整合式心理护理联合综合性营养干预对食管癌术后放疗患者心理健康状况营养状况及癌因性疲乏的影响

Effects of integrated psychological nursing combined with comprehensive nutrition intervention on mental health status,nutritional status and cancer-related fatigue of patients with esophageal cancer undergoing radiotherapy after operation

目的探讨整合式心理护理联合综合性营养干预对食管癌术后放疗患者心理健康状况、营养状况、癌因性疲乏及生活质量的影响。方法将228例食管癌患者按随机数字表法分为对照组和观察组,各114例。对照组采取常规护理干预,观察组在此基础上采取整合式心理护理联合综合性营养干预,观察4周。干预前后采用症状自评量表评定患者的心理健康状况,检测其营养状况(前白蛋白、白蛋白、转铁蛋白),采用Piper疲乏量表评定患者的癌因性疲乏,采用癌症患者生活功能指数量表评定患者的生活质量。结果(1)心理健康状况:干预后两组症状自评量表的恐怖症状、焦虑情绪、抑郁情绪、敌对态度维度评分均较干预前显著降低(P<0.01),观察组显著低于对照组(P<0.01)。(2)营养状况:干预后两组前白蛋白、白蛋白、转铁蛋白含量均较干预前显著降低(P<0.01),但观察组显著高于对照组(P<0.01)。(3)癌因性疲乏:干预后观察组癌因性疲乏状况较干预前显著改善(P<0.01),且显著优于对照组(P<0.01);干预前后对照组癌因性疲乏状况比较差异无统计学意义(P>0.05)。(4)生活质量:干预后两组癌症患者生活功能指数量表的躯体健康能力、心理健康、社会关系健康、癌症造成的负担维度评分较干预前显著升高(P<0.01),观察组显著高于对照组(P<0.01)。结论整合式心理护理联合综合性营养干预可明显改善食管癌术后放疗患者的心理健康状况及营养状况,减轻其癌因性疲乏,提高生活质量。

Objective To explore the effects of integrated psychological nursing combined with comprehensive nutrition intervention on mental health status,nutritional status,cancer-related fatigue and life quality of patients with esophageal cancer undergoing radiotherapy after operation.Methods A total of 228 patients with esophageal cancer were randomly divided into control group and observation group according to random number table method,with 114 cases in each group.The control group received routine nursing,and the observation group received integrated psychological nursing combined with comprehensive nutrition intervention on the basis of the control group for 4 weeks.Mental health status of patients was assessed by the self-report symptom inventory,symptom cheek list 90(SCL-90)before and after intervention,and nutritional status(prealbumin,albumin,transferrin)was detected.Piper fatigue scale(PFS)was used to assess cancer-related fatigue,and the functional living index cancer(FLIC)was used to assess life quality of patients.Results(1)Mental health status:After intervention,the scores of horror symptom,anxiety,depression,and hostile attitude of SCL-90 in the observation group were significantly lower than those in the control group(P<0.01),and the observation group was significantly lower than the control group(P<0.01).(2)Nutritional status:After intervention,the contents of prealbumin,albumin and transferrin in the two groups were significantly decreased compared with those before intervention(P<0.01),but the observation group was significantly higher than the control group(P<0.01).(3)Cancer-related fatigue:After intervention,cancer-related fatigue in the observation group was significantly improved compared with that before intervention(P<0.01),and was significantly better than that in the control group(P<0.01).There was no significant difference in cancer-related fatigue in the control group before and after intervention(P>0.05).(4)Quality of life:After intervention,the scores of physical health ability,mental health,social relationship health and burden caused by cancer of FLIC in the two groups were significantly higher than those before intervention(P<0.01),and the observation group was significantly higher than the control group(P<0.01).Conclusions Integrated psychological nursing combined with comprehensive nutrition intervention can significantly improve the mental health status and nutritional status of patients with esophageal cancer undergoing radiotherapy after operation,reduce cancer-related fatigue,and improve the quality of life.