阶段性认知行为干预在行化学治疗肺癌患者中的应用效果

Application effect of staged cognitive behavioral intervention in lung cancer patients undergoing chemotherapy

目的分析阶段性认知行为干预在行化学治疗(简称“化疗”)肺癌患者中的应用效果。方法以2019年10月至2021年8月江南大学附属医院行化疗的180例肺癌患者为研究对象,根据随机数字表法将其分为对照组和观察组,各90例。对照组患者实施常规护理结合心理干预,观察组患者基于对照组的护理方案实施阶段性认知行为干预。比较2组的免疫指标水平、生存质量、心理状态和不良反应发生率。结果干预4周后,2组生存质量核心量表(QLQ-C30)的功能和整体生活质量领域评分均高于干预前,QLQ-C30症状领域评分和肺癌特异性量表评分均低于干预前,且观察组的上述评分均优于对照组,差异均有统计学意义(P均<0.05)。干预4周后,2组的免疫球蛋白(IgM、IgG)、自然杀伤细胞活性和CD4^(+)水平均高于干预前(P均<0.05),且观察组均高于对照组(P均<0.05)。干预4周后,2组的抑郁自评量表和焦虑自评量表评分均低于干预前(P均<0.05),且观察组均低于对照组(P均<0.05)。观察组的过敏、骨髓抑制、神经毒性和消化道反应发生率均低于对照组(P均<0.05)。结论行化疗的肺癌患者接受阶段性认知行为干预有助于提高其生存质量和免疫功能,缓解其不良情绪,降低不良反应发生率。

Objective To analyze the application effect of staged cognitive behavioral intervention in the patients with lung cancer undergoing chemotherapy.Methods A total of 180 lung cancer patients who underwent chemotherapy in the Affiliated Hospital of Jiangnan University from October 2019 to August 2021 were selected as the research objects.They were allocated into control and observation groups by the use of a random number table,each with 90 cases.The patients in the control group were given routine nursing combined with psychological intervention,and the patients in the observation group were given staged cognitive behavioral intervention based on the nursing plan of the control group.The immune indicator levels,quality of life,psychological state,and incidence of adverse reactions were compared between the two groups.Results After 4 weeks of intervention,the scores of function and overall quality of life domain of quality of life questionnaire-core 30(QLQ-C30)in both groups were higher than those before the intervention,and the scores of QLQ-C30 symptom domain and lung cancerspecific questionnaire were lower than those before the intervention(all P<0.05).The above scores of the observation group were better than those of the control group(all P<0.05).After 4 weeks of intervention,the levels of immunoglobulin(IgM,IgG),natural killer cell activity,and CD4^(+)in both groups were higher than those before the intervention(all P<0.05),and the levels in the observation group were higher than those in the control group(all P<0.05).After 4 weeks of intervention,the scores of self-rating depression scale and self-rating anxiety scale in both groups were lower than those before the intervention(all P<0.05),and the scores in the observation group were lower than those in the control group(both P<0.05).The incidences of allergy,myelosuppression,neurotoxicity,and gastrointestinal reactions in the observation group were lower than those in the control group(all P<0.05).Conclusion Staged cognitive behavioral intervention for lung cancer patients undergoing chemotherapy can help improve their quality of life and immune function,relieve their negative emotions,and reduce the incidence of adverse reactions.