绘画疗法对血液肿瘤化疗患者疲乏和情绪影响的研究

Effects of painting therapy on cancer-related fatigue and emotional distress in patients with hematological neoplasms undergoing chemotherapy

目的探讨绘画疗法对减轻血液肿瘤化疗患者癌因性疲乏和焦虑抑郁情绪的临床效果。方法选择2018年10月至2019年5月在上海交通大学医学院附属瑞金医院血液肿瘤科层流病房住院的78例患者为研究对象,以2018年10月至2019年1月纳入的39例患者为对照组,2019年2—5月纳入的39例患者为干预组。2组患者均接受常规健康教育和心理护理,干预组患者在此基础上增加每周1次,共4周的绘画干预。采用Piper疲乏修订量表(PFS-R)、焦虑自评量表(SAS)和抑郁自评量(SDS)分别于干预前、干预完成时和干预后1个月评估2组患者疲乏和情绪状况。对照组失访1例,干预组失访3例。结果绘画疗法后干预组2个时间点疲乏、焦虑、抑郁总分分别为(4.04±0.91)、(48.81±3.92)、(46.06±4.53)、(3.55±0.84)、(47.47±4.33)、(45.17±4.74)分,对照组分别为(5.34±1.18)、(51.13±3.88)、(50.63±4.36)、(5.07±1.40)、(52.74±4.04)、(51.24±4.01)分。2组患者疲乏总分及各维度得分,焦虑和抑郁总分的时间效应差异有统计学意义(F时间值为48.859~126.096,均P<0.05);疲乏总分及感觉、情绪、行为维度得分,焦虑和抑郁总分的组间效应与交互效应差异有统计学意义(F组间值为6.037~37.014,F交互值为7.696~35.754,均P<0.05)。结论绘画疗法能有效缓解血液肿瘤化疗患者的疲乏,改善其焦虑、抑郁情绪。

Objective To evaluate the clinical effects of painting therapy on fatigue,anxiety and depression in patients with hematological neoplasms undergoing chemotherapy.Methods Totally 78 patients with hematological neoplasms admitted to the laminar flow ward in a tertiary hospital in Shanghai from October 2018 to May 2019 were enrolled.Patients who were included from October 2018 to January 2019 constituted the control group(39 cases),others from February to May 2019 constituted the intervention group(39 cases).Patients in both groups received routine health education and psychological care,and the intervention group received extra 4 weeks of painting intervention once a week.The Revised Piper Fatigue Scale(PFS-R),Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS)were used to assess fatigue and emotional status of two groups during chemotherapy before the intervention,after the intervention and one month after the intervention.One case in control group was lost to follow-up while three cases in intervention group.Results At 2 times points after painting therapy,total fatigue、anxiety and depression score in the intervention group were(4.04±0.91),(48.81±3.92),(46.06±4.53),(3.55±0.84),(47.47±4.33),(45.17±4.74)points;those in the control group were(5.34±1.18),(51.13±3.88),(50.63±4.36),(5.07±1.40),(52.74±4.04),(51.24±4.01)points.The time effect on fatigue of each dimension and total scores,anxiety and depression scores was significant(F values were 48.859-126.096,P<0.05);the group effect and the interaction effect of intervention and time on sensory,emotional,behavioral and total fatigue scores,anxiety and depression scores were significant(F values were 6.037-37.014,P<0.05;F values were 7.696-35.754,P<0.05).Conclusion Painting therapy can effectively alleviate fatigue and relieve anxiety and depression in patients with hematological neoplasms undergoing chemotherapy.