护理干预对鼻咽癌患者首次化疗焦虑情绪的影响

Effects of nursing intervention on anxiety of nasopharyngeal carcinoma patients in their first chemotherapy

目的探讨护理干预对鼻咽癌患者首次化疗焦虑情绪的影响。方法选择行首次化疗的鼻咽癌患者80例，按随机数字表法分为对照组和干预组各40例，对照组按常规护理，干预组运用具有针对性的放松训练、认知干预、家庭支持和睡眠护理等综合干预进行护理。采用焦虑自评量表（SAS）和医院睡眠问卷（SMH）测评患者入院第1天、化疗前1d和化疗结束当天的焦虑和睡眠状况。结果两组患者入院时SAS、SMH评分差异均无统计学意义（P〉0．05），两组的SAS评分均〉50分。两组患者人院第1天SAS评分差异无统计学意义（P〉0．05）；对照组人院第1天SAS评分（59．42±6．98）分，干预组（48．67±7．05）分，两组比较差异有统计学意义（t=6．853，P〈0．01）；对照组化疗结束当天SAS评分（56．98±5．69）分，干预组（45．35±5．93）分，两组比较差异有统计学意义（t=8．946，P〈0．01）。两组患者人院第1天SMH评分差异无统计学意义（P〉0．05）；对照组入院第1天SMH评分（13．55±2．17）分，干预组（17．23±2．82）分，两组比较差异有统计学意义（t=-6．538，P〈0．01）；对照组化疗结束当天SMH评分（14．92±2．40）分，干预组（18．03±2．35）分，两组比较差异有统计学意义（t=-5．839，P〈0．01）；干预组患者干预后SAS评分较干预前降低、SMH评分较干预前升高，差异均有统计学意义（F分别为36．45，20．27；P〈0．01）。结论护理干预能有效缓解患者焦虑情绪、改善患者睡眠质量，使其顺利完成首次化疗，值得推广应用。

Objective To explore the effects of nursing intervention on the anxiety of nasopharyngeal carcinoma （NPC） patients in their first chemotherapy. Methods Totals of 80 NPC patients were randomly divided into control group and intervention group,with 40cases each group. Control group received conventional care, while intervention group received the comprehensive nursing intervention such as relaxation training, cognitive intervention, family supporting and sleep care and so on. Self-rating anxiety scale （SAS） and St. Mary＇ s hospital sleep questionnaire （SMH） were used to investigated patients at the first hospital day, the day before chemotherapy and the last day of chemotherapy. Results There was no difference of the SAS and SMH score of patients in the first hospital day between two groups （ P 〉 0.05 ）, and the average score of SAS of two groups was more than 50. In the control group, the average score of SAS in the day before chemotherapy and the last day of chemotherapy was （59.42 ± 6.98） and （56.98± 5.69）, respectively, higher than （48.67 ± 7.05 ） and （45.35 ±5.93） of the intervention group,and the difference was statistically significant （t = 6. 853, -6. 538, respectively;P 〈0.01 ）. The average score of SMH of control group in the day before chemotherapy and the last day of chemotherapy was （ 13.55 ±2.17） and （ 14.92 ±2.40） ,and that of intervention group was （ 17.23 ±2.82） and （ 18.03 ± 2.35 ）, and the difference was statistically significant （ t = - 5. 839, P 〈 0.01 ）. After intervention , in the intervention group,the scores of SAS was decreased and the score of SMH was increased（ F =36.45,20.27, respectively ;P 〈 0.01 ）. Conclusions The comprehensive care can effectively relieve patients＇ anxiety, improve their sleep, and encourage them to actively cooperate with chemotherapy, so it is worth to be widely applied.