自我效能理论干预模式对肝癌经导管肝动脉化疗栓塞术后患者的影响

Impact of self-efficacy theory intervention model in patientswith hepatocellular carcinoma after transcatheterarterial chemoembolization

目的探讨基于自我效能理论的干预模式对肝癌经导管肝动脉化疗栓塞(TACE)术患者恐惧疾病进展(FoP)、负性情绪和癌因性疲乏的影响。方法回顾性分析94例原发性肝癌患者的临床资料,根据干预方式的不同将患者分为对照组和观察组,每组47例。对照组出院后实施常规护理,观察组实施基于自我效能理论的干预,2组均干预至出院后3个月。比较2组出院时和出院后1、3个月自我效能感[健康行为自我效能感量表(GSES)],出院时和出院后3个月的FoP[汉化版恐惧疾病进展简化量表(FoP-Q-SF)]、负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、癌因性疲乏[Piper疲乏修订量表(R-PFS)]、生存质量[肝癌患者生存质量测定量表(QOL-LC V2.0)]情况。结果出院后1、3个月,2组GSES评分相较出院时逐渐升高,且观察组评分高于对照组,差异有统计学意义(P<0.05);出院后3个月,2组FoP-Q-SF总分及各维度评分、SAS评分、SDS评分、R-PFS各维度评分均低于出院时,且观察组低于对照组,差异有统计学意义(P<0.05);出院后3个月,2组QOL-LC V2.0总分及各维度评分均高于出院时,且观察组高于对照组,差异有统计学意义(P<0.05)。结论基于自我效能理论的干预模式可提升原发性肝癌TACE术后患者自我效能感,减轻负性情绪及FoP程度,改善癌因性疲乏状况,提升生存质量。

Objective To explore the impact of the intervention model based on self-efficacy theory on fear of progression(FoP),negative emotions,and cancer-related fatigue in patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization(TACE).Methods The clinical data of 94 patients with primary liver cancer were retrospectively analyzed.The patients were divided into control group and observation group according to different intervention methods,with 47 patients in each group.The control group received routine nursing mode after discharge,while the observation group received intervention model based on self-efficacy theory.Both groups were intervened for 3 months after discharge.The self-efficacy[General Self-Efficacy Scale(GSES)]at discharge and one-and three-month after discharge,FoP[Fear of Progression Questionnaire-Short Form(FoP-Q-SF)],negative emotions[Self-rating Anxiety Scale(SAS),Self-rating Depression Scale(SDS)],cancer-related fatigue[Revised Piper Fatigue Scale(R-PFS)],and quality of life[Quality of Life Questionnaire for Liver Cancer Patients(QOL-LC V2.0)]at discharge and three-month after discharge were compared between the two groups.Results One month and three months after discharge,the GSES scores of both groups gradually increased compared to those at discharge,and the scores of the observation group were higher than those of the control group(P<0.05).Three months after discharge,the total and sub-dimension scores of FoP-Q-SF,SAS scores,SDS scores,and R-PFS were lower in both groups compared to those at discharge,and the observation group had lower scores than the control group(P<0.05).Three months after discharge,the total and sub-dimension scores of QOL-LC V2.0 were higher in both groups compared to those at discharge,and the observation group had higher scores than the control group(P<0.05).Conclusion The intervention model based on self-efficacy theory can enhance the self-efficacy of patients with primary liver cancer after TACE,relieve negative emotions and severity of FoP,improve cancer-related fatigue,and enhance the quality of life.