组(37例)。一组采用常规化疗方案,另一组在常规化疗的基础上加用综合心理干预(采用症状自评量表评定患者精神症状)。治疗前后采用抑郁自评量表(SAS)、焦虑自评量表(SDS)和中国癌症化疗生活质量(QLQ-CCC)进行检测。组间采用t检验。结果①肺癌患者症状自评量表各因子评分干预前后比较,躯体化、强迫症状、人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神病性评分降低(P<0.01)。心理干预组第8周SDS及SAS评分均明显低于对照组(P<0.01)。②化疗生存质量评分结果显示,干预组患者的生理功能障碍、心理功能障碍、日常活动影响、社会功能障碍等4方面的评分低于对照组,治疗满意度评分高于对照组。结论肺癌患者存在明显的心理障碍,综合心理治疗可显著减低肺癌化疗患者焦虑、抑郁程度及提高患者的生存质量。

Objective To study the effects of psychological intervention on anxiety,depression and survival quality in lung cancer patients undergoing chemotherapy.Methods Seventy-two cases of lung cancer patients undergoing chemotherapy were randomly divided into control group（35 cases） and psychological intervention group（37 cases）.The control group was treated with conventional chemotherapy,the intervention group was treated with conventional chemotherapy plus an integrated psychological intervention（A symptom checklist assessment for patients with psychological symptoms）.SAS,SDS,and QLQ-CCC were used for statistical works before and after treatment and t test was used for difference between the two groups.Results ①Lung cancer symptoms self-rating scale score of all factors： somatization,obsessive-compulsive symptoms,interpersonal relationships,depression,anxiety,hostility,terror,paranoia,psychotic score lowered after intervention（P〈0.01）.SDS and SAS scores of psychological intervention group in the first 8 weeks were significantly lower than those of the control group（P〈0.01）.②Quality of life score results showed that four aspects of social dysfunction scores in the intervention group such as social dysfunction,physical dysfunction,psychosocial dysfunction and daily activity were lower than those of the control group,but treatment satisfaction score was higher.Conclusion Lung cancer patients had significant psychological barrier and integrated psychological therapy can significantly reduce anxiety and depression in patients with lung cancer hundergoing chemotherapy,depression and improve patient′s quality of life.