基于失效模式与效应分析的PERMA模式对降低血液肿瘤化疗患者心理负担负面情绪和自我效能的影响

Impact of PERMA model based on failure mode and effect analysis on reducing psychological burden,negative emotion and self-efficacy of haematological oncology chemotherapy patients

目的探讨基于失效模式与效应分析的PERMA模式对降低血液肿瘤化疗患者心理负担、负面情绪和自我效能的影响。方法选取河南省人民医院2022年11月至2024年1月收治的150例血液肿瘤化疗患者,采用随机数字表法,将患者分为对照组(常规护理)和试验组(采取心理干预措施失效模式与效应分析的PERMA模式),每组各75例。比较两组患者的心理负担、负面情绪、创伤后成长、自我效能、应对方式及治疗依从性。结果干预后,对照组和试验组简式心境状态量表(POMS)评分分别为(109.73±11.04)分和(99.49±10.27)分(P<0.001),焦虑自评量表(SAS)评分分别为(50.15±5.51)分和(47.05±4.02)分(P<0.001),抑郁自评量表(SDS)评分分别为(45.63±4.54)分和(44.51±4.41)分(P>0.05),试验组POMS、SAS评分下降更低;两组创伤后成长量表(PTGI)评分均增加,且试验组升高更为明显[分别为(76.23±8.17)分和(83.40±8.21)分,P<0.001]。对照组和试验组积极应对评分均增加,且试验组升高更为明显[分别为(19.73±2.04)分和(22.49±2.27)分,P<0.001];两组消极应对评分均有所下降,且试验组下降更低[分别为(12.53±1.17)分和(8.40±1.27)分,P<0.001]。对照组和试验组GSES评分增加,且试验组升高更为明显[分别为(27.42±3.41)分和(34.58±4.87)分,P<0.001]。与对照组比较,试验组总依从性更高(分别为80.0%和96.0%,P<0.05)。结论基于失效模式与效应分析的PERMA模式可降低患者心理负担,改善创伤后成长、负面情绪,以积极的方式处理不良事件,提高治疗依从性。

Objective To explore the impact of the PERMA model based on Failure Mode and Effects Analysis(FMEA)on reducing psychological burden,negative emotions,and improving self-efficacy in hematologic malignancy chemotherapy patients.Methods A total of 150 patients undergoing chemotherapy for hematologic malignancies at Henan Provincial People's Hospital from November 2022 to January 2024 were selected.They were randomly divided into a control group(routine care)and an experimental group(psychological intervention using the PERMA model based on FMEA),with 75 patients in each group.Psychological burden,negative emotions,post-traumatic growth(PTG),selfefficacy,coping strategies,and treatment adherence were compared between the two groups.Results After intervention,the POMS scores in the control and experimental groups were(109.73±11.04)and(99.49±10.27),respectively(P<0.001),SAS scores were(50.15±5.51)and(47.05±4.02),respectively(P<0.001),and SDS scores were(45.63±4.54)and(44.51±4.41),with no significant difference between the two groups(P>0.05).The experimental group showed a greater reduction in POMS and SAS scores.Both groups showed an increase in PTGI scores,with a more significant increase in the experimental group(76.23±8.17 vs.83.40±8.21,P<0.001).Positive coping scores increased in both groups,with a more noticeable rise in the experimental group(19.73±2.04 vs.22.49±2.27,P<0.001).Negative coping scores decreased in both groups,with the experimental group showing a greater reduction(12.53±1.17 vs.8.40±1.27,P<0.001).GSES scores increased in both groups,with a more pronounced improvement in the experimental group(27.42±3.41vs.34.58±4.87,P<0.001).The experimental group also demonstrated higher overall treatment adherence compared to the control group(80.0%vs.96.0%,P<0.05).Conclusion The PERMA model based on Failure Mode and Effects Analysis can reduce psychological burden,improve post-traumatic growth and negative emotions,promote positive coping with adverse events,and enhance treatment adherence in hematologic malignancy chemotherapy patients.