皮肤癌患者术前的心理状态分析及护理干预对策

Preoperative psychological state analysis and nursing intervention of skin cancer patients

目的通过对皮肤癌患者术前的心理状态进行分析,并提出相关的护理对策,以期降低患者的手术应激水平,为手术的顺利进行及术后的顺利康复创造条件。方法选取蚌埠医学院第一附属医院2017年1—12月收治的40例皮肤癌患者作为研究对象,采用症状自评量表(SCL-90)、自评焦虑量表(SAS)、自评抑郁量表(SDS)对患者的术前心理状态进行评估。并将结果与中国常模进行比较。结果该组患者的症状自评量表总均分、自评焦虑量表评分、自评抑郁量表评分均高于国内常模,差异有统计学意义(均P<0.05)。症状自评量表筛查中有14例患者有精神症状阳性患者14例,自评焦虑量表筛查有14例阳性,自评抑郁量表筛查有15例阳性。症状自评量表中以强迫化症状、躯体化、敌对的得分最高,该量表所有各因子平均分均高于国内常模,差异具有统计学意义(均P<0.05)。结论头面部是皮肤癌的好发区域,该类患者担心手术后容貌受损,心理负担重,导致患者术前的心理压力较大,焦虑、抑郁情绪突出,找出患者存在的主要的心理问题,给予有的放矢的心理护理干预,减轻患者的不良情绪和癌症及手术治疗带来的疲乏,以促进患者手术的顺利进行及术后的顺利康复。

Objective By analyzing the preoperative psychological state of skin cancer patients and put forward nursing counter measures, to create conditions for the smooth operation of the operation and the smooth recovery after surgery. Methods Forty skin cancer patients admitted and treated in our hospital from January 2017 to December 2017 were selected as the research objects. Symptom self-rating scale(SCL-90), self-rating anxiety scale(SAS) and Self-rating depression scale(SDS) were used to assess the preoperative psychological state of these patients. The result was compared with Chinese norm. Results The total mean score of symptom self-rating scale, self-rating anxiety scale score and self-rating depression scale score of the patients in this group were all higher than the domestic norm, and had significant difference(all P<0.05). During the SCL-90 screening, fourteen patients had psychotic symptoms, SAS screening had 14 positive cases and SDS screening had 15 positive cases. The scores of compulsive symptom, somatization and hostility were the highest in SCL-90. The average score of all the factors in this scale is higher than the domestic norm, and had significant difference(all P<0.05). Conclusion The head and face are the predilection areas of skin cancer. Preoperative psychological stress, anxiety, depressed mood is outstanding in skin cancer patients. We need to give assessment in time and undertake necessary nursing intervention, to create conditions for the smooth operation of the operation and the smooth recovery after surgery.