多学科团队参与家庭会议干预模式对晚期癌症患者家属焦虑抑郁情绪影响的效果评价

Evaluation on the Effect of Multidisciplinary Team Participation in Family Meeting on Anxiety and Depression of Family Members of Patients with Advanced Cancer

目的探讨晚期癌症患者家属焦虑抑郁情绪的影响因素及多学科团队参与家庭会议干预模式的干预效果。方法通过对上海市浦东新区某社区卫生服务中心辖区内2019年1-3月期间的72名晚期癌症患者家属(主要照顾者)进行问卷调查,了解其焦虑、抑郁情绪状况,分析其影响因素。在基线调查研究的基础上,按随机数字表法将入选患者家属分为干预组和对照组,两组均给予常规综合服务。干预组在此基础上组织召开多学科参与的家庭会议,采用焦虑(SAS)、抑郁(SDS)量表评价干预效果,干预时间为6个月。结果干预前,患者家属SAS和SDS评分明显高于国内常模(P<0.001);干预组和对照组的SAS和SDS评分处于基线平衡(均P>0.05)。单因素分析结果显示:不同性别、教育程度及有无固定职业的家属SAS和SDS评分差异均有统计学意义(均P<0.05)。干预6个月后,与对照组相比,干预组患者家属的SAS和SDS评分低于对照组(P<0.001)。结论晚期癌症患者家属有明显的焦虑、抑郁情绪,且与其性别、受教育程度和职业状况有关。多学科团队参与的家庭会议干预能够有效地改善晚期癌症患者家属的焦虑、抑郁情绪。

OBJECTIVE To explore the influencing factors of anxiety and depression of family members of patients with advanced cancer and the effect evaluation of intervention model of multidisciplinary team participating in family meeting. METHODS Through a questionnaire survey of 72 family members(main caregivers) of advanced cancer patients in a community health service center in Pudong New Area of Shanghai from January to March 2019, to understand their anxiety and depression, and analyze the influencing factors. On the basis of the baseline investigation, 72 family members of patients were divided into intervention group and control group according to the method of digital random table, and they were given routine comprehensive services. On this basis, the intervention group organized a multi-disciplinary family meeting, and the intervention effect was evaluated with anxiety scale(SAS) and depression Scale(SDS). The intervention time was 6 months. RESULTS Before the intervention, the SAS and SDS scores of the family members of the patients were significantly higher than those of the domestic norm(P<0.001), and the SAS and SDS scores between the intervention group and the control group were in the baseline balance(P>0.05). The results of univariate analysis showed that there were significant differences in SAS and SDS scores among different genders, education levels and families with or without fixed occupation(P<0.05). After 6 months of intervention, compared with the control group, the SAS and SDS scores of family members in the intervention group were lower than the control group(P<0.001). CONCLUSION Family members of patients with advanced cancer had obvious anxiety and depression, which were related to their gender, education level and occupational status;family meeting intervention with multi-disciplinary team participation could effectively improve the anxiety and depression of family members of patients with advanced cancer.