远程个体化照护对乳腺癌创伤后应激障碍的影响

Effect of Remote Individualized Care on Post-Traumatic Stress Disorder of Breast Cancer

目的探究远程个体化照护对乳腺癌患者创伤后应激障碍(post-traumatic stress disorder,PTSD)的影响。方法收集2020年5月—2021年5月在福建医科大学附属第二医院甲乳外科接受手术治疗的200例乳腺癌PTSD患者,将患者按照随机数字表法分成对照组和观察组,每组各100例。观察组给予行为认知干预,包括认知重塑和行为训练两部分,认知重塑包括心理诊断、认知干预,行为训练包括运动行为干预、音乐疗法、放松训练。对照组进行常规护理。比较干预前后创伤后应激障碍量表(post-traumatic stress disorder self-rating scale,PTSDSS)、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)评分以及自我管理能力评分、并发症发生率。结果干预后观察组PTSD-SS总评分为(74.44±4.67)分,低于对照组的(80.55±2.88)分。观察组患者SDS评分为(53.34±4.33)分,低于对照组的(62.45±3.89)分,SAS评分为(51.28±2.37)分,低于对照组的(59.66±2.73)分,差异有统计学意义(P<0.05);采取干预前,两组患者的自我管理能力评分差异无统计学意义(P>0.05),干预后观察组患者自我管理能评分高于对照组,差异有统计学意义(P<0.05);观察组并发症总发生率(2.00%)低于对照组(15.00%),差异有统计学意义(P<0.05)。结论为达到降低乳腺癌术后所出现的创伤应激程度,可用远程个体化照护进行干预,对其心理有良好的改善效果。

Objective To explore the effect of remote individualized care on post-traumatic stress disorder(PTSD)in breast cancer patients.Methods A total of 200 patients with PTSD of breast cancer who received surgical treatment in the department of thyroid and breast surgery,the Second Affiliated Hospital of Fujian Medical University from May 2020 to May 2021 were collected and divided into control group and observation group according to random number table method,with 100 cases in each group.The observation group was given behavioral cognitive intervention,including cognitive remodeling and behavioral training.The cognitive remodeling included psychological diagnosis and cognitive intervention,while the behavioral training included exercise behavioral intervention,music therapy and relaxation training.The control group received routine nursing.Post-traumatic stress disorder self-rating scale(PTSD-SS),self-rating anxiety scale(SAS),self-rating depression scale(SDS),selfmanagement ability and complication rate were compared before and after the intervention.Results After intervention,the total score of PTSD-SS in the observation group(74.44±4.67)points was lower than that in the control group(80.55±2.88)points.SDS score of observation group was(53.34±4.33)points lower than that of control group(62.45±3.89)points,SAS score of observation group was(51.28±2.37)points lower than that of control group(59.66±2.73)points,the difference was statistically significant(P<0.05).Before intervention,there was no significant difference in the score of self-management ability between the two groups(P>0.05).After intervention,the score of self-management ability in the observation group was higher than that in the control group,and the difference was statistically significant(P<0.05).The total complication rate of observation group was 2.00%lower than that of control group(15.00%),and the difference was statistically significant(P<0.05).Conclusion In order to reduce the degree of traumatic stress after breast cancer surgery,remote individualized care can be used to intervene,which has a good effect on psychological improvement.