认知行为干预对晚期前列腺癌去势手术后合并焦虑抑郁情绪患者的效果评价

Evaluation of cognitive behavior intervention for advanced prostate cancer patients with anxiety and depression after castration surgery

目的评价认知行为干预对晚期前列腺癌去势手术患者焦虑抑郁情绪及应对方式的影响。方法选取2015年1月至2018年11月广州军区广州总医院诊治的42例晚期前列腺癌去势手术后合并焦虑抑郁情绪患者作为研究对象。按照随机数字表法将其随机分成试验组(n=21)和对照组(n=21)。对照组按照相关诊疗标准进行药物治疗和常规护理;试验组在对照组基础上采用认知行为干预,每周3次。在干预前、术后第7天和术后第14天,用焦虑自评量表(SAS)和抑郁自评量表(SDS)分别评定两组患者的焦虑和抑郁情绪,用医学应对方式得分(MCMQ)评定两组患者应对行为。结果术后7天和术后第14天,试验组患者的SAS和SDS评分均低于对照组,差异具有统计学意义(均P<0.05),试验组SAS及SDS评分不同时点间差异均具有统计学意义(均P<0.001);干预7天后,两组患者面对得分及回避得分组间差异均具有统计学意义(均P<0.05),而屈服得分在干预14天后差异具有统计学意义(P<0.001),试验组面对得分比对照组高,回避得分及屈服得分比对照组低,试验组面对得分、回避得分及屈服得分不同时点间差异均具有统计学意义(均P<0.001)。随访治疗1年后的患者发现,试验组患者在认知功能、情绪功能、躯体功能、角色功能、社会功能、总体生活质量得分高于对照组,差异均具有统计学意义(均P<0.05)。结论认知行为干预能改善晚期前列腺癌去势手术后患者的焦虑抑郁负性情绪,改善应对方式,值得临床进一步推广。

Objective To evaluate the effect of cognitive behavioral intervention on the anxiety and depression and coping mode of prostate cancer patients after castration surgery. Methods 42 advanced prostate cancer patients with anxiety and depression after castration surgery in the General Hospital of Guangzhou Military Command of PLA between January 2015 to November 2018 were selected and randomly divided into control group(21 cases) and experimental group(21 cases). The control group received drug treatment and routine nursing, and the experimental group was given cognitive behavior intervention on the basis of the control group, 3 times a week. The Self-rating Anxiety Scale(SAS), the Self-rating Depression Scale(SDS) and Medical Coping Mode Questionnaire(MCMQ) were used to assess the anxiety, depression and coping mode respectively before intervention, and at 7 days and 14 days postoperative. Results The scores of SAS and SDS in the experimental group were significantly lower than those in the control group at 7 days and 14 days postoperative, with statistically significant differences(all P<0.05), and the differences in the scores of SAS and SDS among different time points were statistically significant in the experimental group(all P<0.001). After 7 days of intervention, the scores of facing coping style and avoidance coping mode of the experimental group were significantly better than those in the control group, with statistically significant differences(all P<0.05), and the scores of the resignation coping in the experimental group were significantly lower than those in the control group on the 14 th day(P<0.001). The differences in the facing coping style, the avoidance coping mode and the resignation coping mode among different time points were statistically significant in the experimental group(P<0.001). After one year of follow-up treatment, the scores of cognitive function, emotional function, physical function, role function, social function and overall quality of life in the experimental group were significantly higher than those in the control group(all P<0.05). Conclusions Cognitive behavioral intervention can significantly relieve the anxiety and depression and improve the coping mode of prostate cancer patients after castration surgery, which is worthy of clinical popularization and application.