骨肿瘤患者姑息心理护理的方法及效果

Methods and effect of psychological palliative nursing in patients with bone tumors

目的探讨骨肿瘤患者姑息心理护理的方法及效果，以改善骨肿瘤患者住院化疗期间的焦虑、抑郁、悲观等负性情绪，提高患者的生存质量，从而达到提高治疗效果的目的。方法根据姑息护理的理论，对2009年2月至2010年2月在我科住院接受化疗，符合研究入选标准的39名骨肿瘤患者进行心理护理。并应用简明心境量表及生活质量核心问卷对患者治疗前、中、后分别进行测评。并应用统计学方法对结果进行分析。结果在研究对象组内动态比较中，POMS量表治疗中各分量表得分均有不同程度上升，与治疗后得分比较差异具有统计学意义（P〈0．01），与治疗前比较，只有迷惑得分比较差异无统计学意义（P〉0．05）。迷惑、抑郁、愤怒、精力、疲乏和总分在治疗后与治疗前的比较差异具有统计学意义（P〈0．01或P〈0．05）。QLQ—C30量表各分量表得分治疗后与治疗中比较，所有指标得分差异均有统计学意义（P〈0．01）；治疗后与治疗前比较，躯体、情绪、总体状况和疼痛得分差异具有统计学意义（P〈0．0I），其余角色、社会、认知等得分差异无统计学意义（P〉0．05）；治疗前与治疗中比较，除情绪和总体状况得分差异无统计学意义（P〉0．05）外，其余分量表得分差异均具有统计学意义（P〈0．01）。结论应用姑息理论，对骨肿瘤患者进行科学的心理护理及辅导，可以有效地改善患者的不良情绪，从而提高患者的生存质量。

Objective To decrease anxiety, depression, pessimism and other negative emotions in bone cancer patients during chemotherapy, to enhance the quality of life of patients and to achieve the objective of improving treatment. Methods According to theory of palliative care, from February 2009 to February 2010, 39 patients with bone tumors admitted for chemotherapy in our department met the inclusion criteria and were enrolled for psychological care. The POMS scale and quality of life core questionnaire were used in the patients before, during, and after the treatment. The results were analyzed. Results In the dynamic comparison, treatment of the subscale scores of POMS increased in varying degrees, with significant difference compared with the scores after treatment（ P 〈 0. 01 ）. Significant differences were found in energy, depression, confusion, and total score after treatment in comparison with the pre-treatment but （ P 〈 0. 01 or P 〈 0. 05 ） not found in the remaining indicators （ P 〉 0. 05 ）. All the scores of QLQ-C30 showed significant differences after treatment compared with during the treatment （P 〈 0. 01 ）. While comparing before and after the treatment, there were significant differences in terms of physical, emotional and overall condition scores as well as pain scores （ P 〈 0. 01 ）, but not in other roles, social and cognition scores （ P 〉 0. 05 ）. There was no significant difference regarding emotional and overall condition scores （ P 〉 0. 05 ）, while other subscale scores showed significant differences（ P 〈 0. 01 ）. Conclusions Application of palliative theory with scientific psychological care and counseling in bone tumors patients can effectively decrease the negative emotions of patients and improve the quality of life of patients.