耳穴压豆联合精细化随访管理对早期肺癌患者术后慢性疼痛的影响

Effect of auricular acupressure combined with refined follow-up management on chronic pain after surgery in early-stage lung cancer patients

目的观察耳穴压豆联合精细化随访管理对早期肺癌患者术后慢性疼痛心理灵活性、健康感知及睡眠质量的影响。方法选取2022年1月—2023年7月于南昌大学第一附属医院进行手术的80例早期肺癌术后长期慢性疼痛患者为研究对象,按照组间基本特征具有可比性的原则分为对照组与观察组,每组40例。对照组患者进行常规护理,观察组患者在对照组基础上进行耳穴压豆联合随访管理。两组患者采用视觉模拟评分法(VAS)于干预前及干预后1周、4周、12周评定疼痛度;于干预前后使用接纳与行动问卷第2版(AAQ-Ⅱ)及认知融合问卷(CFQ)进行联合评估心理灵活性;于干预前后使用健康感知量表(HPQ)评估健康感知;使用睡眠状况自评量表(SRSS)评估睡眠质量;于干预前后使用简明健康调查问卷(SF-36)评估生活质量。结果两组患者干预前、干预后1周、干预后4周、干预后12周VAS评分逐渐下降,时间比较差异有统计学意义(P_(时间)<0.05);干预后的1周、4周、12周观察组VAS评分低于对照组,组间比较差异有统计学意义(P_(组间)<0.05);随着观察时间延长,组间差距逐渐增大,差异有统计学意义(P_(交互)<0.05)。干预后,观察组AAQ-Ⅱ、CFQ评分低于对照组,差异有统计学意义(P<0.05)。干预后,观察组患者健康状况、健康史、健康展望、健康担忧、对疾病的态度及对疾病的抵御能力评分高于对照组,差异有统计学意义(P<0.05)。干预后,观察组患者SRSS评分低于对照组,差异有统计学意义(P<0.05)。干预后,两组患者社会功能及情感职能评分比较差异无统计学意义(P>0.05),但观察组患者生理机能、生理职能、躯体疼痛、一般健康状况、活力、精神健康维度评分高于对照组,比较差异有统计学意义(P<0.05)。结论耳穴压豆联合精细化随访管理干预运用于早期肺癌患者术后长期慢性疼痛中,可降低患者疼痛感,提高心理灵活性,调节健康感知水平,改善患者的生活质量及睡眠质量。

Objective To observe the effects of auricular acupressure combined with refined follow-up management on psychological flexibility,health perception and sleep quality in early-stage lung cancer patients with chronic pain after surgery.Methods A total of 80 early-stage lung cancer patients with long-term chronic pain after surgery who underwent surgery at the First Affiliated Hospital of Nanchang University from January 2022 to July 2023 were selected as the research subjects.According to the principle of comparability of basic characteristics between groups,they were divided into a control group and an observation group,with 40 cases in each group.The patients in the control group received routine nursing care,while the patients in the observation group received auricular acupressure combined with follow-up management on the basis of the control group.Both groups of patients were assessed for pain intensity using the Visual Analogue Scale(VAS)before the intervention and 1 week,4 weeks,and 12 weeks after the intervention.The Acceptance and Action Questionnaire(AAQ-Ⅱ)and Cognitive Fusion Questionnaire(CFQ)were used to jointly assess psychological flexibility before and after the intervention.The Health Perception Questionnaire(HPQ)was used to evaluate health perception before and after the intervention.The Self-Rating Scale of Sleep(SRSS)was used to assess sleep quality,and the Short Form Health Survey(SF-36)was used to evaluate quality of life before and after the intervention.Results The VAS scores for both groups of patients gradually decreased before intervention and at 1 week,4 weeks and 12 weeks after intervention,with statistically significant differences over time(P<0.05).At 1 week,4 weeks and 12 weeks after the intervention,the VAS scores of the observation group were lower than those of the control group,the differences between the groups were statistically significant(P<0.05).As the observation period extended,the intergroup differences gradually increased,the differences were statistically significant(P<0.05).After the intervention,the AAQ-Ⅱ and CFQ scores in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05).After the intervention,the observation group had higher scores on health status,health history,health outlook,health concerns,attitude toward disease,and resistance to disease than the control group,the differences were statistically significant(P<0.05).After the intervention,the SRSS score in the observation group was lower than that in the control group,the difference was statistically significant(P<0.05).After the intervention,there was no statistically significant difference in the scores of social function and emotional role between the two groups(P>0.05),but the scores of physiological function,physiological role,body pain,general health,vitality and mental health in the observation group were higher than those in the control group,the differences were statistically significant(P<0.05).Conclusion The intervention of auricular acupressure combined with refined follow-up management in early-stage lung cancer patients with long-term chronic pain after surgery can reduce pain perception,enhance psychological flexibility,regulate health perception levels,and improve patients'quality of life and sleep quality.