延续性康复干预对化疗后鼻咽癌患者负性情绪及生活质量的影响

Effect of continuous rehabilitative intervention on the negative emotions and quality of life of patients with nasopharyngeal carcinoma after chemotherapy

目的分析延续性康复干预对鼻咽癌化疗患者的负性情绪、应对方式、生活质量及不良反应的影响。方法选取166例鼻咽癌患者,依据随机数字表法分为观察组83例(延续性康复干预)和对照组83例(常规干预)。比较两组患者出院后6个月的化疗不良反应、应对方式、抑郁程度和生活质量。结果出院后6个月,观察组患者张口困难严重、口干严重和有听力下降的发生率分别为3.61%、21.69%、63.86%,均低于对照组的51.81%、55.42%、80.72%,差异均有统计学意义(P﹤0.05);干预后,观察组患者的CD4+、CD8+水平及白细胞数量均明显高于对照组,差异均有统计学意义(P﹤0.01);观察组患者抑郁的发生率为2.41%,明显低于对照组的19.28%,差异有统计学意义(P﹤0.01);观察组患者积极应对的百分比为96.39%,高于对照组的72.29%,差异有统计学意义(P﹤0.05);观察组患者疲劳、恶心呕吐、疼痛、食欲下降、便秘、腹泻、睡眠障碍的发生率均明显低于对照组,差异均有统计学意义(P﹤0.01)。结论延续性康复干预可以减轻化疗后鼻咽癌患者的负性情绪,增强积极应对,降低不良反应的发生率,增强免疫功能,提高生活质量。

Objective To analyze the effect of continuous rehabilitative intervention on the negative emotions, coping style and quality of life, as well as adverse reactions in patients with nasopharyngeal carcinoma who underwent chemotherapy. Method A total of 166 patients with nasopharyngeal carcinoma were included as study group（n=83, with continuous rehabilitative intervention） or control group（n=83, with routine intervention）. In 6 months after discharge, patients in the two groups were compared for the incidence of adverse reactions induced by chemotherapy, coping style, degree of depression and quality of life. Result In 6 months after discharge, the incidence of difficulty opening mouth, severe dry mouth and hearing loss were 3.61%, 21.69%, and 63.86% in study group, while were lower than those in control group at 51.81%, 55.42%, and 80.72%, respectively, showing statistically significant differences（P0.05）; after intervention, the CD4^＋, CD8^＋and WBC were higher in study group than those in control group, the difference was of statistical significance（P0.01）; the incidence of depression in study group patients was 2.41%, which was significantly lower than that in control group at 19.28%, with statistically significant difference observed（P0.01）; 96.39% of patients in study group had active attitude against these adverse reactions, while only 72.29% in control group did, there was notable difference between the two groups（P0.05）; in study group, the rate of fatigue, nausea and vomiting, pain, decreased appetite,constipation, diarrhea and sleep disorder were markedly lower than those in control group, demonstrating statistical significance（P0.01）. Conclusion The continuous rehabilitative intervention can reduce the negative emotions for patients with nasopharyngeal carcinoma after chemotherapy, thus may enhance the positive response against negative feelings, reducing the incidence of adverse reactions, improving immune function and quality of life.