心理咨询模式在恶性肿瘤血液透析患者护理中的应用效果

Application of psychological counseling model in nursing care of hemodialysis patients with malignant tumors

目的探讨心理咨询模式在恶性肿瘤血液透析患者护理中的临床应用价值。方法选取2017年6月至2018年6月期间西安市中心医院血液科收治的136例恶性肿瘤血液透析患者作为研究对象,按照随机数表法将患者分为观察组和对照组,每组68例。对照组患者行常规模式护理,观察组患者在对照组护理基础上加以心理咨询模式护理,用焦虑自评量表(SAS)、抑郁自评量表(SDS)评估患者护理前后的心理状态,用生活质量测定量表(QOL)评估患者护理前后的生活质量,应用患者填写问卷调查方式评价护理前后的护理满意度等情况。结果护理前,两组患者的SAS、SDS评分比较差异均无统计学意义(P>0.05);护理后,两组患者的SAS评分均较护理前有所下降,且观察组护理后的SAS评分降低较对照组更明显,差异均有统计学意义(P<0.05);护理后,两组患者SDS评分均较护理前有所下降,且观察组护理后的SDS评分明显低于对照组,差异均具有统计学意义(P<0.05);护理前,两组患者QOL量表中的生理功能、躯体功能、情感职能、社会功能等指标差异比较差异均无统计学意义(P>0.05);护理后,两组患者的上述4项指标评分均较护理前有所上升,且观察组均明显高于对照组,差异均具有统计学意义(P<0.05);护理后观察组患者的护理总满意度为94.12%,明显高于对照组的82.35%,差异具有统计学意义(P<0.05)。结论心理咨询模式护理可有效改善恶性肿瘤血液透析患者的负面情绪,增强患者治疗信心,对患者预后具有积极作用,值得临床应用。

Objective To explore the clinical application value of psychological counseling model in nursing of hemodialysis patients with malignant tumors. Methods A total of 136 hemodialysis patients with malignant tumors,who admitted to Department of Hematology of Xi’an Central Hospital from June 2017 to June 2018 were selected and divided into the observation group and control group according to random number table method, with 68 cases in each group. The patients in the control group received routine mode nursing, while the patients in the observation group received psychological counseling mode nursing on the basis of nursing in the control group. Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS) were used to assess the psychological status of patients before and after nursing. Quality of Life Scale(QOL) was used to assess the quality of life of patients before and after nursing, and the patients completed questionnaires to evaluate nursing satisfaction before and after nursing. Results Before nursing,there was no significant difference in SAS and SDS scores between the two groups(P>0.05);after nursing, the SAS scores of the two groups were lower than those before nursing, and the SAS score of observation group decreased more obviously than that of control group after nursing(P<0.05);after nursing, the SDS scores of the two groups were lower than those before nursing, and the SDS score of the observation group after nursing was significantly lower than that of the control group(P<0.05). Before nursing, there was no significant difference in the physiological function, physical function, emotional function and social function of QOL scale between the two groups(P>0.05). After nursing, the scores of the above four indexes of the two groups were higher than those before nursing, and the observation group was significantly higher than those before nursing(all P<0.05);the total satisfaction rate of the patients in the observation group was 94.12%, which was significantly higher than 82.35% in the control group(P<0.05). Conclusion Psychological counseling model nursing can effectively improve the negative emotions of hemodialysis patients with malignant tumors, enhance patients’ confidence in treatment, and have a positive effect on the prognosis of patients, which is worthy of clinical application.