营养支持联合集体心理治疗对胃癌患者术后心理弹性及并发症发生率的影响

Effects of nutritional support combined with group psychotherapy on postoperative psychological resilience and complication rate of patients with gastric cancer

目的探讨营养支持联合集体心理治疗对胃癌患者术后心理弹性及并发症发生率的影响。方法将200例胃癌患者按建档顺序分为研究组(102例)和对照组(98例),均行腹腔镜胃癌根治术治疗,术后对照组给予常规护理及营养支持,研究组在对照组基础上予以集体心理治疗。比较两组并发症发生率、患者满意度以及干预前后一般焦虑自评量表、抑郁自评量表、心理弹性量表、Herth希望量表、欧洲癌症治疗与研究组织生活质量量表评分。结果干预后两组焦虑自评量表、抑郁自评量表评分均较干预前显著降低(P<0.01),研究组显著低于对照组(P<0.01)。干预后两组心理弹性量表评分均较干预前显著提高(P<0.01),研究组显著高于对照组(P<0.01)。干预后两组Herth希望量表的同他人维系的亲密关系、看待现实及未来的积极态度维度评分均较干预前显著提高(P<0.01),研究组同他人维系的亲密关系、看待现实及未来的积极态度维度评分显著高于对照组(P<0.01),采取的积极行动维度评分略高于对照组,但差异无统计学意义(P>0.05)。干预后两组欧洲癌症治疗与研究组织生活质量量表评分均较干预前显著提高(P<0.01),研究组显著高于对照组(P<0.01)。研究组并发症发生率显著低于对照组(P<0.05),患者满意度显著高于对照组(P<0.05)。结论营养支持联合集体心理治疗可显著改善胃癌患者术后焦虑抑郁情况,提高其心理弹性、希望水平、生活质量及患者满意度,推广应用价值较高。

Objective To explore the effects of nutritional support combined with group psychotherapy on postoperative psychological resilience and complication rate of patients with gastric cancer.Methods A total of 200 patients with gastric cancer were divided into study group(102 cases)and control group(98 cases)according to the order of filing,and all of them received laparoscopic radical gastrectomy.The patients in the control group were given conventional nursing and nutritional support after operation.The study group was given group psychotherapy on the basis of the control group.The complication rate,patient satisfaction,self-rating anxiety scale(SAS),self-rating depression scale(SDS),Connor-Davidson resilience scale(CD-RISC),Herth hope index(HHI),European organization for research and treatment of cancer,quality of life questionnaire core 30(EORTC QLQ-C30)before and after intervention were compared between the two groups.Results The SAS and SDS scores of the two groups after intervention were significantly lower than those before intervention(P<0.01),and the study group was significantly lower than the control group(P<0.01).The scores of CD-RISC in both groups after intervention were significantly higher than those before intervention(P<0.01),and the study group was significantly higher than the control group(P<0.01).The scores of close relationship with others,positive attitude towards reality and future of HHI in both groups after intervention were significantly improved compared with those before intervention(P<0.01).The scores of close relationship with others,positive attitude towards reality in the study group were significantly higher than those in the control group(P<0.01),and the score of positive action was slightly higher than that of the control group,and the difference was not statistically significant(P>0.05).The scores of EORTC QLQ-C30 in both groups after intervention were significantly higher than those before intervention(P<0.01),and the study group was significantly higher than the control group(P<0.01).The complication rate of the study group was significantly lower than that of the control group(P<0.05),and the patient satisfaction was significantly higher than that of the control group(P<0.05).Conclusions Nutritional support combined with group psychotherapy can significantly improve postoperative anxiety and depression in patients with gastric cancer,improve their psychological resilience,hope level,quality of life and patient satisfaction,and have high application value.