无痛理念下认知行为模式干预对食管癌术后患者疼痛程度和心理状态的影响

Effect of cognitive-behavioral model intervention under the painless concept on the pain level and psychological state of postoperative patients with esophageal cancer

目的探讨无痛理念下认知行为模式干预对食管癌术后患者疼痛程度和心理状态的影响。方法依据干预方法的不同将107例食管癌患者分为无痛组(n=56)和常规组(n=51),常规组患者接受常规干预,无痛组患者接受无痛理念下认知行为模式干预。比较两组患者疼痛程度[视觉模拟评分法(VAS)、疼痛分级指数(PR)]、负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、自我管理能力[自我管理能力量表(SMS)]、生活质量[欧洲癌症研究与治疗组织生命质量测定量表(EORTC QLQ-C30)]和并发症发生情况。结果干预后,两组患者VAS、PR、SAS、SDS评分均低于本组干预前,无痛组患者VAS、PR、SAS、SDS评分均低于常规组,差异均有统计学意义(P﹤0.05)。干预后,两组患者SMS各维度评分及总分均高于本组干预前,无痛组患者SMS各维度评分及总分均高于常规组,差异均有统计学意义(P﹤0.05)。干预后,两组患者EORTC QLQ-C30各维度评分均高于本组干预前,无痛组患者EORTC QLQ-C30各维度评分均高于常规组,差异均有统计学意义(P﹤0.05)。无痛组患者的并发症总发生率为7.14%,低于常规组患者的23.53%,差异有统计学意义(P﹤0.05)。结论无痛理念下认知行为模式干预可有效缓解食管癌患者术后疼痛程度,减轻焦虑和抑郁情绪,强化自我管理能力,提高生活质量,从而降低并发症发生率。

Objective To explore the effect of cognitive-behavioral model intervention under the painless concept on the pain level and psychological state of postoperative patients with esophageal cancer.Method According to different intervention methods,107 patients with esophageal cancer were divided into painless group(n=56)and conventional group(n=51).Patients in the conventional group received routine intervention,while patients in the painless group re-ceived cognitive-behavioral model intervention under the painless concept.The pain levels[visual analogue scale(VAS),pain rating(PR)],negative emotions[self-rating anxiety scale(SAS),self-rating depression scale(SDS)],self-manage-ment ability[self-management scale(SMS)],quality of life[European Organization for Research and Treatment of Can-cer quality of life questionnaire core 30(EORTC QLQ-C30)],and incidence of complications were compared between the two groups.Result After intervention,the VAS,PR,SAS,and SDS scores of both groups were lower than those be-fore intervention,the VAS,PR,SAS,and SDS scores in painless group were lower than those in conventional group,and the differences were statistically significant(P<0.05).After intervention,the dimension scores and total scores of SMS in both groups were higher than those before intervention,the dimension scores and total score of SMS in painless group were higher than those in conventional group,and the differences were statistically significant(P<0.05).After interven-tion,the dimension scores of EORTC QLQ-C30 in both groups were higher than those before intervention,the dimension scores of EORTC QLQ-C30 in painless group were higher than those in conventional group,and the differences were statistically significant(P<0.05).The total incidence of complications in painless group was 7.14%,which was lower than 23.53%in conventional group,and the difference was statistically significant(P<0.05).Conclusion Cognitive-behavior-al model intervention under the painless concept can effectively alleviate postoperative pain in esophageal cancer pa-tients,reduce anxiety and depression,strengthen self-management ability,improve quality of life,and thus reduce the inci-dence of complications.