综合干预对卵巢癌术后化学治疗间歇期患者情绪、应对方式和生存质量的影响

Effect of comprehensive intervention on the emotion, coping styles and the HRQOL of patients with ovarian cancer during the period of chemotherapy

目的探讨综合干预对卵巢癌术后化学治疗期患者的情绪、应对方式的影响。方法纳入57例卵巢癌术后化学治疗间歇期患者,其中研究组28例、对照组29例。研究组接受八段锦、健康宣教和心理疏导相结合的多模态综合干预共12周,对照组患者继续原有的生活方式不变。干预前、后分别采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、医学应对问卷(MCMQ)、36项健康调查简表(SF-36)对患者进行情绪、应对方式和生存质量评价,并比较2组患者各项评分间的差异。结果干预后,研究组患者的HAMA、HAMD评分均比干预前下降(P均<0.05),且均低于对照组(P均<0.05);研究组MCMQ的面对评分升高、屈服评分下降,与干预前及对照组比较差异均有统计学意义(P均<0.05);研究组患者的SF-36评分高于干预前,且高于对照组(P均<0.05)。相关性分析显示,卵巢癌患者HAMA评分与MCMQ的屈服评分呈正相关(r=0.302,P=0.002),HAMA、HAMD均与MCMQ的面对评分呈负相关(r分别为-0.343、-0.209,P均<0.05),HAMA、HAMD均与MCMQ的回避评分呈正相关(r分别为0.403、0.278,P均<0.05)。结论综合干预能有效缓解卵巢癌术后化学治疗期患者的焦虑、抑郁情绪,促进患者产生积极应对方式,减少消极应对方式,提高其生存质量。

Objective To investigate the effect of comprehensive interventions on the emotion and coping style of patients with ovarian cancer during postoperative chemotherapy. Methods Fifty-seven patients with ovarian cancer during chemotherapy period were selected and divided into the study (n=28) and control groups (n=29). In the study group, patients received multi-mode comprehensive interventions including Baduanjin exercise, health education and psychological coundeling. Patients in the control group experienced no changes in their lifestyle. Before and after the interventions, patients’ emotion, coping style and quality of life were assessed by the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Medical Coping Modes Questionnaire (MCMQ) and 36-Item Short Form Health Survey (SF-36) and statistically compared between two groups. Results In the study group, the HAMA and HAMD scores were significantly decreased after comprehensive interventions (both P < 0.05), considerably lower compared with those in the control group (both P < 0.05). In the study group, the score of confrontation was significantly increased, whereas the score of resignation in MCMQ was considerably decreased after the comprehensive interventions, which also significantly differed from those in the control group (all P < 0.05). After the comprehensive interventions, the SF-36 score was significantly enhanced in the study control, remarkably higher compared with that of the control group (both P < 0.05). Correlation analysis demonstrated that the HAMA score was positively correlated with the score of resignation in MCMQ in ovarian cancer patients( r = 0.302, P= 0.002).The HAMA and HAMD scores were negatively associated with the score of confrontation of MCMQ (r =-0.343 and -0.209, both P < 0.05). The HAMA and HAMD scores were positively correlated with the score of avoidance in MCMQ (r = 0.403 and 0.278, both P < 0.05). Conclusions Comprehensive interventions can effectively relieve the anxiety and depression of ovarian cancer patients after chemotherapy, promote patients to take positive coping styles, reduce negative coping styles and improve the quality of life.