正念减压训练联合安宁疗护对肺癌脑转移患者癌痛程度、自我感受负担及尊严感的影响

Effect of Mindfulness-based Stress Reduction Training Combined with Hospice Care on Cancer Pain Degree,Self-perceived Burden,and Sense of Dignity in Patients with Brain Metastases of Lung Cancer

目的:探究正念减压训练联合安宁疗护对肺癌脑转移患者癌痛程度、自我感受负担及尊严感的影响。方法:选取2021年7月—2022年7月信阳市中心医院收治的94例肺癌脑转移患者作为研究对象,采用随机数表法将其分为对照组(n=47)和观察组(n=47),对照组给予常规护理,观察组在常规护理的基础上采用正念减压训练联合安宁疗护的模式干预3个月。比较干预前、干预3个月后,两组患者癌痛程度[简明疼痛量表(BPI)和视觉模拟疼痛评估量表(VAS)评分]、自我感受负担程度[自我感受负担量表(SPBS)评分]、尊严感[尊严感量表(PDI)评分]、生存质量[癌症患者生命质量测定量表(FACT)评分]差异。结果:干预后,两组患者BPI的当前疼痛程度、24 h内剧烈疼痛程度、24 h内轻微疼痛程度、24 h内平均疼痛程度评分均较干预前低,且观察组各项评分低于对照组,差异有统计学意义(t=3.079、2.152、2.308、3.288,P<0.05);干预后,两组患者情感、身体因素等自我负担程度相关SPBS评分均较干预前低,且观察组上述评分低于对照组,差异有统计学意义(t=3.064、3.543、3.013,P<0.05);干预后,两组患者疾病相关PDI尊严感评分均较干预前低,且观察组评分低于对照组,差异有统计学意义(t=3.191、2.570、3.296、2.943,P<0.05);干预后,两组患者FACT评分均较干预前高,且观察组评分高于对照组,差异有统计学意义(t=3.515、3.446、3.344、2.571,P<0.05)。结论:采用正念减压训练联合安宁疗护的模式对肺癌脑转移患者进行干预后,能够有效改善患者癌痛情况以及自我感受负担程度,提高患者尊严感以及生存质量。

Objective:To explore the effect of mindfulness-based stress reduction training combined with hospice care on cancer pain degree,self-perceived burden and sense of dignity in patients with brain metastases of lung cancer.Methods:94 patients with brain metastases of lung cancer admitted to the hospital from July 2021 to July 2022 were selected as research subjects,and they were divided into control group(n=47)and observation group(n=47)by random number table method.The control group was given routine nursing,and the observation group was treated with mindfulness-based stress reduction training combined with hospice care on the basis of the control group,and both groups were intervened for 3 months.Before intervention and after 3 months of intervention,the differences in cancer pain degree[Brief Pain Inventory(BPI),Visual Analogue Scale(VAS)],self-perceived burden degree[Self-Perceived Burden Scale(SPBS)],sense of dignity[Patient Dignity Inventory(PDI)]and quality of life[Functional Assessment of Cancer Therapy-Cancer(FACT)]were compared between the two groups of patients.Results:After intervention,the current pain degree,severe pain degree within 24 h,mild pain degree within 24 h and average pain degree score of BPI in both groups were lower than before intervention,and the scores in the observation group were lower than those in the control group,with statistically significant difference(t=3.079,2.152,2.308,3.288;P<0.05).After intervention,SPBS scores related to the degree of self-burden related to emotional and physical factors in both groups were lower than before intervention,and the scores above in the observation group were lower than those in the control group,with statistically significant difference(t=3.064,3.543,3.013;P<0.05).After intervention,disease-related PDI dignity scores in both groups were lower than before intervention,and the scores in the observation group were lower than those in the control group,with statistically significant difference(t=3.191,2.570,3.296,2.943;P<0.05).After intervention,the FACT scores of both groups were higher than those before intervention,and the scores of the observation group were higher than those of the control group,with statistically significant difference(t=3.515,3.446,3.344,2.571;P<0.05).Conclusion:The combination of mindfulness-based stress reduction training and hospice care for intervention of patients with brain metastases of lung cancer can effectively improve the cancer pain and self-perceived burden degree,and enhance the sense of dignity and quality of life.