系统康复护理对喉癌患者围手术期心理状态及术后恢复的干预研究

Intervention Study of Systematic Rehabilitation Nursing on Psychological Status and Postoperative Recovery of Laryngeal Carcinoma Patients in Perioperative Period

目的:探讨系统康复护理对喉癌患者围手术期心理状态及术后恢复的干预效果。方法:本研究采用前瞻性队列研究设计,将200例经病理证实的喉癌患者随机分为干预组和对照组。干预组进行系统康复护理,分别在手术前、手术后进健康教育、心理护理、饮食指导、发音指导等;对照组给予常规护理。分别在手术前1天、手术后1周采用抑郁自评量表(SDS)、焦虑自评量表(SAS)和中文版症状自评SCL-90量表对两组患者心理状态进行评估,并采用SF-36健康调查简表对两组患者手术前后生活质量进行评估,以评价系统康复护理对喉癌患者围手术期心理状态及术后恢复的干预效果。结果:两组患者在性别、年龄、疾病病程、文化程度、手术方式等方面无统计学差异(P>0.05)。干预组的SAS评分、SDS评分分别低于对照组,差异有统计学意义(均P<0.05);干预后干预组患者的SAS评分、SDS评分分别低于干预前,差异有统计学意义(均P<0.05)。干预组除人际关系紧张因子评分外,其余8个因子评分均明显低于对照组,差异有统计学意义(均P<0.05);干预后干预组患者除人际关系紧张、精神病性因子外,其余7个因子评分均明显低于干预前,差异有统计学意义(均P<0.05)。干预组生活质量8个因子评分均明显高于对照组,差异有统计学意义(均P<0.05);干预后干预组患者生活质量8个因子评分均明显高于干预前,差异有统计学意义(均P<0.05)。结论:喉癌手术患者围手术期存在一定的心理健康问题,抑郁、焦虑情绪等不良心理状态普遍存在,通过系统康复护理可以改善患者不良心理状态,有利于患者术后恢复。

Objective： To explore the intervention effect of systematic rehabilitation nursing on the psychological status and postoperative recovery of laryngeal carcinoma patients in perioperative period. Methods： This study was designed as a prospective cohort study,200 patients with laryngeal carcinoma confirmed by pathology were randomly divided into intervention group and control group. The intervention group received systematic rehabilitation nursing,including health education,psychological nursing,diet instruction and pronunciation guidance before and after the operation,while the control group received routine nursing care. In the 1 day before operation and 1 weeks after surgery with Self-rating Depression Scale（ SDS）,Self-rating Anxiety Scale（ SAS） and Chinese version of self rating symptom scale SCL-90 to evaluate two groups of patients with mental state,and the SF-36 health survey questionnaire of two groups to compare the quality of life before and after surgery,rehabilitation nursing intervention effect on perioperative psychological status,and postoperative recovery in patients with laryngeal carcinoma. Results：There was no significant difference between the two groups in gender,age,disease course,education level and operation mode（ P 0. 05）. The intervention group SAS score and SDS score were lower than the control group,the difference was statistically significant（ P 0. 05）; group of patients with SAS score and SDS score after intervention were lower than those before intervention,the difference was statistically significant（ P 0. 05）. In the intervention group interpersonal factor score,the other 8 factor scores were significantly lower than the control group,the difference was statistically significant（ P 0. 05）; group of patients except interpersonal tensions and psychotic factors after intervention,the other 7 factor scores were significantly lower than those before intervention,the difference was statistically significant（ all P 0. 05）. The scores of 8 factors in the intervention group were significantly higher than those in the control group（ all P 0. 05）; after intervention,the scores of 8 factors in the intervention group were significantly higher than those before the intervention,and the difference was statistically significant（ P 0. 05）. Conclusions： Poor mental health state,widespread anxiety and depression are common in perioperative laryngeal cancer patients. The system of rehabilitation nursing can improve the psychological state,which is beneficial to postoperative recovery.