急性白血病化疗患者应对及效能认知干预评价

Effects of cognitive psychotherapy on coping style and self-efficacy in patients with acute leukemia under chemotherapy

目的探讨急性白血病化疗患者应对方式、自我效能状况及认知心理干预效果。方法选取急性白血病化疗患者82例,随机分为认知干预组42例和对照组40例;认知干预组在住院期间除常规护理外,同时进行认知干预,对照组进行常规护理;观察评定2组应对方式、一般自我效能感得分,比较干预效果。结果急性白血病化疗患者应对方式中的回避维度得分、屈服维度得分分别为(16.98±2.83)、(10.76±2.83)分,均高于常模,差异有统计学意义(P=0.000);面对维度得分与常模差异无统计学意义(P=0.802);一般自我效能感得分为(2.52±0.59)分,低于常模,差异有统计学意义(P=0.000);进行认知心理干预后,干预组面对维度得分、一般自我效能感得分提高,回避维度得分、屈服维度得分降低,差异均有统计学意义(均P<0.01)。结论认知心理干预可促进急性白血病化疗患者更多的采用积极应对方式,提高自我效能感,具有有效性和可行性。

Objective To investigate the coping style and self-efficacy in patients with acute leukemia under chemotherapy and to evaluate the effects of cognitive psychotherapy.Methods Eighty two patients with acute leukemia under chemotherapy were recruited and assigned into routine nursing group and cognitive psychotherapy group.All the patients were evaluated with Medical Coping Modes Questionnaire（MCMQ）,General Self-Efficacy Scale（GSES） before and after the intervention.Results The scores of avoidance（16.98±2.83）and resignation（10.76±2.83）of MCMQ of the patients were higher than those of the norm with a significant difference（P=0.000）.The score of confrontation of the patients（19.38±3.67）was similar to that of the norm.The general self-efficacy score（2.52±0.59） of the patients was lower than that of the norm with a significant difference（P=0.000）.Compared with the control group,the scores of confrontation and self-efficacy were significantly improved in the experimental group,while the scores of avoidance and resignation were significantly decreased（P〈0.05）.Conclusion Avoidance and resignation are the coping styles most frequently used by the patients with acute leukemia under chemotherapy and their self-efficacy level was low.Cognitive psychotherapy is proved to be effective to promote the patients using more positive coping styles and improving self-efficacy.