心理护理干预对膀胱癌患者膀胱全切回肠代膀胱术后生存质量的影响

Effect of Psychological Nursing Intervention on Quality of Life in Patients with Bladder Cancer after Radical Cystectomy and Ileal Neobladder

目的：研究膀胱癌患者膀胱全切回肠代膀胱术后心理护理干预对生存质量的影响。方法：选取我院2012年1月至2017年7月240例膀胱癌患者为研究对象,所有患者在我院接受膀胱全切回肠代膀胱术治疗。将纳入患者按随机数表法分为观察组与对照组,每组120例。对照组给予膀胱全切回肠代膀胱术后常规护理,观察组在常规护理基础上给予心理护理干预,包括造口宣教、示范教育、自信心训练、积极情绪疗法、视听注意力转移、家庭心理教育、出院后心理干预等。评估两组患者干预前与干预6周后心理状态、自我护理能力以及生存质量,统计膀胱全切回肠代膀胱术后并发症发生率。结果：观察组干预6周后心理状态评分（POMS）总分,显著低于对照组的（t=-12.252,P=0.000）,自我护理能力（ESCA）总分、生存质量（WHOQOL-BREF）总分,显著高于对照组的（t=4.097、6.195,P=0.000、0.000）。结论：心理护理干预可以改善膀胱全切回肠代膀胱术后膀胱癌患者心理健康状况,提高患者生存质量。

Objective：To study the effect of psychological nursing intervention on quality of life of patients with bladder cancer after radical cystectomy and ileal neobladder.Methods：A total of 240 patients with bladder cancer treated in the hospital from January 2012 to July 2017 were selected as study subjects,and all of them were treated by radical cystectomy and ileal neobladder.They were randomly divided into observation group and control group with 120 patients in each group. The control group was given routine nursing after radical cystectomy and ileal neobladder while the observation group was given psychological nursing intervention,including stoma education,exemplary education,self-confidence training,positive emotional therapy,audiovisual attention shift,family psychological education and psychological intervention after discharge. The psychological status,self-care ability and quality of life of two groups were evaluated before the intervention and after 6 weeks of intervention.The incidence of complications after total cystectomy and ileal neobladder was statistically analyzed.Results：The total score of Profile of Mood States（ POMS） in the observation group after 6 weeks of intervention was significantly lower than that in the control group（ t =-12.252,P〈0.001）,while scores of self-care ability and quality of life were significantly higher than those in control group（ t = 4.097,6.195;P〈0.001）. Conclusion：Psychological nursing intervention can improve the psychological health status and quality of life of patients with bladder cancer after total cystectomy and ileal neobladder.