心理疏导结合感知控制对鼻咽癌放疗患者癌因性疲劳和生活质量的影响

The Effect of Psychological Counseling Combined with Perceptual Control on Cancer-related Fatigue and Quality of Life of Patients with Nasopharyngeal Carcinoma Undergoing Radiotherapy

目的：研究心理疏导结合感知控制对鼻咽癌放疗患者癌因性疲劳（CRF）和生活质量的影响。方法：70例鼻咽癌患者根据干预方法不同分为观察组和对照组各35例,观察组放疗期间全程给予心理疏导结合感知控制,对照组仅给予感知控制干预。评估放疗近期疗效、心理状态、CRF程度及生活质量。结果：两组放疗近期疗效分布比较无统计学意义（χ2=0.38,P〉0.05）。两组干预后焦虑自评量表（SAS）、抑郁自评量表（SDS）评分均较干预前明显降低（t观察组=-10.29,-10.65,P〈0.001;t对照组=-9.51,-10.05,P〈0.001）,而观察组降低幅度明显较对照组大（t=-2.60,-2.47,P〈0.05）。观察组、对照组干预后CRF程度较干预前明显轻（U=21.14,5.69;P〈0.05）,且干预后观察组CRF程度明显较对照组轻（U=8.59,P〈0.05）。干预后观察组癌症患者生活质量核心问卷调查表（QLQC30）评分中5项功能量表评分显著较对照组高,3项症状量表评分显著较对照组低,差异有统计学意义（t功能量表评分=3.41,3.49,5.07,3.47,2.73;t症状量表评分=-5.02,-3.66,-2.36;P〈0.05）。结论：对严格筛选的鼻咽癌放疗患者实施心理疏导结合感知控制可有效改善心理状态,减轻CRF,提高生活质量。

Objective：To study the effect of psychological counseling combined with perceptual control on cancerrelated fatigue（CRF）and quality of life of patients with nasopharyngeal carcinoma（NPC）undergoing radiotherapy.Methods：A total of 70 patients with NPC were divided into the observation group and the control group with 35 patients in each group according to different intervention methods.The observation group was given psychological counseling and perceptual control intervention during radiotherapy,while the control group was only given perceptual control intervention.The short-term curative effect of radiotherapy,psychological status,degree of CRF and quality of life were evaluated.Results：There was no significant difference in the short-term curative effect of radiotherapy between the two groups.Scores of the self-rating anxiety scale（SAS）and the self-rating depression scale（SDS）in the two groups were significantly decreased after the intervention（tobservation group=-10.29,-10.65;P〈0.001;tcontrol group=-9.51,-10.05,P〈0.001）,and the decrease in observation group was significantly greater than that in the control group（t=2.60,2.47;P〈0.05）.The degree of CRF in the two groups decreased significantly after the intervention（U=21.14,5.69;P〈0.05）,and the degree of CRF in the observation group was significantly milder than that in the control group after the intervention（U=8.59,P〈0.05）.After the intervention,scores of 5 function scales in the Core Quality of Life Questionnaire（QLQ-C30）of the observation group were significantly higher than those in the control group,while scores of 3 symptom scales were significantly lower than those in the control group（tfunction scale score=3.41,3.49,5.07,3.47,2.73,tsymptom scale score=-5.02,-3.66,-2.36;P〈0.05）.Conclusion：Psychological counseling combined with perceptual control can effectively improve the mental status,reduce CRF and improve the quality of life of strictly screened patients with NPC undergoing radiotherapy.