日常记录法对肺癌患者心理恐惧感及应对方式的影响

Effect of daily recording on psychological fear and coping style of lung cancer patients

目的:探讨日常记录法对肺癌患者心理恐惧感及应对方式的影响。方法:选取2017年4月-2019年4月来某院就诊的92例肺癌患者为研究对象,将患者随机分为观察组和对照组,每组46例。对照组患者实行常规护理干预,观察组患者在对照组基础上,由获得国家级心理咨询师的护理人员指导患者进行日常想法记录,记录内容包括日期、情绪、情境,自主想法以及合理回答等,干预时间为3个月。干预前后分别采用医学应对方式问卷(Medical coping modes questionnaire,MCMQ),恐惧疾病进展量表(Fear of progression Questionnaire-Short Form,FoP-Q-SF),简明癌症患者心理适应状况问卷(Mini Mental Adjustment to Cancer Scale,Mini-MAC-19)评估干预效果。结果:干预前,两组患者MCMQ中面对,回避,屈服等各得分量表均无明显差异;干预后,对照组患者各量表评分无明显差异,观察组患者面对量表评分显著高于干预前,回避和屈服量表得分均低于干预前,且与对照组相比具有明显统计学差异(t=-14.505,20.841,7.886;P<0.05);干预前,两组患者FoP-Q-SF评分无明显差异;干预后,观察组患者FoP-Q-SF评分下降,并显著低于对照组患者(t=7.518,P<0.001)。干预前,两组患者Mini-MAC-19评分无显著差异;干预后,观察组患者无助和焦虑评分明显低于对照组,积极态度得分明显高于对照组(t=10.162,14.642,-11.377,2.930;P<0.01)。结论:日常记录法能够降低肺癌患者的心理恐惧感,同时促进患者选择更为积极的面对癌症的应对方式,是改善癌症患者心理恐惧的有效方式。

Objective:To investigate the effect of daily recording on psychological fear and coping style of lung cancer patients.Methods:A total of 92 patients with lung cancer who came to our hospital from April to April 2019 in 2017 were enrolled.The patients were randomly divided into observation group and control group,with 46 cases in each group.Patients in the control group underwent routine nursing intervention,on the basis of the control group,the observation group received guidance from the nursing staff of the national psychological counselor to conduct daily thought records,including date,mood,situation,independent thinking and reasonable answer.The intervention time was 3 months.Before and after the intervention,the Medical Coping Mode Questionnaire(MCMQ),the Fear of Progress Questionnaire-Short Form(FoP-Q-SF),and the Concise Cancer Patients’Mental Adaptation Questionnaire(Mini Mental Adjustment to Cancer Scale,Mini-MAC-19)evaluated the effect of the intervention.Results:Before intervention,there was no significant difference in MCMQ score scales such as face,avoidance and yield between the two groups;After intervention,there was no significant difference in the scale scores of patients in the control group.The scale scores of patients in the observation group were significantly higher than that before intervention,and the scores of avoidance and yield scales were lower than that before intervention,and there were statistically significant differences compared with the control group(t=-14.505,20.841,7.886;P<0.05)Before intervention,there was no significant difference in FoP-Q-SF score between the two groups.After intervention,the FoP-Q-SF score in the observation group was significantly lower than that in the control group(t=7.518,P<0.0001).Before intervention,there was no significant difference in the Mini-MAC-19 scores of patients between the two groups;After intervention,all indexes of Mini-MAC-19 scale in both groups showed significant changes,The helplessness and anxiety scores of the patients in the observation group were significantly lower than those in the control group,and the positive attitude score was significantly higher than that of the control group.(t=10.162,14.642,-11.377,2.930;P<0.01).Conclusion:Daily recording method can reduce the psychological fear of lung cancer patients,and promote patients to choose a more positive way to deal with cancer.It is an effective way to improve the psychological fear of cancer patients,and it is worth further promotion.