聚焦解决模式对结直肠癌患者焦虑抑郁状况化疗依从性及免疫功能的影响

Effect of focusing on solving model on anxiety status,depression status,chemotherapy compliance and immunologic function in patients with colorectal cancer

目的探讨聚焦解决模式对结直肠癌患者焦虑抑郁状况化疗依从性及免疫功能的影响。方法选择74例结直肠癌患者,采用随机数字表法分为观察组和对照组,各37例。对照组患者采用常规护理方法,观察组患者在常规护理的基础上,采用聚焦解决模式,即组建聚焦解决模式小组。运用抑郁自测量表(SAS)和焦虑自测量表(SDS)对两组患者干预前后的焦虑抑郁评分进行比较,并对两组患者干预前后的依从性进行比较。采用碱性磷酸酶法对患者外周血T细胞亚群的CD+4、CD+8进行测定。结果干预前两组患者的焦虑抑郁评分差异无统计学意义(P>0.05)。护理干预后,两组患者的焦虑和抑郁评分均有明显改善,但观察组患者的改善情况明显优于对照组患者,差异有统计学意义(P<0.05)。治疗前两组患者的依从性差异无统计学意义(P>0.05)。干预治疗后,观察组患者的依从性明显高于对照组,差异有统计学意义(P<0.05)。治疗后观察组患者外周血CD+4和CD+4/CD+8升高,CD+8明显降低,而对照组干预前后的差异无统计学意义(P>0.05)。结论聚焦解决模式能够明显改善结直肠癌症患者的抑郁和焦虑情绪,并能有效提高患者的依从性和免疫功能。

Objective To explore the effect of focusing on solving model on anxiety status, depres- sion status, chemotherapy compliance and immunologic function in patients with colorectal cancer. Methods A total of 74 cases of colorectal cancer patients were selected and randomly divided into observation group and control group, with 37 eases in each group. Control group were treated by routine nursing methods, while observation group patients, on the basis of the nursing methods of patients in the control group, with focus on solving mode, namely a focus to solve the model group. Anxiety and depression scores were evalua- ted by self-rating anxiety scale （SAS） and self-rating depression scale （SDS） in two groups before and after the intervention, and compliance of two groups before and after the intervention were compared. Peripheral blood T cell subsets of CD4 and CDs were measured by alkaline phosphatase method. Results Anxiety and depression scores before intervention in two groups had no statistically significant difference （ P 〉 0. 05 ）. After nursing intervention, anxiety and depression scores in two groups were improved significantly, but the improved level in control group was obviously better than that in observed group, with significant difference （ P 〈 0. 05 ）. Before treatment, the difference about compliance of two groups was no statistically significance （ P 〉 0. 05）. After intervention therapy, compliance of observation group was obviously higher than that in the control group, and the difference was statistically significant （P 〈 0.05 ）. After treatment, peripheral blood CD＋ and CD4＋/CD8＋ , CD8＋ of observation group were significantly decreased, while therewas no statistically significant difference compared before and after the intervention in control group （P 〉 0. 05）. Conclusions Focus on solving model can obviously improve depression and anxiety in colorectal cancer patients, and can effectively improve compliance and immunologic function of patients.