聚焦解决模式联合耳穴贴压法对绝经宫颈癌患者后装腔内放疗后焦虑及疼痛的影响

Effect of solution-focused approach combined with auricular acupressure on anxiety and pain of patients with postmenopausal cervical cancer during afterloading brachytherapy

目的：观察聚焦解决模式联合耳穴贴压对减轻绝经宫颈癌患者后装治疗焦虑疼痛的影响。方法将120例首次进行宫腔治疗的绝经期宫颈癌患者采取随机数字表法分为观察组和对照组各60例，两组均采用常规护理方法，观察组在此基础上实施聚焦解决模式护理联合耳穴贴压，在干预前和干预后1周再次行宫腔置器前进行焦虑自评量表（ SAS ）评估，对宫腔置器术中疼痛评分及术后满意度进行测评。结果干预前两组SAS得分比较，差异无统计学意义（ P＞0．05）。干预后1周，观察组SAS得分为（42．3±44．46）分，明显低于对照组（49．76±4．57）分，两组比较差异有统计学意义（ t＝-9．00，P＜0．05）；观察组患者术中疼痛1级15例（25％），2级42例（70％），3级2例（3．33％），4级1例（1．67％）；对照组疼痛1级2例（3．33％），2级28例（46．67％），3级27例（45％），4级3例（5％），观察组患者术中疼痛情况明显轻于对照组，两组比较差异有统计学意义（ Z＝-5．74；P＜0．001）。观察组术后满意度得分（4．89±0．10）亦明显优于对照组（3．87±0．51）分，两组比较差异有统计学意义（t＝15．21，P＜0．05）。结论聚焦解决模式联合耳穴贴压能够减轻宫腔置器术中的焦虑紧张、疼痛程度，提高患者满意度。

Objective To observe the effect of solution-focused approach combined with auricular acupressure on relieving the anxiety and pain of patients with postmenopausal cervical cancer during afterloading brachytherapy .Methods One hundred and twenty patients who treated with uterine cavity for the first time were randomly divided into the observation group （ n =60 ） and the control group （ n =60 ） .The control group received the conventional nursing , and the observation group received the solution-focused approach nursing combined with auricular acupressure on the basis of the conventional nursing .The self-rating anxiety scale （ SAS ） was used before the intervention and one week after the intervention （ once again before afterloading brachytherapy ） , and the score of pain and the satisfaction of patients were evaluated during the afterloading brachytherapy .Results No difference was not found in the score of SAS before the intervention between two groups （P〉0.05）.The score of SAS was （42.3 ±44.46） in the observation group one week after the＆nbsp;intervention , and was significantly lower than （ 49 .76 ±4 .57 ） in the control group , and the difference was statistically significant （t=-9.00, P〈0.05）.The cases of the grade Ⅰof pain were 15 cases （25%）, gradeⅡwere 42 cases （70%）, grade Ⅲ were 2 cases （3.33%）, grade Ⅳ were 1 case （1.67%） in the observation group during operation , and were respectively 2 cases （3.33%）, 28 cases （46.67%）, 27 cases （45%）, 3 cases （5%） in the control group, and the degree of pain in the observation group during operation was significantly better than the control group , and the difference was statistically significant （Z=-5.74, P〈0.001）.The satisfaction of patients in the observation group during operation （4.89 ±0.10） was better than （3.87 ±0.51） in the control group and the difference was statistically significant （t =15.21, P〈0.05）. Conclusions The solution-focused approach combined with auricular acupressure during afterloading brachytherapy can reduce the anxiety , pain, and improve the satisfaction of patient .