基于认知适应理论的干预策略对肺癌患者不良情绪、心理韧性、死亡态度的影响

Effects of an intervention strategy based on cognitive adaptation theory on maladaptive emotions,psychological resilience,and attitudes towards death in lung cancer patients

目的 探讨基于认知适应理论的干预策略对肺癌放化疗患者不良情绪、心理韧性、死亡态度的影响。方法 选取安徽省界首市中医院2021年3月至2023年9月收治的肺癌放化疗患者86例,按照随机数字表法将其分为对照组和观察组,各43例。对照组采取常规护理干预,观察组基于认知适应理论进行护理干预。比较两组干预前、干预2个月后的焦虑自评量表(SAS)、抑郁自评量表(SDS)、心理韧性量表、死亡态度描绘量表(DAP-R)评分。结果 干预前,两组SAS、SDS评分比较,差异无统计学意义(P>0.05);干预后,两组SAS、SDS评分较干预前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。干预前,两组乐观、坚韧、自强评分比较,差异无统计学意义(P>0.05);干预后,两组乐观、坚韧、自强评分较干预前升高,且观察组高于对照组,差异有统计学意义(P<0.05)。干预前,两组死亡恐惧、死亡逃避、自然接受、逃离接受、趋近接受评分比较,差异无统计学意义(P>0.05);干预后,两组自然接受评分高于干预前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论 基于认知适应理论的干预方案可改善肺癌放化疗患者心理韧性与不良情绪,减轻患者对死亡的逃避与恐惧心理。

Objective To explore the effects of an intervention strategy based on cognitive adaptation theory on maladaptive emotions,psychological resilience,and attitudes towards death in patients undergoing radiotherapy for lung cancer.Methods Eighty-six cases of lung cancer radiotherapy patients admitted to Jieshou Hospital of Traditional Chinese Medicine in Anhui Province from March 2021 to September 2023 were selected and they were divided into control group and observation group of 43 cases each according to the random number table method.The control group adopted conventional nursing interventions,and the observation group carried out nursing interventions based on cognitive adaptation theory.The self-rating anxiety scale(SAS),self-rating depression scale(SDS),mental toughness scale,and death attitude profile-revised(DAP-R)scores of the two groups were compared before the intervention and after two months of intervention between the two groups.Results Before intervention,there were no statistically significant differences in the SAS and SDS scores between the two groups(P>0.05);after intervention,the SAS and SDS scores of the two groups were lower than before intervention,and those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).Before intervention,there were no statistically significant differences in optimism,resilience,and self-improvement scores between the two groups(P>0.05);after intervention,the optimism,resilience,and self-improvement scores of the two groups were higher than before intervention,and those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Before intervention,there were no statistically significant differences in the scores of fear of death,death avoidance,natural acceptance,fleeing acceptance,and converging acceptance between the two groups(P>0.05);after intervention,the scores of natural acceptance of the two groups were higher than before intervention,and those in the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Conclusion An intervention programme based on cognitive adaptation theory improves psychological resilience and maladaptive emotions in patients undergoing radiotherapy for lung cancer and reduces patients’avoidance and fear of death.