共情式心理疏导结合音乐放松疗法对结肠癌肝转移化疗患者情绪状态、希望水平及癌因性疲乏的影响

Empathetic psychological counseling combined with music relaxation therapy on the emotional state,hope level,and cancer-related fatigue in patients with colon cancer liver metastasis undergoing chemotherapy

目的 探讨共情式心理疏导结合音乐放松疗法对结肠癌肝转移化疗患者情绪状态、希望水平及癌因性疲乏的影响,以期为结肠癌肝转移化疗患者的护理干预提供参考。方法 选取2021年1月—2022年12月空军军医大学第一附属医院收治的83例结肠癌肝转移化疗患者,按照护理方法不同分为对照组(n=40)与观察组(n=43)。对照组患者接受常规护理干预,观察组患者在对照组基础上采用共情式心理疏导结合音乐放松疗法进行干预。比较2组患者干预前后的情绪状态、希望水平、癌因性疲乏状况、生存质量以及护理满意度。结果 干预前,2组患者7项广泛性焦虑量表(GAD-7)及简单自测抑郁量表(PHQ-9)评分比较,差异均无统计学意义(P>0.05);干预后,2组患者GAD-7及PHQ-9评分均低于干预前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者中文版Herth希望量表(HHI)的积极态度、积极行动、亲密关系3个维度评分比较,差异均无统计学意义(P>0.05);干预后,2组患者HHI量表各维度评分均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者癌因性疲乏量表(CFS)的躯体、认知、情感3个维度评分比较,差异均无统计学意义(P>0.05);干预后,2组患者CFS量表各维度评分均低于干预前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者欧洲癌症患者生存质量核心量表(EORTC-QLQ-C30)的认知功能、社会功能、角色功能、情绪功能、躯体功能5个维度评分比较,差异均无统计学意义(P>0.05);干预后,2组患者EORTC-QLQ-C30量表各维度评分均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。观察组患者的护理满意度为90.70%(39/43),高于对照组的72.50%(29/40),差异有统计学意义(χ^(2)=4.635,P=0.031)。结论 共情式心理疏导结合音乐放松疗法应用于结肠癌肝转移化疗患者护理中,有助于改善患者情绪状态和癌因性疲乏状况,提升患者希望水平及生存质量,值得在临床推广应用。

Objective To explore the impact of empathetic psychological counseling combined with music relaxation therapy on the emotional state,hope level,and cancer-related fatigue in patients with colon cancer liver metastasis undergoing chemotherapy,aiming to provide a reference for nursing interventions in these patients.Methods A total of 83 patients with colon cancer liver metastasis undergoing chemotherapy treated at the First Affiliated Hospital of Air Force Medical University from January 2021 to December 2022 were selected and assigned to a control group(n=40)and an observation group(n=43)based on different nursing methods.The control group received routine nursing interventions,while the observation group empathetic psychological counseling combined with music relaxation therapy in addition to the control group's interventions.The emotional state,hope level,cancer-related fatigue,quality of life,and degree of satisfaction with nursing of the two groups were compared before and after the intervention.Results Before intervention,there was no statistically significant difference in the scores of the 7-item Generalized Anxiety Disorder Scale(GAD-7)and the Patient Health Questionnaire-9(PHQ-9)between the two groups(P>0.05);after intervention,the scores of GAD-7 and PHQ-9 in both groups were significantly decreased,and the observation group's scores were significantly lower than the control group's(P<0.05).Before intervention,there was no statistically significant difference in the subscale scores(positive attitude,positive action,and intimate relationship)of the Chinese version of the Herth Hope Index(HHI)between the two groups(P>0.05);after intervention,the subscale scores of the HHI in both groups were significantly increased,and the observation group's scores were significantly higher than the control group's(P<0.05).Before intervention,there was no statistically significant difference in the subscale scores(physical,cognitive,and emotional)of the Cancer Fatigue Scale(CFS)between the two groups(P>0.05);after intervention,the subscale scores of the CFS in both groups were significantly declined,and the observation group's scores were significantly lower than the control group's(P<0.05).Before intervention,there was no statistically significant difference in the subscale scores(cognitive function,social function,role function,emotional function,and physical function)of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30(EORTC-QLQ-C30)between the two groups(P>0.05);after intervention,the subscale scores of the EORTC-QLQ-C30 in both groups were significantly elevated,and the observation group's scores were significantly higher than the control group's(P<0.05).The degree of satisfaction with nursing in the observation group was significantly higher than that in the control group[90.70%(39/43)vs.72.50%(29/40);χ^(2)=4.635,P=0.031].Conclusion The application of empathetic psychological counseling combined with music relaxation therapy in patients with colon cancer liver metastasis undergoing chemotherapy is conducive to improving the patient's emotional state and cancer-related fatigue and promoting the patients'hope level and quality of life,holding promise for a wider clinical application.