认知行为疗法对化疗癌症患儿治疗依从性及免疫功能的影响

Effect of cognitive behavioral therapy on treatment compliance and immune function in children with cancer receiving chemotherapy

目的:探讨认知行为疗法对化疗癌症患儿治疗依从性及免疫功能的影响,为癌症患儿的心理护理提供依据。方法:采用便利抽样方法选取符合标准的癌症患儿50例,并按照癌症类型、分期和年龄进行配对,根据其意愿分为治疗组和对照组各25例。对照组只采用常规心理护理,治疗组采用认知行为疗法,干预时间共5周。干预前后,采用Frankl依从量表(Frankl compliance scale,FCS)、Houpt行为量表(Houpt behavior scale,HBS)和外周血淋巴细胞含量(peripheral blood lymphocyte content,PBLC)评估其治疗依从性及免疫功能,并对结果进行比较分析。结果:干预后,治疗组的治疗依从性(3.20±0.40)、NK细胞含量(natural kill cell,NKC;20.36±10.76)明显高于对照组的治疗依从性(2.72±0.61)及NK细胞含量(16.68±8.44),且差异具有统计学意义(t治疗依从性=3.256,P=0.002;tNK细胞含量=2.356,P=0.024)。T淋巴细胞含量较干预前明显增加(72.26±11.34 vs. 76.33±11.07;t=2.460,P=0.021),但对照组干预前后在治疗依从性及淋巴细胞含量上并无明显差异(均P>0.05)。结论:认知行为疗法通过纠正患儿对患癌事件的歪曲认知,可以增强治疗依从性,对提高免疫调节能力及改善预后有一定的积极作用。

Objective:To investigate the effect of cognitive behavioral therapy on treatment compliance and immune function in children with cancer receiving chemotherapy,and to provide a basis for psychological nursing for children with cancer. Methods:Convenience sampling was used to select 50 children with cancer who met related criteria,and after being matched for type of cancer,stage,and age,they were divided into treatment group and control group according to their preference,with 25 patients in each group. The patients in the control group were given routine psychological nursing,and those in the treatment group were given cognitive behavioral therapy;the course of treatment was 5 weeks for both groups. Before and after intervention,Frankl Compliance Scale(FCS),Houpt Behavior Scale(HBS),and peripheral blood lymphocyte content(PBLC)were used to evaluate treatment compliance and immune function,and the results were analyzed and compared between the two groups. Results:After intervention,compared with the control group,the treatment group had significantly higher treatment compliance(3.20±0.40 vs. 2.72±0.61,t=3.256,P=0.002)and content of natural killer cells(20.36±10.76 vs. 16.68±8.44,t=2.356,P=0.024). The treatment group had a significant increase in T lymphocytes after intervention(72.26±11.34 vs. 76.33±11.07,t=2.460,P=0.021),but in the control group,there were no significant changes in treatment compliance and T lymphocytes after intervention(all P>0.05). Conclusion:In children with cancer,cognitive behavioral therapy can enhance treatment compliance by correcting their distorted understanding of cancer events and thus plays an important role in improving immunoregulation capability and prognosis.