心理护理干预对老年恶性肿瘤患者疼痛反应、情绪改善及治疗依从性的临床观察

Clinical research of psychological nursing intervention on the compliance of pain medication in ederly patientswith malignant tumor1

０３１ 目的 探讨心理护理干预对老年恶性肿瘤患者服用止疼药物治疗依从性的临床观察。方法 回顾性分析符合入选标准的老年恶性肿瘤患者９２例，所有患者按照三阶梯止痛原则给予规范化的药物治疗， 将患者随机分为两组，对照组给予常规护理干预，观察组在对照组基础上实施心理护理干预。比较两组治疗 前后疼痛反应的改善情况、抑郁以及焦虑情绪变化情况，以及治疗依从性及护理满意度。结果 观察组疼痛 缓解率为８９．３６％，显著优于对照组的６４４４％（Ｚ＝－３．５３４，Ｐ＜０．０５），观察组总缓解率显著高于对照组 （χ２＝４．０５８，Ｐ＜０．０５）；抑郁评分（１７．５２±４．０６）分，显著低于对照组的（２３．３５±３．２４）（ｔ＝７．５９２，Ｐ＜００５）； 焦虑评分（１７．５２±４．０６）分，显著低于对照组的（１８．０５±４．０２）分（ｔ＝７．６２２，Ｐ＜０．０５）；观察组服用止痛药物 的依从性显著优于对照（Ｚ＝－６．９９４，Ｐ＜００５）；观察组护理满意度为８７．２３％，对照组为７５．５６％，组间比较 观察组满意度总体优于对照组（Ｚ＝－２．７６４，Ｐ＜０．０５）。结论 心理护理干预能有效的改善老年恶性肿瘤患 者的疼痛反应，焦虑以及抑郁情绪，从而提高治疗的依从性，提高护理工作的满意度。

Objective Toexploretheeffectofpsychologicalnursinginterventiononthecomplianceofpain medicationinederlypatientswithmalignanttumor.Methods Retrospectiveanalysisof92elderlypatientswith malignanttumorswasconducted.Allpatientsweretreatedwithstandardizeddrugsaccordingtothethree-step analgesicprinciple.Thepatientswererandomlydividedintotwogroups,thecontrolgroupwasgivenroutinenursing intervention,andtheobservationgroupwasgivenpsychologicalnursinginterventiononthebasisofthecontrolgroup. Theimprovementofpainresponse,depressionandanxiety,thetreatmentcomplianceandnursingsatisfactionoftwo groupsbeforeandaftertreatmentwerecompared.Results Thepainreliefrateoftheobservationgroupwas89.36%, whichwassignificantlyhigherthan64.44% ofthecontrolgroup（Z=-3.534,P〈0.05）.Thetotalremissionrateof theobservationgroupwassignificantlyhigherthanthatofthecontrolgroup（χ2=4.058,P〈0.05）.Thedepression scoreoftheobservationgroup[（17.52±4.06）points]wassignificantlylowerthan（23.35±3.24）pointsofthe controlgroup（t=7.592,P〈0.05）.Theanxietyscoreoftheobservationgroup[（17.52±4.06）points]was significantlylowerthan（18.05±4.02）pointsofthecontrolgroup（t=7.622,P〈0.05）.Thecomplianceofthe observationgroupwithanalgesicdrugswasbetterthanthatofthecontrolgroup（Z=-6.994,P〈0.05）.Thenursing satisfactionoftheobservationgroupwas87.23%,whichwassignificantlyhigherthan75.56% ofthecontrolgroup （Z= -2.764,P〈0.05）.Conclusion Psychologicalnursinginterventioncaneffectivelyimprovethepain response,anxietyanddepressionofelderlypatientswithmalignanttumor,thustoimprovethecomplianceandsafetyof thetreatmentandthecareofnursingstaff.