自我超越思维下干预策略在乳腺癌改良根治术患者中的应用

Improvement effect of intervention strategies under the framework of self-transcendence thinking in patients undergoing modified radical mastectomy

目的:探讨自我超越架构下干预策略对乳腺癌改良根治术患者心理负担、应对方式及希望水平的影响。方法:选择2018年2月至2019年2月广州医科大学附属第三医院及广州医科大学附属肿瘤医院收治的145例乳腺癌根治术患者作为研究对象,采用随机数字表法分为观察组(73例)及对照组(72例),对照组给予常规护理措施及健康指导,观察组在常规护理措施基础上给予自我超越思维架构下干预策略,于干预前及干预结束后1周采用自我超越量表(STS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)、简易应对方式量表(SCSQ)、Herth希望量表、自我管理效能量表、癌因性疲乏量表对患者自我超越水平、心理负担、应对方式、希望水平、自我效能、癌因性疲乏进行评价。结果:干预后观察组STS评分显著高于对照组,SDS、SAS评分显著低于对照组(t=4.278,-3.345,-3.393;P<0.05);干预后观察组积极应对得分高于对照组(t=2.037,P<0.05),消极应对得分低于对照组(t=-2.917,P<0.05);干预后观察组Herth希望量表中现实及未来积极态度、积极行动、与他人亲密关系3个维度得分显著高于对照组(t=5.581,2.239,3.447;P<0.05),自我效能量表中正性态度、自我减压维度得分显著高于对照组(t=3.963,5.372;P<0.05);干预后观察组认知疲乏、情感疲乏及总疲乏评分显著低于对照组(t=-3.005,-4.584,-2.623;P<0.05)。结论:自我超越思维架构下的干预策略可改善乳腺癌改良根治术患者心理负担,帮助患者积极应对疾病,提高自身希望水平及自我效能,减轻癌因性疲乏。

Objective:To explore the effects of intervention strategies under the framework of self-transcendence thinking on psychological burden,coping styles and hope level in patients undergoing modified radical mastectomy.Methods:A total of 145 patients undergoing radical mastectomy in The Third Affiliated Hospital of Guangzhou Medical University and Affiliated Cancer Hospital and Institute of Guangzhou Medical University were enrolled as the research objects between February 2018 and February 2019.They were divided into observation group(73 cases)and control group(72 cases)by random number table method.The control group was given routine nursing measures and health guidance.On basis of routine nursing measures,observation group was given nursing strategies under the framework of self-transcendence thinking.Before intervention and at 1 week after intervention,self-transcendence,psychological burden,coping styles,hope level,self-efficacy and cancer-related fatigue were evaluated by Self-Transcendence Scale(STS),self-rating anxiety scale(SAS),self-rating depression scale(SDS),simplified coping style questionnaire(SCSQ),Herth hope scale,self-management efficacy scale and cancer-related fatigue scale.Results:After intervention,scores of STS in observation group were significantly higher than those in control group,while the SDS and SAS were significantly lower than those in control group(t=4.278,-3.345,-3.393;P<0.05),score of positive coping was higher than that in control group(t=2.037,P<0.05),and score of negative coping was lower than that in control group(t=-2.917,P<0.05).After intervention,scores of Herth hope scale(positive attitudes to reality and future,positive actions,intimacy with others)in observation group were significantly higher than those in control group(t=5.581,2.239,3.447;P<0.05),and scores of self-efficacy scale(positive attitude,self-decompression)were significantly higher than those in control group(t=3.963,5.372;P<0.05).After intervention,scores of cognition fatigue and emotion fatigue,and total scores of fatigue in observation group were significantly lower than those in control group(t=-3.005,-4.584,-2.623;P<0.05).Conclusion:Intervention strategies under the framework of self-transcendence thinking can improve psychological burden in patients undergoing modified radical mastectomy,help them positively cope with diseases,improve hope level and self-efficacy,and reduce cancer-related fatigue.