团体认知行为管理对甲状腺癌患者治疗依从性和生活质量的影响

Effect of group cognitive behavioral management on treatment adherence and quality of life in thyroid cancer patients

目的 探讨团体认知行为管理对甲状腺癌患者治疗依从性和生活质量的影响。方法 将2019年2月至2020年2月实施团体认知行为管理前的甲状腺癌患者纳入对照组(n=57),2020年3月至2021年1月实施团体认知行为管理后的甲状腺癌患者纳入观察组(n=63),对照组接受常规护理,观察组在对照组的基础上进行团体认知行为管理。比较两组患者的心理状态[医院焦虑抑郁量表(HADS)]、治疗依从性[8条目Morisky药物依从性量表(MMAS-8)]、生活质量[健康调查简表(SF-36)],记录两组患者术后恢复情况及并发症发生情况。结果 干预后,两组患者焦虑、抑郁评分均低于入院时,且观察组患者焦虑、抑郁评分均低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者治疗依从率高于对照组,并发症总发生率低于对照组,差异均有统计学意义(P﹤0.05)。观察组患者术后视觉模拟评分法(VAS)评分明显低于对照组,首次下床时间、住院时间均明显短于对照组,差异均有统计学意义(P﹤0.01)。干预后,两组患者SF-36量表各维度评分均高于入院时,且观察组患者SF-36量表各维度评分均高于对照组,差异均有统计学意义(P﹤0.05)。结论 团体认知行为管理应用于甲状腺癌患者,可显著提高患者依从性,改善心理状态,促进术后恢复,降低并发症发生率,从而提高生活质量。

Objective To investigate the effect of group cognitive behavioral management on treatment adherence and quality of life in thyroid cancer patients.Method A total of 57 thyroid cancer patients before the group cognitive be-havioral management from February 2019 to February 2020 were included in the control group(received routine nurs-ing),and 63 patients after the group cognitive behavioral management from March 2020 to January 2021 were included in the observation group(received routine nursing and additional group cognitive behavioral management).The psycho-logical states[hospital anxiety and depression scale(HADS)],treatment adherence[8-item Morisky medication adher-ence scale(MMAS-8)],and quality of life[the MOS 36-item short form health survey(SF-36)]were compared between the two groups,and postoperative recovery and complications were recorded.Result After intervention,the scores of anx-iety and depression in both groups were lower than those at admission,with lower scores in the observation group than those in the control group(P<0.05);the treatment adherence rate of the observation group was higher,and total incidence of postoperative complications was lower than those in the control group(P<0.05);the postoperative visual analogue scale(VAS)score of the observation group was lower than that of the control group,the first ambulation time and hospi-talization time were shorter than those of the control group(P<0.01);after intervention,each dimensional scores of SF-36 in both groups were higher than those at admission,with higher scores in the observation group than those in the control group(P<0.05).Conclusion Group cognitive behavioral management for thyroid cancer patients can improve the adher-ence and psychological states,promote the postoperative recovery,reduce complications and improve the quality of life.