接纳与承诺疗法干预对乳腺癌术后患者创伤后成长的影响

Effect of continued acceptance and commitment therapy intervention on post-traumatic growth of postoperative patients with breast cancer

目的评价接纳与承诺疗法干预对乳腺癌术后患者创伤后成长的影响。方法根据住院时间将120例乳腺癌患者分为观察组62例和对照组58例,2017年1-12月的58例患者设为对照组,行常规的健康教育和出院随访,住院期间行接纳与承诺疗法干预3次;选择2018年1-12月的62例患者设为观察组,在对照组基础上,于出院后2~3个月对患者继续行接纳与承诺疗法干预3~4次。采用简体中文版创伤后成长评定量表(PTGI)测评患者干预前、出院时(即干预后)、出院2个月、出院3个月、出院6个月的创伤后成长状况。结果2组患者干预前创伤后成长评分差异无统计学意义(P>0.05),出院时(即干预后)观察组和对照组患者创伤后成长评分为(67.02±14.17)分和(66.93±14.24)分,均优于干预前的(51.72±11.65)分和(51.86±11.67)分,差异有统计学意义(t=7.634、7.725,P<0.05);出院3、6个月时,观察组患者的创伤后成长得分分别为(67.12±14.07)、(68.21±14.48)分,明显优于对照组的(54.17±11.64)、(54.02±11.12)分,差异有统计学意义(t=7.957、7.674,P<0.01)。结论住院期间的接纳与承诺疗法干预可有效提升乳腺癌术后患者创伤后成长,出院后继续接纳与承诺疗法干预可为患者提供院外延续性护理方案,在提升乳腺癌术后患者创伤后成长方面与对照组相比有更好的远期效果。

Objective To evaluate the effects of continued acceptance and commitment therapy intervention on post-traumatic growth of postoperative patients with breast cancer.Methods According to the hospitalization time,120 patients with breast cancer were divided into observation group(62 cases)and control group(58 cases).From January to December 2017,58 patients were used as control group.Regular health education and discharge follow-up were performed.Intervention with the commitment therapy 3 times;62 patients from January to December 2018 were selected as the observation group.On the basis of the control group,the patient continued to receive and commit the intervention for 3 to 4 times from February to March after discharge.The post-traumatic growth status of patients before,at the time of discharge(after the intervention),at the hospital for 2 months,at the hospital for 3 months,and at the hospital for 6 months was assessed using the Simplified Chinese version of the Post-Treatment Growth Rating Scale(PTGI).Results There was no significant difference in the post-traumatic growth scores between the two groups(P>0.05).The post-traumatic growth scores of the two groups were 67.02±14.17,66.93±14.24,which were better than 51.72±11.65,51.86±11.67 before the intervention(t=7.634,7.725,P<0.05).At 3 months and 6 months after discharge,the post-traumatic growth scores of the observation group were(67.12±14.07)and(68.21±14.48),which were significantly better than the control group(54.17±11.64).54.02±11.12),the difference was statistically significant(t=7.957,7.674,P<0.01).Conclusion Acceptance and commitment therapy intervention during hospitalization can effectively improve post-traumatic growth of postoperative patients with breast cancer.Continued admission and commitment therapy intervention after discharge can provide patients with out-of-hospital continuous care programs to improve post-traumatic growth of postoperative patients with breast cancer.It has a better long-term effect than the control group.