正念减压疗法对骨肉瘤膝关节置换术后患者不良情绪、膝关节功能、睡眠及生活质量的影响

Effects of mindfulness-based stress reduction on negative emotion,knee joint function,sleep quality and quality of life in patients with osteosarcoma after knee arthroplasty

目的探讨正念减压疗法对骨肉瘤膝关节置换术后患者不良情绪、膝关节功能、睡眠及生活质量的影响。方法根据干预措施的不同将120例骨肉瘤膝关节置换术后患者分为正念组(n=65)和常规组(n=55),常规组患者接受常规干预措施,正念组患者在常规干预的基础上接受正念减压疗法,两组患者均干预4周。比较干预前及干预4周后两组患者的不良情绪[焦虑自评量表(SAS)评分和抑郁自评量表(SDS)评分]、膝关节功能(Harris评分)、睡眠质量[匹兹堡睡眠质量指数(PSQI)量表评分]及生活质量。采用多因素Logistic回归模型分析正念减压干预效果的影响因素。结果干预后,两组患者的SAS、SDS及PSQI评分均低于本组干预前,且正念组患者的SAS、SDS及PSQI评分均低于常规组,差异均有统计学意义(P<0.05)。干预后,两组患者的Harris评分均高于本组干预前,且正念组患者的Harris评分高于常规组,差异均有统计学意义(P<0.05)。干预后,两组患者的生理功能、心理功能、社会关系、治疗评分均低于本组干预前,且正念组患者的上述评分均低于常规组,差异均有统计学意义(P<0.05)。多因素Logistic回归分析结果显示,年龄、干预形式及家庭练习均是正念减压干预效果的影响因素(P<0.01)。结论正念减压疗法能够缓解骨肉瘤膝关节置换术后患者的焦虑和抑郁情绪,提高膝关节功能,改善睡眠及生活质量,且相较于青少年,成年人的干预效果更加显著。

Objective To investigate the effect of mindfulness-based stress reduction(MBSR)on negative emotion,knee joint function,sleep quality and quality of life in patients with osteosarcoma after knee arthroplasty.Method According to the different intervention measures,120 patients with osteosarcoma after knee arthroplasty were divided into mindfulness group(n=65)and conventional group(n=55).Patients in the conventional group received conventional intervention,while patients in the mindfulness group received MBSR on the basis of conventional intervention.Both groups were intervened for 4 weeks.The negative emotions[scores of self-rating anxiety scale(SAS)and self-rating depression scale(SDS)],knee joint function(Harris scores),sleep quality[scores of Pittsburgh sleep quality index(PSQI)]and quality of life were compared between the two groups before and after 4 weeks of intervention.Multivariate Logistic regression model was used to analyze the factors affecting the effect of MBSR.Result After the intervention,the SAS,SDS and PSQI scores of the two groups were lower than those before the intervention,and the SAS,SDS and PSQI scores of the mindfulness group were lower than those of the conventional group(P<0.05).After the intervention,the Harris score of the two groups was higher than that before the intervention,and the Harris score of the mindfulness group was higher than that of the conventional group,the differences were statistically significant(P<0.05).After the intervention,the scores of physiological function,psychological function,social relationship and treatment of the two groups were lower than those before the intervention,and the above scores of the mindfulness group were lower than those of the conventional group,the differences were statistically significant(P<0.05).Multivariate Logistic regression analysis showed that age,intervention form and family practice were the influencing factors of MBSR effect(P<0.01).Conclusion The MBSR can reduce the level of anxiety and depression,and can improve knee joint function,sleep quality and quality of life in patients with osteosarcoma after knee arthroplasty,and compared with adolescents,the MBSR has more significant effect on adults.