自我超越思维构架下院内心理干预在结肠癌化疗患者中的应用观察

Effect of psychological intervention based on self-transcendence in patients with colon cancer undergoing chemotherapy

目的探讨自我超越思维构架下院内心理干预对结肠癌化疗患者自我效能、希望和自我超越水平、毒副反应的影响。方法纳入2017年2月至2019年1月我院收治的136例结肠癌患者为研究对象,随机分为对照组(实施常规院内心理干预,n=68)与观察组(在对照组干预前提下实施自我超越思维构架下院内心理干预,n=68)。分别于干预前及干预结束时,采用中文版Herth希望量表、中文版癌症自我管理效能量表(SUPPH)、中文版自我超越量表(STS)评估患者希望水平、自我效能水平及自我超越水平,并观察两组毒副反应发生情况。结果干预后,两组中文版Herth希望量表(对现实和未来的积极态度、采取的积极行动、与他人保持的亲密关系及总量表)、SUPPH量表(正性态度、自我减压、自我决策及总量表)、中文版STS量表总分高于干预前,且观察组上述各指标评分高于对照组,差异均有统计学意义(均P<0.05)。两组骨髓抑制、口腔黏膜炎、手足综合征及肝肾损害发生率比较差异均无统计学意义(均P>0.05)。观察组胃肠症状发生率为32.4%,低于对照组的50.0%,差异有统计学意义(P<0.05)。结论自我超越思维构架下院内心理干预能有效提高结肠癌化疗患者希望水平和自我效能,增强个体自我超越能力,减少胃肠道症状。

Objectives To investigate the effect of psychological intervention based on self-transcendence on self-efficacy,hope,self-transcendence level,and toxic side effects in patients with colon cancer undergoing chemotherapy.Methods One hundred and thirty-six patients with colon cancer treated at our hospital between February 2017 and January 2019 were recruited.Pa⁃tients were randomly assigned to the control group(n=68,receiving routine in-hospital psychological intervention)and the treat⁃ment group(n=68,receiving psychological intervention based on self-transcendence in addition to routine intervention).Herth Hope Scale(HHS)was used to measure hope,Strategies Used by People to Promote Health(SUPPH)was used to measure selfefficacy and Self-Transcendence Scale(STS)was used to measure self-transcendence level before and after the intervention.Tox⁃ic side effects were recorded.Results After the intervention,scores of HHS(inner sense of temporality and future,inner posi⁃tive readiness and expectancy,and interconnectedness with self and others,and total scale),SUPPH(positive attitude,stress reduc⁃tion,and making decision,and total scale),and STS increased in both group.They were significantly higher in the treatment group than in the control group(P<0.05).The incidence of bone marrow suppression,oral mucositis,hand-foot syndrome,and liv⁃er and renal function damage did not differ between the two groups(P>0.05).The incidence of gastrointestinal symptoms was 32.4%in the treatment group,which was significantly lower than in the control group(50%,P<0.05).Conclusion In patients with colon cancer undergoing chemotherapy,in-hospital psychological intervention based on self-transcendence increases patients’hope,self-efficacy,and self-transcendence level.It can also reduce patients’gastrointestinal symptoms.