造血干细胞移植患者心理状况分析与护理对策

Analysis and nursing strategies of the psycholgical status of patients with hemopoietic stem cell transplantation

目的回顾性分析造血干细胞移植患者在层流病房的抑郁、焦虑等心理状况与心理护理的经验。方法对53例人住层流病房进行移植的患者于人住时、预处理后和出层流病房时分别应用自评抑郁量表（SDS）和焦虑自评量表（SAS）了解患者心理状况并对进行心理护理。结果53例患者入层流病房时SDS及SAS评分分别为（0．406±0．063）和（33．570±6．741）分，预处理后分别为（0．512±0．125）和（42．700±9．716）分，差异均有统计学意义（P〈0．01）。经针对性护理措施后，出层流病房时SDS及SAS评分分别为（0．439±0．094）和（34．47±6．764）分，明显低于预处理后（P〈0．01）。结论实施个体化的有效心理疏导和健康教育有助于改善移植患者在层流病房内抑郁、焦虑等不良心理状况，是移植成功的重要保障；有效沟通及医患互动是让患者保持积极心态、促进康复的重要手段。

Objective To analyze psychologic status including the degree of depression and anxiety of hematopoietic stem cell transplantation （HSCT） recipients in laminar air flow room （LAFR） and the associated nursing care experiences. Methods Self-rating depression scale （SDS） and self-rating anxiety scale （SAS） of 53 were used to investigate the recipients with respect to the degree of depression and anxiety at the first day when they went in the LAFR, after the conditioning regimen and they left the LAFR. Psychologic status of the recipients after the specific nursing care and psychologic support was analyzed retrospectively. Results The average scores by SDS and SAS of 53 recipients at the first day when they were admitted in the LAFR were （0.406 ±0.063 ） and （33. 570 ± 6. 741 ） respectively. The average scores of the recipients by SDS and SAS after the conditioning regimen were （0. 512 ± 0. 125 ） and （42. 700 ±9. 716） respectively, which were significantly higher than the scores at the first day in the LAFR （ P = 0. 000 , 0. 000 ） . After a series of specific nursing care and psychologic support, the average scores by SDS and SAS when the recipients left the LAFR were （0.439 ± 0. 094） and （34.47 ± 6. 764 ） respectively, which were significantly lower than those after the conditioning regimen （P =0.000,0. 000）. There was no statistical significance between the scores by SDS and SAS in recipients when they were admitted and left the LAFR （ P = 0. 085,0. 554 ）. Conclusions Effective nursing care and psychologic support have a positive impact on improving the psychologic status of HSCT recipients in the LAFR and promoting rehabilitation after HSCT.