团体心理辅导对改善晚期肺癌患者心理困扰及自我感受负担的效果研究

The effect of group psychological counseling on improving the psychological distress and self-perceived burden of patients with advanced lung cancer

目的评价由护士为主导的团体心理辅导对晚期肺癌患者心理困扰及自我感受负担的应用效果。方法将医院放疗科住院的晚期肺癌患者随机分为观察组和对照组,两组患者的治疗方法和常规护理方法均相同,观察组在对照组护理方法基础上,实施4周的团体心理辅导,每周1次,以知信行理论为基础包括理性-情绪行为疗法、支持-表达、信心疗法、呼吸操等行为训练及家庭作业等,分别在干预前、干预后第4周和第6周,采用自评问卷调查两组患者心理困扰和自我感受负担情况,并比较干预的效果。结果在干预第4周和第6周后,观察组患者的简明心境问卷总分、负性情绪及自我感受负担得分均明显下降,活力维度得分明显上升,与对照组比较,差异均具有统计学意义(P<0.01或P<0.05)。结论由护士为主导的团体心理辅导能有效解决晚期肺癌患者心理困扰和自我感受负担问题,作为延伸护理服务可以在临床中推广使用。

Objective To evaluate the effect of nurse-led group counseling on psychological distress and self-perceived burden in patients with advanced lung cancer.Methods The advanced lung cancer patients hospitalized in the radiotherapy department were randomly divided into the observation group and the control group.The treatment methods and routine nursing methods were the same for both groups.The observation group was given group counseling on the basis of the control group nursing methods for 4 weeks,and once a week.The group counseling was based on the theory of knowledge,belief,and behavior,including behavior training such as rational-emotional behavior therapy,support-expression,confidence therapy,and breathing exercise and homework.Self-assessment questionnaires were adopted before the intervention and at the 4 th and 6 th weeks after the intervention to investigate the psychological distress and self-perceived burden of two groups,and the effectiveness of intervention was compared.Results After the 4 th and 6 th weeks of intervention,the scores of concise mood,negative emotion and self-perceived burden in the observation group were all significantly decreased,and the latitude in activity was obviously increased.Compared with the control group,the difference was statistically significant（ P〈0.01 or P〈0.05）.Conclusion The nurse-led group counseling can effectively solve the problem of psychological distress and self-perceived burden in patients with advanced lung cancer,and can be used as an extended nursing service in clinical practice.