创造性故事疗法对全脑放疗相关轻度认知功能障碍的干预效果研究

Intervention effect of creative story therapy on mild cognitive dysfunction related to whole-brain radiotherapy

[目的]观察创造性故事疗法对脑转移癌全脑放疗相关轻度认知功能障碍(MCI)病人认知功能、疾病不确定感、健康行为的干预效果。[方法]将2018年4月—2019年4月在广西医科大学附属肿瘤医院放疗科住院的85例脑转移癌全脑放疗后存在轻度认知功能障碍的病人随机分为对照组42例和干预组43例。两组均参加12周共12次病区开展的健康宣教会,干预组的健康宣教会内容增加创造性故事疗法干预活动。于第1次干预前、最后1次干预结束,分别采用简明精神状态量表(MMSE)评估病人认知功能;采用中文版Mishel疾病不确定感量表(MUIS)评估病人疾病不确定感水平;采用健康促进生活方式量表Ⅱ(HPLPⅡ)评定病人的健康行为状况。[结果]干预前两组MMSE得分比较差异无统计学意义(P>0.05),干预后干预组MMSE量表中注意力与计算力、延迟回忆、语言维度以及总分均高于对照组(P均<0.05)。干预前两组MUIS量表得分比较差异无统计学意义(P>0.05),干预后干预组MUIS量表各维度得分及总分均低于对照组(P均<0.05)。干预前两组HPLPⅡ得分比较差异无统计学意义(P均>0.05),干预后干预组HPLPⅡ量表各维度得分及总分均高于对照组(P均<0.05)。[结论]创造性故事疗法可改善脑转移癌全脑放疗病人认知功能障碍,降低病人疾病不确定感,促进病人改善个人健康生活方式。

Objective:To observe the intervention effect of creative story therapy on the cognitive function,disease uncertainty,and healthy behaviors of patients with brain metastasis and mild cognitive impairment(MCI)related to whole-brain radiotherapy.Methods:A total of 85 MCI patients with brain metastasis after whole-brain radiotherapy who hospitalized in the radiotherapy department in Affiliated Tumor Hospital of Guangxi Medical University from April 2018 to April 2019 were randomly divided into the control group(42 cases)and the intervention group(43 cases).Both groups of patients participated in 12 times of health evangelization sessions for 12 weeks,and the intervention group added creative story therapy intervention activities.Before the first intervention and at the end of the last intervention,the Concise Mental State Scale(MMSE)was used to evaluate the patients′cognitive function;the Chinese version of the Mishel Disease Uncertainty Scale(MUIS)was used to evaluate the patients′level of uncertainty.The Health Promoting Lifestyle Profile-II(HPLP-II)was used to assess the health behavior status of patients.Results:Before the intervention,there was no significant difference in MMSE scores between the two groups(P>0.05).After the intervention,the scores of attention and calculation ability,delayed recall,language dimension,and total score of the MMSE in the intervention group were higher than those of the control group(all P<0.05).Before the intervention,there was no statistically significant difference in the scores of the two groups of MUIS(P>0.05).After the intervention,the scores of each dimension and the total score of MUIS in the intervention group were lower than those in the control group(all P<0.05).Before the intervention,there was no significant difference in HPLP-II scores between the two groups(all P>0.05).After the intervention,all dimensions and total score of HPLP-II in the intervention group were higher than those in the control group(all P<0.05).Conclusions:Creative story therapy could improve the cognitive dysfunction of patients with brain metastasis undergoing whole-brain radiotherapy,reduce the patients′disease uncertainty,and promote patients to improve their personal healthy lifestyle.