手术前后心理干预对前列腺癌去势手术患者焦虑抑郁情绪及QLQ-C30评分的影响

Effect of Psychological Nursing Intervention Before and After Operation on Anxiety and Depression and QLQ-C30 Score in Prostate Cancer Patients with Castration

目的：探究手术前后心理护理干预对前列腺癌去势手术患者焦虑抑郁情绪及QLQ-C30评分的影响。方法：选取80例于2014年5月至2016年5月入我院诊治的前列腺癌患者作为研究对象,采用回顾性分析法分析所有患者的临床资料,按照资料中的护理方法将80患者分为研究组和对照组各40例。对照组行双侧睾丸切除术、药物治疗和常规护理,研究组在行双侧睾丸切除术、药物治疗和常规护理的基础上,另在手术前后（围手术期）给予心理护理干预。在干预前、术后第7天和术后第1个月,用生活质量核心问卷（QLQ-C30）评定两组患者生活质量,用焦虑自评量表（SAS）和抑郁自评量表（SDS）分别评定两组患者的焦虑和抑郁情绪。结果：（1）两组患者术后7天和术后1个月QLQ-C30评分与干预前比较存在明显差异（F=4.540,18.100,6.460.8.840,11.680,33.080,3.670,11.100,3.950,15.300,3.290,15.300,3.290,12.550;P〈0.05）,且术后7天和术后1个月,QLQ-C30表中研究组患者的整体生活质量、角色功能、情感功能、认知功能均显著高于对照组,差异具有统计学意义（t=3.322,3.627,3.507,4.144,2.526,3.105,2.474,2.764,3.239,2.748,2.613,2.550;P〈0.05）;（2）两组患者术后7天和术后1个月SAS、SDS评分与干预前比较存在明显差异（F=77.340,733.750,405.250,40.380;P〈0.001）,且术后7天和术后1个月,研究组患者的SAS和SDA评分均显著低于对照组,差异具有统计学意义（t=4.029,5.302,8.649,10.972;P〈0.001）结论：对采用去势手术治疗前列腺癌的患者,手术前后进行心理护理干预能显著提高患者术后生活质量,并有效减轻患者的焦虑和抑郁状态。

Objective： To investigate the effect of psychological nursing intervention before and after operation on anxiety and depression and QLQ-C30 score in prostate cancer patients with castration. Methods： A total of 80 prostate cancer patients diagnosed and treated in our hospital from May 2014 to May 2016 were enrolled in this study and their clinical data were analyzed retrospectively.According to different nursing methods found in the data,80 patients were divided into experimental group and control group,40 cases in each group. The control group underwent bilateral orchiectomy,medication and routine nursing.And the experimental group was given psychological nursing intervention before and after the operation on the basis of the control group＇s treatment.The Quality of Life Questionnaire（ QLQ-C30） was used to assess the quality of life of both groups,and the anxiety and depression were evaluated respectively by self-rating Anxiety Scale（ SAS） and the selfrating Depression Scale（ SDS） respectively before intervention,and at postoperative 7 th day and postoperative 1 st month.Results：（1） There was a significant difference in QLQ-C30 scores between the two groups at 7 days and 1 month after operation（ F = 4.540,18. 100,6. 460. 8. 840,11.680,33. 080,3. 670,11. 100,3. 950,15. 300 3. 290,15. 300,3. 290,12. 550; P〈0.05）,and at 7 days and 1 month after operation,the items in QLQ-C30 including overall quality of life,role function,emotional function and cognitive function of the patients in experimental group were significantly higher than those in the control group（ t = 3.322,3.627,3.507,4.144,2.526,3.105,2.474,2.764,3.239,2.748,2.613,2.550; P〈0.05）.（2） There were significant differences in SAS and SDS scores between the two groups at 7 days and at 1 month after surgery（ F = 77.340,733.750,405.250,40.380; P〈0.001）; The scores of SAS and SDA in the experimental group were significantly lower than those in the control group at 7 days and 1 month after operation（ t = 4.029,5.302,8.649,10.972; P〈0.001）.Conclusion： Preoperative and postoperative psychological nursing intervention can significantly improve postoperative quality of life and relieveanxiety and depression in prostate cancer patients with castration.