临床路径管理配合家属参与式心理干预对行鼻内镜下手术治疗局部复发性鼻咽癌患者心理弹性、应对方式和生活质量的影响

Effects of clinical pathway management combined with family-participatory psychological intervention on psychological resilience,coping styles and quality of life in patients with locally recurrent nasopharyngeal carcinoma treated by nasal endoscopic surge

目的:探讨临床路径管理配合家属参与式心理干预对行鼻内镜下手术治疗局部复发性鼻咽癌(NPC)患者心理弹性、应对方式和生活质量的影响。方法:选择我院100例行鼻内镜下手术治疗局部复发性NPC患者,按照入院单双顺序分为对照组(n=50)和观察组(n=50),对照组给予常规护理干预,观察组给予临床路径管理配合家属参与式心理干预,比较两组患者心理弹性、应对方式和生活质量。结果:①干预后,观察组患者坚韧与控制、力量、乐观评分均显著高于对照组(t=2.325,4.271,2.197;P<0.05);②干预后,观察组患者求助、解决问题评分明显高于对照组(t=4.259,2.087;P<0.05),合理化、退避、自责和幻想评分明显低于对照组(t=-5.235,-5.443,-5.728,-5.312;P<0.05);③干预后,观察组患者总体健康、生理职能、躯体疼痛、活力、社会职能情感职能、精神健康评分均显著高于对照组(t=4.683,2.519,3.132,3.966,2.761,2.395;P<0.05)。结论:临床路径管理配合家属参与式心理干预可增强行鼻内镜下手术治疗局部复发性NPC患者心理弹性,改善其应对方式,提高生活质量。

Objective:To explore the effects of clinical pathway management combined with family-participatory psychological intervention on psychological resilience,coping styles and quality of life in patients with locally recurrent nasopharyngeal carcinoma(NPC)treated by nasal endoscopic surgery.Methods:A total of 100 cases of patients with locally recurrent NPC treated by nasal endoscopic surgery in our hospital were divided into control group(n=50)and observation group(n=50)according to the order of hospital admission.Control group was given routine nursing intervention,and observation group was given clinical pathway management combined with family-participatory psychological intervention.The psychological resilience,coping styles and quality of life were compared between the two groups.Results:After intervention,the scores of tenacity and control,strength and optimism in observation group were significantly higher than those in control group(t=2.325,4.271,2.197;P<0.05).After intervention,the scores of asking for help and problem-solving in observation group were significantly higher than those in control group while the scores of rationalization,withdrawal,self-accusation and illusion were significantly lower than those in control group(t=4.259,2.087,-5.235,-5.443,-5.728,-5.312;P<0.05).After intervention,the scores of overall health,role physical,physiological pain,vitality,social function,emotional function and mental health in observation group were significantly higher than those in control group(t=4.683,2.519,3.132,3.966,2.761,2.395,4.218;P<0.05).Conclusion:Clinical pathway management combined with family-participatory psychological intervention can enhance the psychological resilience,improve the coping styles and improve the quality of life for patients with locally recurrent nasopharyngeal carcinoma treated by nasal endoscopic surgery.