运动心理睡眠护理干预在乳腺癌患者放疗期间的应用效果观察

Exercise, psychological and sleep intervention in patients with breast cancer undergoing radiotherapy

目的 探讨运动―心理―睡眠护理干预在乳腺癌患者放疗期间的应用效果,分析其对患者癌因性疲乏及心理状态的影响。方法 选取2019年1月至2021年1月间青岛市中心医院接受放射治疗的86例乳腺癌患者,采用随机数表法将其分为对照组和观察组,每组43例。对照组患者采用常规护理,观察组则在此基础上加用运动―心理―睡眠护理干预,记录患者焦虑(HAMA)、抑郁(HAMD)不良心理状态变化情况,评价两组患者干预前后的生活质量和癌因性疲乏状况。结果 干预前,两组患者疲乏量表各项得分及总分、HAMA、HAMD量表得分和生活质量量表各项得分比较,差异无统计学意义(P>0.05)。干预后,两组疲乏量表各项得分均降低,观察组患者疲乏量表中行为、情感、感觉及总分均低于对照组,差异均有统计学意义(均P<0.05);观察组HAMA、HAMD量表得分均低于对照组,差异均有统计学意义(均P<0.05)。观察组患者生活质量量表各项评分均高于对照组,差异均有统计学意义(均P<0.05)。结论 与传统常规护理干预相比,运动―心理―睡眠护理干预可显著改善乳腺癌患者放疗期间的癌因性疲乏状况,缓解患者焦虑、抑郁的不良心理状态,进而提高其生活质量,应用效果良好,值得推荐。

Objective To explore the efficacy of exercise, psychological and sleep intervention in patients with breast cancer on radiotherapy, and to analyze the effect on cancer-related fatigue and psychological status. Methods Eighty-six patients with breast cancer undergoing radiotherapy were selected at Qingdao Central/Cancer Hospital from January 2019 to January 2021. They were randomly divided into an and observation group and a control with 43 patients in each group. The observation group received exercise, psychological and sleep intervention apart from routine nursing and the control group received routine nursing alone. Changes in adverse psychological status including Hamilton depression scale(HAMD) and Hamilton anxiety scale(HAMA) were recorded, and quality of life and cancer-related fatigue were evaluated in the two groups before and after the intervention. Results Before the intervention, there was no significant difference in the scores and overall scores of revised piper fatigue scale(PFS-R) scale, HAMA and HAMD scale and quality of life scale between the two groups(P>0.05). After the intervention, the scores of PFS-R scale decreased in the two groups. Behavior, emotion, feeling scores and overall scores of PFS-R scale were significantly lower in the observation group than in the control group(all P<0.05). The scores of HAMA and HAMD were significantly lower in the observation group than in the control group(all P<0.05). In addition, the scores of 36-item short form survey(SF-36) for quality of life were significantly higher in the observation group than in the control group(all P<0.05). Conclusion Compared with traditional nursing intervention, exercise, psychological and sleep intervention can significantly relieve cancer-related fatigue, lessen psychological state of anxiety and depression, and improve quality of life in patients with breast cancer on radiotherapy.