问题提示清单配合共享决策指导干预对肺癌患者术后心理状态及复发恐惧的影响

Influence of problem prompt list combined with shared decision-making guidance intervention on postoperative psychological status and fear of recurrence in patients with lung cancer

目的:观察问题提示清单配合共享决策指导干预对肺癌患者术后心理状态及复发恐惧的影响。方法:选取某院2023年1-12月肺癌患者473例纳入研究,使用数字编号信封法将其随机分为观察组(n=236)和对照组(n=237),两组患者均给予手术治疗和常规护理干预,对照组给予问题提示清单护理,观察组在以上基础上给予共享决策指导。比较两组患者干预前后的心理状态[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)]、复发恐惧[癌症复发恐惧量表(FCRI)]和生活质量[WHO生活质量测定简表(WHO-Qol-BREF)]差异,记录两组患者术后并发症发生率并比较。结果:经干预后,观察到两组患者在HAMA、HAMD以及FCRI评分上均呈显著降低趋势(t=27.353,19.549,23.827,25.247,17.674,22.294;P<0.05),并且观察组评分降低幅度明显大于对照组(t=2.378,2.651,2.304;P<0.05);此外,两组患者在心理、生理、环境以及社会关系4个领域的评分均较干预前有显著上升趋势(t=24.031,20.165,13.324,16.801,21.271,17.236,10.603,13.977;P<0.05),而观察组在这些领域的提升幅度上明显高于对照组(t=2.445,2.553,2.799,2.787;P<0.05);在术后并发症发生率上,观察组也表现出明显低于对照组的趋势(χ^(2)=10.774,P<0.05)。结论:肺癌患者术后给予问题提示清单配合共享决策指导干预可有效改善患者心理状态,降低患者术后复发恐惧感,提高患者生活质量,降低术后并发症发生风险。

Objective:To observe the influence of problem prompt list combined with shared decision-making guidance intervention on postoperative psychological status and fear of recurrence in patients with lung cancer.Methods:A total of 473 patients with lung cancer from January 2023 to December 2023 in Henan Cancer Hospital were randomly selected and included in the study.The above patients were randomized into observation group(n=236)and control group(n=237)by digital number envelope method.Both groups were given surgical treatment and routine nursing intervention,and the control group received problem prompt list nursing while the observation group was given shared decision-making guidance on the basis.The psychological status[Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD)],fear of recurrence[Fear of Cancer Recurrence Inventory(FCRI)]and quality of life[WHO Quality of Life Scale(WHO-Qol-BREF)]were compared before and after intervention.The incidence rates of postoperative complications were recorded and compared.Results:After intervention,the scores of HAMA,HAMD and FCRI in the two groups showed significant decreasing trends(t=27.353,19.549,23.827,25.247,17.674,22.294;P<0.05),and the decreases of the above scores were significantly greater in observation group than those in control group(t=2.378,2.651,2.304;P<0.05).In addition,the scores of the two groups of patients in the four fields of psychology,physiology,environment and social relations were significantly increased than those before intervention(t=24.031,20.165,13.324,16.801,21.271,17.236,10.603,13.977;P<0.05),and the increases of these fields in observation group were significantly higher(t=2.445,2.553,2.799,2.787;P<0.05).The incidence rates of postoperative complications in observation group were obviously lower in comparison with control group(χ^(2)=10.774,P<0.05).Conclusion:The postoperative application of problem prompt list combined with shared decision-making guidance intervention in patients with lung cancer can effectively improve the psychological status,reduce the fear of recurrence after surgery,enhance the quality of life,and lower the risk of postoperative complications.