ACT干预对直肠癌Miles术后肠造口患者心理弹性、自护能力及生活质量的影响

Effect of ACT intervention on mental resilience,self-care ability and quality of life in patients with Miles postoperative enterostomy for rectal cancer

目的探讨实施接纳与承诺疗法(acceptance and commitment therapy,ACT)对直肠癌行腹会阴联合直肠癌根治术(Miles术)后肠造口患者的心理弹性、自护能力及生活质量的影响。方法选取2020年1月-2023年1月绵阳市肿瘤医院普外科收治的直肠癌Miles术后肠造口患者86例作为研究对象,按照入院先后顺序分为对照组与试验组,每组各43例。对照组给予常规护理干预,试验组在对照组基础上给予ACT干预,比较两组护理后心理弹性(坚韧、自强、乐观评分)、自护能力(自我责任、自护技能、自我概念、健康知识评分)及生活质量(Stoma-QOL评分)。结果护理后,试验组坚韧、自强、乐观各维度评分高于对照组(P<0.05)。护理后,试验组自我责任、自护技能、自我概念、健康知识各维度评分均高于对照组(P<0.05)。护理后,试验组Stoma-QOL评分高于对照组(P<0.05)。结论采用ACT干预对直肠癌根治术后肠造口患者的心理弹性、自护能力及生活质量均有改善作用。

Objective To explore the effect of acceptance and commitment therapy(ACT)on psychological resilience,self-care ability and quality of life of rectal cancer patients with enterostomy after Miles operation.Methods A total of 86 rectal cancer patients with enterostomy after Miles surgery admitted to the General Surgery Department of Mianyang Cancer Hospital from January 2020 to January 2023 were selected as the research objects.According to the order of admission,they were divided into the control group and the experimental group,with 43 cases in each group.The control group was given routine nursing intervention,and the experimental group was given ACT intervention on the basis of the control group.The psychological resilience(scores of tenacity,self-reliance and optimism),self-care ability(scores of self-responsibility,self-care skills,self-concept and health knowledge)and quality of life(scores of Stoma QOL)were compared between the two groups after nursing.Results After nursing,the scores of tenacity,self-reliance and optimism in the experimental group were higher than those in the control group(P<0.05).After nursing,the scores of self-responsibility,self-care skills,self-concept and health knowledge in the experimental group were higher than those in the control group(P<0.05).After nursing,the Stoma-QOL score of the experimental group was higher than that of the control group(P<0.05).Conclusion ACT intervention can improve the psychological resilience,self-care ability and quality of life of patients with enterostomy after radical resection of rectal cancer.