认知行为干预对子宫内膜癌手术患者心理状态、自我效能及生活质量的影响

Effect of cognitive-behavioral intervention on the mental state,self-efficacy,and quality of life of patients undergoing endometrial carcinoma surgery

目的探讨认知行为干预对子宫内膜癌(EC)手术患者心理状态、自我效能及生活质量的影响。方法将接受手术治疗的127例子宫内膜癌患者根据干预方案不同分为对照组(n=66,接受常规干预)和观察组(n=61,接受常规干预+认知行为干预)。比较两组患者干预前后的心理状态、自我效能、生活质量改善情况并分析干预效果的影响因素。结果两组患者术中出血量、术后抗生素使用时间比较,差异均无统计学意义(P﹥0.05);观察组患者术后住院时间明显短于对照组(P﹤0.01)。干预后,两组患者的焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分均明显低于本组干预前,自我效能感量表(GSES)评分明显高于本组干预前,差异均有统计学意义(P﹤0.01);且观察组患者的SAS、SDS评分均明显低于对照组,GSES评分明显高于对照组,差异均有统计学意义(P﹤0.01)。干预后,两组患者生活质量(QOL)评分量表各维度评分均明显高于本组干预前(P﹤0.01),且观察组患者QOL量表各维度评分均明显高于对照组(P﹤0.01)。Logistic回归模型分析结果显示,年龄≥65岁、文化程度为小学及以下、SAS评分≥50分、SDS评分≥53分、GSES评分﹤30分、QOL评分﹤76分均是EC患者不良干预效果的独立危险因素(P﹤0.05)。结论认知行为干预可改善EC手术患者负性情绪,提高患者的自我效能及生活质量,是一种具有应用前景的新干预模式,可在临床进行推广。

Objective To investigate the effect of the cognitive-behavioral intervention(CBI)on the mental state,self-efficacy,and quality of life of patients undergoing endometrial carcinoma(EC)surgery.Method A total of 127 patients with EC who received surgical were divided into the control group(n=66,receiving the conventional intervention)and the observation group(n=61,receiving conventional intervention+cognitive-behavioral intervention)according to different intervention programs.The alternations of mental state,self-efficacy,and quality of life of the two groups of patients before and after intervention were compared,and the influencing factors of intervention effect were analyzed.Result There were no significant differences in the intraoperative blood loss volume and postoperative antibiotic use time between the two groups(P>0.05).The postoperative hospital stay in the observation group was significantly shorter than that in the control group(P<0.01).After the intervention,the scores of the self-rating anxiety scale(SAS)and the self-rating depression scale(SDS)of the two groups were significantly lower than their selves before the intervention,and the general self-efficacy scale(GSES)score was significantly higher than that before the intervention,the differences were statistically significant(P<0.01);the SAS and SDS scores of patients in the observation group were significantly lower than those of the control group,and the GSES scores were significantly higher than those of the control group,the differences were both statistically significant(P<0.01).After the intervention,the scores of each dimension of the quality of life(QOL)scale of the two groups were significantly higher than those of this group before the intervention(P<0.01),and the scores of each dimension of QOL in the observation group were significantly higher than those of the control group(P<0.01).Logistic regression model analysis showed that,age≥65 years old,education level of elementary school and below,SAS score≥34 points,SDS score≥25 points,GSES score<30 points,QOL score<76 points were independent risk factors for bad intervention effects in EC patients(P<0.05).Conclusion Cognitive-behavioral intervention could improve the negative emotions of patients receiving EC surgery and moderate their self-efficacy and quality of life.It is a denovo intervention model with promising applications and could be promoted in the clinical context.