基于“SHARE”模式告知肿瘤患者初诊断后焦虑和抑郁变化的临床观察

Changes in anxiety and depression in cancer patients being informed of the initial diagnosis result based on the “SHARE” model

目的探讨采用“SHARE”模式告知肿瘤患者初诊断后焦虑和抑郁变化的临床效果。方法选取2016年12月至2017年12月间青海大学附属医院收治的108例肿瘤患者,采用“SHARE”模式进行肿瘤初诊断告知,使用焦虑自评量表(SAS)及抑郁自评量表(SDS)在告知前及告知后6周分别对患者进行焦虑和抑郁比较。结果告知肿瘤初诊断后,患者SAS和SDS评分评分均较告知前下降,差异均有统计学意义(均P<0.05)。不同性别、文化程度及肿瘤分期的肿瘤患者各组间告知前后,△SAS和△SDS均出现明显差异性(P<0.05)。不同年龄、民族、病种及治疗方案的肿瘤患者各组间告知前后,△SAS和△SDS均无明显差异(均P>0.05)。结论采用“SHARE”模式告知肿瘤患者初诊断,可适当改善其焦虑和抑郁状态,有一定的正性临床效果。同时密切关注性别、文化程度及肿瘤分期在告知过程中的影响,为青海地区肿瘤“坏消息”告知工作提供沟通经验。

Objective To observe the changes in anxiety and depression in cancer patients being informed of the initial diagnosis result based on the“SHARE”model.Methods A total of 108 patients with cancer who were treated at Qinghai University Affiliated Hospital from December 2016 to December 2017 were recruited in the study.Patients were informed of the initial diagnosis result using the“SHARE”model.Changes in anxiety and depression were evaluated and compared by self-rating anxiety scale(SAS)and self-rating depression scale(SDS)before the notification and at 6 weeks after the notification.Results The scores of SAS and SDS decreased in both groups when the patients were informed of the initial diagnostic result(P<0.05).The differences in SAS and SDS scores were observed among patients of different gender,education,and tumor stage(all P<0.05).There was no significant difference in SAS and SDS scores among patients of different age,ethic,culture,disease and treatment(P>0.05).Conclusion Using“SHARE”model to inform cancer initial diagnosis result can improve the anxiety and depression state of patients with certain positive clinical effect.Moreover,we should pay close attention to the influence of gender,education and cancer stage on the process of informing in order to provide communication experience and reference for the informimg patinets of the bad news of cancer.