团体正念认知疗法对化疗期间乳腺癌患者抑郁焦虑及生活质量的影响

Effect of Group Mindfulness Cognitive Therapy on the Depression,Anxiety and Quality of Life in Patients with Breast Cancer During Chemotherapy

目的探究团体正念认知疗法对化疗期乳腺癌患者的抑郁焦虑情绪及生活质量的影响。方法选择2016年1月至2017年6月于四川大学华西医院肿瘤科招募130例化疗期乳腺癌患者,随机分成试验组(65例,完成62例)和对照组(65例,完成61例),两组均给予常规护理,试验组在此基础上进行团体正念认知疗法。在干预前和干预后分别对两组患者进行抑郁自评量表(SDS)、焦虑自评量表(SAS)及EORTC生命质量测查表(QLQ-C30)评估,比较干预后两组患者的抑郁焦虑情绪和生活质量的改善情况。结果干预后试验组的SDS(t=-6.202,P<0.001)、SAS(t=-4.974,P<0.001)评分明显低于对照组。干预后试验组在QLC-C30中的躯体功能(t=6.092,P<0.001)、角色功能(t=3.427,P=0.001)、认知功能(t=4.625,P<0.001)、情感功能(t=4.625,P<0.001)、社会功能(t=4.843,P<0.001)方面的评分明显高于对照组,在疲倦(t=-2.014,P=0.046)、疼痛(t=-2.636,P=0.010)、呼吸困难(t=-2.442,P=0.016)和失眠(t=-4.731,P<0.001)方面的评分明显低于对照组。结论团体正念认知疗法能够有效缓解化疗期乳腺癌患者的抑郁焦虑情绪,提高患者的部分生活质量,值得在临床中推广。

Objective To explore the effect of group mindfulness cognitive therapy on the depression, anxiety and quality of life in patients with breast cancer during chemotherapy. Methods A total of 130 patients with breast cancer treated with chemotherapy in West China Hospital of Sichuan University from January of 2016 to June of 2017 were selected and divided randomly into the observation group with 65 cases in total and 62 cases completing the study and the control group with 65 cases in total and 61 cases completing the study. Both groups were given the conventional care, while the observation group was additionally given the group mindfulness cognitive therapy. The depression, anxiety, quality of life before and after intervention were evaluated by Self-rating Depression Scale (SDS), Self-rating Anxiety Scale (SAS) and EORTC Quality of Life Questionnaire C30 (QLQ-C30) respectively in the two groups. The improvement of depression, anxiety and quality of life after intervention were compared between the two groups. Results After intervention, the observation group was significnatly lower than the control group in the SDS score ( t =-6.202, P <0.001) and the SAS score ( t =-4.974, P <0.001). The observation group was significantly higher than the control group in the scores of physical function ( t =6.092, P <0.001 ), role function ( t =3.427, P =0.001), cognitive function ( t =4.625, P <0.001), emotional function ( t =4.625, P <0.001)and social function ( t =4.843, P <0.001) in QLC-C30, while the observation group was significnatly lower than the control group in the scores of fatigue ( t =-2.0144, P =0.0462), pain ( t =-2.636, P =0.010), dyspnea ( t =-2.442, P =0.016) and insomnia ( t =-4.731, P <0.001). Conclusion The group mindfulness cognitive therapy can effectively alleviate the depression and anxiety of patients with breast cancer during chemotherapy and improve their quality of life, so it is worth promoting in clinical practice.