认知行为干预乳腺癌病人生存质量

The effect of cognitive behavioral therapy on quality of life in patients with breast cancer

目的通过临床实验验证自行编制的“音乐治疗加放松内心意象训练”这种改良的认知行为干预疗法的效果,探讨本疗法能否提高乳腺癌化疗患者的生存质量。方法运用随机对照的方法,对128例乳腺癌化疗患者进行了认知行为干预临床实验研究。采用中国癌症化疗患者生存质量量表(QLQ-CCC)及卡氏功能状态量表作为乳腺癌化疗患者生存质量状况和认知行为干预效果的测查指标,在实验设计和患者筛选时对医学变量进行了控制,同时对心理变量也进行了控制。结果乳腺癌化疗患者的生存质量状况以化疗前最好,化疗后次之,化疗中最差。经过认知行为干预的乳腺癌化疗患者,化疗后其生存质量各功能指标均明显提高,化疗中仅以心理情绪状况明显提高。结论“音乐治疗加放松内心意象训练”这种认知行为干预方法简便实用,可明显提高乳腺癌化疗患者生存质量。

Objective To develop and test t he effects of'Musicotherapy plus relaxation with guided imagery';to observe if quality of life(QOL)in breast cancer chemotherapy patie nts was increased afte r the cognitiv e behavioval intervention therapy.Methods 128breast cancer ch emotherapy patients were randoml y assigned to receive the method of cognitive b ehavioval psychological i ntervention therapy.The QLQ-CCC(Quality of Life Que stionnaire for Chinese Cancer Patients with Chemobio therapy)and the KPS(Karno fsky performance status)were used as indicators for measuring the results of QO L and cognitive behavioval int ervention therapy in breast cancer c hemotherapy patients.Not only were the medical variables cared about,b ut psychological va riables were als o in controlling confounder.Results From the best to worst,th e status of QOL in breast cancer chemotherapy patients was:pretherapy,postther ap y and during-therapy.After cogniti ve behavioval intervention therapy,most scores of scales in the QLQ-CCC a nd KPS were changed towards better in postth erapy patients,but,only spi ritual /psychological domain were changed towards better in during-th erapy patients.Conclusion'Musicotherapy plus relaxation with guided imagery'was valid and practicable,the QOL in breast cancer chemoth erap y patients will increase siginfican tly after receiving the method of psy c hological intervention.