正向激励干预在肿瘤内科住院患者的应用及对负性情绪、希望水平和应对方式的影响

Application of positive stimulus intervention in inpatients in medical oncology department and its influence on negative emotions,hope level and coping styles

目的:观察正向激励干预在肿瘤内科住院患者的应用及对负性情绪、希望水平和应对方式的影响。方法:按随机数表法将116例肿瘤内科住院患者分为正向激励干预组(研究组,n=58)和常规干预组(对照组,n=58)。于干预前(T1)及干预1个月后(T2)评估两组患者负性情绪[心境状态量表(POMS-SF)]、希望水平[(Herth希望量表(HHI)]、应对方式[医学应对方式问卷(MCMQ)]、心理一致感[心理一致感量表(SOC-13)]和生存质量[中国癌症患者化学生物治疗生活质量量表(QLQ-CCC)],比较前后有无差别。结果:T2时,两组POMS-SF各负性分量表评分除愤怒-敌意无明显变化外均较T1降低(研究组:t抑郁-沮丧=7.285、t疲乏-迟钝=9.332、t迷惑-混乱=9.747、t紧张-焦虑=11.862;对照组:t抑郁-沮丧=3.291、t疲乏-迟钝=3.442、t迷惑-混乱=5.575、t紧张-焦虑=5.179;P<0.05),且研究组低于对照组(t抑郁-沮丧=-3.232、t疲乏-迟钝=-4.621、t迷惑-混乱=-3.475、t紧张-焦虑=-5.400,P<0.05);两组精力-活力评分则均较T1升高(研究组:t=-10.994,对照组:t=-4.432,P<0.05),且研究组高于对照组(t=5.372,P<0.05)。两组HHI量表各维度评分均较T1时升高(研究组:t对现实与未来的态度=-8.132、t采取的积极行动=-11.875、t与他人保持密切关系=-13.262,对照组:t对现实与未来的态度=-3.527、t采取的积极行动=-9.999、t与他人保持密切关系=-6.686;P<0.05),且研究组高于对照组(t对现实与未来的态度=3.773、t采取的积极行动=2.982、t与他人保持密切关系=3.712,P<0.05)。两组MCMQ量表面对评分均较T1时升高(研究组:t=-5.756,对照组:t=-2.839;P<0.05),且研究组高于对照组(t=2.437,P<0.05);屈服评分均较T1时降低(研究组:t=7.501,对照组:t=-4.005;P<0.05),且研究组低于对照组(t=-3.080,P<0.05);回避评分组间及干预前后无明显变化(P>0.05)。两组SOC-13各维度评分均较T1时升高(研究组:t理解感=-8.474、t可控制感=-8.012、t价值感=-7.659,对照组:t理解感=-4.352、t可控制感=-2.735、t价值感=-3.825;P<0.05),且研究组高于对照组(t理解感=2.789、t可控制感=2.764、t价值感=2.801,P<0.05)。两组QLQ-CCC量表精神及心理方面评分均较T1时升高(研究组:t=-5.257,对照组:t=-2.658,P<0.05),且研究组高于对照组(t=2.393,P<0.05);躯体、社会方面评分组间及干预前后无明显变化(P>0.05)。结论:正向激励干预有助于减轻肿瘤内科住院患者负性情绪,提升其希望水平和SOC,调整其应对方式,改善其生存质量。

Objective:To observe the application of positive stimulus intervention in inpatients in medical oncology department and its influence on negative emotions,hope level and coping styles.Methods:A total of 116 inpatients in medical oncology department were divided into positive stimulus intervention group(study group,n=58)and routine intervention group(control group,n=58)according to the random number table method.Before intervention(T1)and after 1 month of intervention(T2),the negative emotions[Profile of Mood States(POMS-SF)],hope level[(Herth Hope Inventory(HHI)],coping styles[Medical Coping Modes Questionnaire(MCMQ)],sense of coherence(SOC)[Sense of Coherence(SOC-13)]and quality of life[Chinese Cancer Patients’ Chemical Biotherapeutic Quality of Life Scale(QLQ-CCC)]were evaluated in the two groups and the differences before and after intervention were compared.Results:At T2,the scores of negative subscales of POMS-SF in the two groups were decreased compared with those at T1 except the anger-hostility score(t=7.285,9.332,9.747,11.62,3.291,3.442,5.575,5.179;P<0.05),and the scores in study group were lower than those in control group(t=-3.222,-4.621,-3.475,-5.40;P<0.05).The energy-activity scores in the two groups were elevated compared with those at T1(t=-10.994,-4.432;P<0.05),and the score in study group was higher than that in control group(t=5.372,P<0.05).The scores of dimensions of HHI scale in the two groups were increased compared with those at T1(t=-8.132,-11.875,-13.262,-3.527,-9.999,-6.686;P<0.05),and the scores in study group were higher than those in control group(t=3.773,2.982,3.712;P<0.05).The facing scores of MCMQ in the two groups were increased compared with those at T1(t=-5.756,-2.839;P<0.05),and the score in study group was higher than that in control group(t=2.437,P<0.05).The yielding scores were decreased compared with those at T1(t=7.501,-4.005;P<0.05),and the score in study group was lower than that in control group(t=-3.080,P<0.05).There was no significant change in the avoidance score between groups and before and after intervention(P>0.05).The scores of dimensions of SOC-13 in the two groups were increased compared with those at T1(t=-8.474,-8.012,-7.659,-4.352,-2.735,-3.825;P<0.05),and the scores in study group were higher than those in control group(t=2.789,2.764,2.801;P<0.05).The scores of mental and psychological aspects of QLQ-CCC scale in the two groups were increased compared with those at T1(t=-5.257,-2.658;P<0.05),and the scores in study group were higher than those in control group(t=2.393,P<0.05).There were no significant changes in the scores of physical and social aspects between groups and before and after intervention(P>0.05).Conclusion:Positive stimulus intervention can help alleviate negative emotions,improve the hope level and SOC,adjust the coping styles,and improve the quality of life of inpatients in medical oncology department.