接纳与承诺疗法用于干预终末期癌痛患者的效果

Effect of acceptance and commitment therapy in patients with end-stage cancer pain

目的探讨接纳与承诺疗法(ACT)用于干预终末期癌痛患者的效果。方法选取2018年1月至2019年1月在江苏省肿瘤医院进行终末期癌痛护理的100例患者,随机分为对照组与研究组,每组50例。两组患者入院后均行常规镇痛治疗与常规终末期癌痛护理,研究组另给予以接纳与承诺疗法为核心的心理灵活性护理。通过对比两组患者的生活质量评价表(QOL)、焦虑自评量表(SAS)与抑郁自评量表(SDS)、中文版接纳与行动问卷(AAQ-Ⅱ)以及KPS评分,评价临床护理效果。结果护理后,研究组QOL评分中的社会/家庭、生理、躯体功能及情感4个维度评分、KPS评分显著高于对照组(P<0.05);SAS、SDS评分与AAQ-Ⅱ评分显著低于对照组(P<0.05)。结论ACT能够提高患者心理灵活性,减轻患者心理痛苦,缓解患者不良情绪,进而间接增强药物镇痛效果并提高患者生活质量,是一种可进行临床推广使用的有效护理干预方法。

Objective To investigate the effect of acceptance and commitment therapy(ACT)on the patients with end-stage cancer pain.Methods A total of 100 patients with end-stage cancer pain in Jiangsu Cancer Hospital from January 2018 to January 2019 were randomly divided into control group and study group,with 50 patients in each group.After admission,both groups of the patients received conventional analgesia treatment and end-stage cancer pain care.And the patients in research group were treated with psychological flexibility care with acceptance and commitment therapy as the core.The scores of quality of life(QOL),self-rating anxiety scale(SAS),self-rating depression scale(SDS),the Chinese version of acceptance and action questionnaire(AAQ-Ⅱ)and KPS score were evaluated to explore the clinical nursing effect.Results After the intervention of nursing,the scores of social/family,physiological,physical function and emotional four dimensions of QOL and KPS in the study group were significantly higher than those in the control group(P<0.05).The scores of SAS,SDS and AAQ-Ⅱwere significantly lower than control group(P<0.05).Conclusions The psychological flexibility of patients can be improved by the method of ACT.And the psychological pain and bad mood can be relieved,which indirectly enhances the analgesic effect of drugs and improves patients'quality of life.It is an effective nursing intervention method which can be promoted in clinic.