治疗性沟通系统对胃癌患者围手术期应对方式及心境状态的干预效果研究

Intervention of therapeutic communication system on the coping style and mood state for peri-operative gastric cancer patients

目的探讨治疗性沟通系统对胃癌患者围手术期应对方式及心境状态的影响。方法采用方便取样法,将127例拟行手术治疗的胃癌患者随机分为两组。对照组予以常规护理(63例),干预组采用治疗性沟通系统干预模式(64例)。于入院第一天及出院前一天测评患者应对方式及心境状态的变化。结果干预前,干预组与对照组一般资料、应对方式及心境状态间差异无显著意义(P>0.05)。干预后,应对方式组内比较中,干预组面对维度有所提高,回避-压抑、屈服、幻想及发泄方面的分值有所下降,差异有显著意义(P<0.01);对照组回避-压抑分值有所下降(P<0.05);组间比较结果显示,除发泄维度外(P=0.353),其余维度差异均有显著意义(P<0.05)。负性心境状态组内比较中,干预组紧张-焦虑、愤怒-敌意、迷乱-混沌、抑郁-沮丧及心境总分较干预前有所改善,差异有显著意义(P<0.05),对照组负性心境总分有所下降,差异有显著意义(P<0.01)。组间比较中,两组患者除疲乏-迟钝、精力-活力维度外,其余维度差异有显著意义(P<0.05)。结论治疗性沟通系统可以优化胃癌患者围手术期应对方式,改善其负性心境状态。

Objective To study the intervention effect of therapeutic communication system on the coping style and mood state for peri-operative gastric cancer patients. Method 127 gastric cancer patients selected by convenient method were randomly divided into 2 groups.The control group received the routine clinical care（63 patients）.The intervention group received therapeutic communication the day of admission and the day before discharge respectively. Result Before the intervention,there was no significant difference（P0.05） between the 2 groups on general information,coping style and mood state.After the intervention,as to the coping style,there were significant meliorations on confrontation,avoidance and suppression,resignation,fantasy and catharses in the intervention group（P0.01）,while only avoidance and suppression was lower than before in the control group（P0.05）.Moreover,the significant differences had come to light between two groups on CCMQ（P0.05） except catharses（P=0.353）.There were significant difference on tension-anxiety,depression-dejection）,anger-hostility,confusion-bewilderment and total mood score（P0.05） in intervention group,the total mood score were lower than before in the control group（P0.01）.Moreover,the significant differences had come to light between the two groups on POMS-SF（P0.05） except fatigue-inertia and tension-anxiety after the intervention. Conclusion Therapeutic communication system is feasible to optimize the coping style and improve the mood state of perioperative gastric cancer patients.