正念认知行为疗法对乳腺癌患者术后情绪 应对方式及希望水平的影响

Effects of mindfulness based cognitive therapy on postoperative mental state and hope level of breast cancer patients

目的探讨正念认知行为疗法对乳腺癌患者术后情绪、应对方式及希望水平的影响。方法将96例乳腺癌患者按照入院时间分为研究组与对照组,各48例。两组均给予常规干预,研究组在此基础上给予正念认知行为疗法干预,干预前后采用疾病认知问卷评定两组疾病认知情况,焦虑自评量表及抑郁自评量表评定焦虑抑郁状态,医学应对方式问卷评定应对方式,Herth希望量表评定希望水平,创伤后成长量表评定创伤后成长水平,比较两组护理满意度。结果干预后两组疾病认知问卷感知益处、接纳评分显著高于干预前(P<0.01),无助感评分显著低于干预前(P<0.01),研究组较对照组变化更显著(P<0.01);两组焦虑自评量表及抑郁自评量表评分均显著低于干预前(P<0.01),研究组较对照组下降更显著(P<0.01);两组医学应对方式问卷屈服、回避维度评分显著低于干预前(P<0.01),面对维度评分显著高于干预前(P<0.01),研究组较对照组变化更显著(P<0.01);两组Herth希望量表及创伤后成长量表各维度评分显著高于干预前(P<0.01),研究组较对照组升高更显著(P<0.01)。结论正念认知行为疗法能提高乳腺癌患者术后疾病认知度,缓解不良情绪,改善应对方式,提升创伤后成长水平、希望水平及护理工作满意度。

Objective To explore the effects of mindfulness based cognitive therapy(MBCT)on postoperative mental state and hope level of breast cancer patients.Methods A total of 96 patients with breast cancer were divided into study group and control group according to the time of admission,with 48 cases in each group.Both groups were given routine intervention,and the study group was given MBCT on this basis.Before and after the intervention,the disease cognition of the two groups was assessed by the illness cognition questionnaire(ICQ),the self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to assess the anxiety and depression status,the medical coping modes questionnaire(MCMQ)was used to assess the coping style,and the Herth hope index(HHI)was used to assess the level of hope,and the posttraumatic growth inventory(PTGI)was used to assess the level of post-traumatic growth.The nursing satisfaction of the two groups was compared.Results After intervention,the perceived benefit and acceptance scores of ICQ of the two groups were significantly higher than those before intervention(P<0.01),and the helplessness scores were lower than those before intervention(P<0.01),and the change in the study group was more significant than that in the control group(P<0.01).The SAS and SDS scores of the two groups were significantly lower than those before intervention(P<0.01),and the decrease of the study group was more significant than that of the control group(P<0.01).The yield and avoidance scores of MCMQ of the two groups were significantly lower than those before intervention(P<0.01),and the face scores were significantly higher than those before intervention(P<0.01),and the change in the study group was more significant than that in the control group(P<0.01).The scores of HHI and PTGI in two groups were significantly higher than those before intervention(P<0.01),the increase in the study group was more significant than that in the control group(P<0.01).Conclusions MBCT can improve the disease recognition of breast cancer patients after surgery,relieve bad emotions,improve coping styles,and improve post-traumatic growth level,hope level and nursing job satisfaction.