个体化综合心理干预对造血干细胞移植期间患者负性情绪及营养状况的影响

Effect of individualized comprehensive psychological intervention on negative emotion and nutritional status of patients undergoing hematopoietic stem cell transplantation

目的探讨个体化综合心理干预对造血干细胞移植期间患者负性情绪及营养状况的影响。方法 60例行造血干细胞移植的患者随机分为干预组和对照组,各30例。对照组在移植治疗期间给予常规护理,干预组在对照组的基础上实施个体化综合心理干预。观察2组移植前(预处理前1 d)和移植后4周(经历预处理阶段、回输阶段和移植后期)焦虑自评量表(SAS)和抑郁自评量表(SDS)评分,同时进行营养指标的测定,并采用主观全面评估法(SGA)量表评估营养状况。结果 2组移植前SAS、SDS评分差异无统计学意义(P>0.05);干预组移植后4周SAS、SDS评分显著低于对照组(P<0.01)。2组移植后4周的体质量指数、肱三头肌皮褶厚度、上臂肌围、血浆白蛋白和血浆前白蛋白水平与移植前比较均有显著下降(P<0.05或P<0.01),但干预组体质量指数、肱三头肌皮褶厚度、上臂肌围和血浆前白蛋白水平均显著高于对照组(P<0.05)。移植后4周,干预组中营养不良发生率26.67%(8/30),显著低于对照组的56.67%(17/30)(P<0.05)。结论在造血干细胞移植期间进行个体化综合心理干预有助于改善患者的负性情绪,减轻患者营养状况下降的程度,减少营养不良的发生。

Objective To explore the effect of individualized comprehensive psychological intervention on negative emotion and nutritional status in patients undergoing hematopoietic stem cell transplantation （ HSCT） . Methods A total of 60 patients with HSCT were randomly assigned to 2 groups. Thirty patients in the control group received routine nursing care , while 30 patients in the in-tervention group received individualized comprehensive psychological intervention in addition to routine nursing care. The negative mood were evaluated by self-rating anxiety scale （SAS） and self-rating depression scale （SDS） in both groups before and at 4 weeks after HSCT. The nutritional indexes were measured and the nutritional status was evaluated by subjective global assessment （ SGA ） . Results The scores of SAS and SDS in the intervention group were significantly lower than those in the control group at 4 weeks after HSCT（P 〈0. 05） . The nutritional indexes at 4 weeks after HSCT were significantly declined than those before HSCT in both groups （ P 〈 0. 05 or P 〈 0. 01 ） . At 4 weeks after HSCT,the body mass in d ex , triceps skinfold, arm circumference and plasma prealbumin in the intervention group were significantly better than those in the control group （ P 〈 0. 05 ） . The incidence of malnutrition in the intervention group was significantly lower than that in the control group （ P 〈 0. 05 ） . Conclusions The individualized comprehensive psychological intervention could help to improve patients with negative emotion and reduce the extent of decreased nutritional status and the incidence of malnutrition in patients undergoing HSCT.