阶梯式心理护理对头颈肿瘤患者焦虑抑郁和生活质量的影响

Effect of stepped psychological care on anxiety,depression and quality of life in patients with head and neck cancer

目的探讨阶梯式心理护理对头颈肿瘤患者焦虑与抑郁情绪和生活质量的影响。方法将86例有焦虑或抑郁情绪的头颈肿瘤住院患者随机分为干预组和对照组各43例,两组均给予常规健康教育和出院后随访,干预组在此基础上实施4步阶梯式心理护理方案,包括2周观察等待、4周指导性自助、6周面对面问题解决疗法、4周专业心理干预和(或)药物疗法,干预前后评估患者焦虑抑郁状况和生活质量。结果干预后干预组焦虑抑郁评分显著低于对照组,干预有效率显著高于对照组(均P <0. 01),干预组在疼痛、吞咽、感觉、发声和进食等生活质量方面有显著改善,与对照组比较,差异有统计学意义(P <0. 05,P <0. 01)。结论以阶梯式护理为指导的心理护理可有效改善头颈肿瘤患者的焦虑、抑郁状况,在一定程度上提升患者生活质量。

Objective To explore the effect of stepped psychological care on anxiety,depression and quality of life in patients with head and neck cancer. Methods Totally,86 hospitalized head and neck cancer patients with HADS-A or HADS-D score > 7 were randomly divided into an intervention group or a control group with 43 cases each. Both groups received routine care and follow-ups after discharge. The intervention group were additionally subjected to a stepped psychological care plan,which included 2 weeks of watchful waiting,4 weeks of guided self-help,6 weeks of face-to-face problem solving therapy sessions,and 4 weeks of specialized psychological intervention and/or drug therapy. Both groups were evaluated in terms of anxiety,depression and quality of life before and after intervention. Results The intervention group had lower anxiety and depression scores than the control group,with the effective rate significantly higher than the latter( P< 0. 01 for both). The intervention group also had significant improvements in pain,swallowing,sensory function,phonation,eating,etc.,than the controls( P < 0. 05,P < 0. 01). Conclusion Stepped psychological care could alleviate anxiety and depression levels of patients with head and neck cancer,and enhance the quality of life of them to some extent.