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改良正念減壓療法對肺癌化療患者癌因性疲乏與睡眠質(zhì)量的影響

2020-06-04 08:01高曉菲
關(guān)鍵詞:睡眠質(zhì)量肺癌

高曉菲

【摘要】目的 改良正念減壓療法對肺癌化療患者癌因性疲乏與睡眠質(zhì)量的影響。方法 回顧性分析本院在改良正念減壓療法施行前后兩組肺癌化療患者的臨床資料。對照組患者入院時間為2018年1月~2018年12月。觀察組患者入院時間為2019年1月~2019年12月。對照組采用常規(guī)心理護理,觀察組基于對照組護理方式基礎(chǔ)上實施改良正念減壓療法。比較兩組在入院時和干預(yù)8周后癌因性疲乏與睡眠質(zhì)量情況差異。結(jié)果 入院時,2 組的匹茲堡睡眠質(zhì)量指數(shù)(PSQI)無統(tǒng)計學(xué)意義(P>0.05);干預(yù)8周后,觀察組的匹茲堡睡眠質(zhì)量指數(shù)低于對照組,差異有統(tǒng)計學(xué)意義(P<0.05);兩組干預(yù)前的簡短疲乏評估量表(BFI)無統(tǒng)計學(xué)意義(P>0.05);通過改良正念減壓療法干預(yù)8周后,觀察組疲乏程度優(yōu)于對照組,差異比較有統(tǒng)計學(xué)意義。結(jié)論 改良正念減壓療法有效降低肺癌患者癌因性疲乏和改善患者睡眠質(zhì)量的影響。

【關(guān)鍵詞】化療患者,肺癌;正念減壓; 癌癥疲乏因子;睡眠質(zhì)量

【中圖分類號】R734.2 【文獻標識碼】A 【文章編號】ISSN.2095.6681.2020.9..03

Effect of modified mindfulness decompression therapy

on cancer-related fatigue and sleep quality in patients

with lung cancer undergoing chemotherapy

GAO Xiao-fei

(Qilu Hospital of Shandong University,Shandong Jinan 250012,China)

【Abstract】Objective? ?To improve the effects of mindfulness decompression therapy on cancer-related fatigue and sleep quality in patients with lung cancer chemotherapy.Methods? ?The clinical data of two groups of patients with lung cancer chemotherapy before and after the implementation of modified mindfulness decompression therapy in our hospital were retrospectively analyzed.Patients in the control group were admitted from January 2018 to December 2018.Patients in the observation group were admitted from January 2019 to December 2019.The control group received conventional psychological nursing.The differences in cancer-related fatigue and sleep quality between the two groups at admission and after 8 weeks of intervention were compared.Results? ?After 8 weeks of intervention,the Pittsburgh Sleep Quality Index of the observation group was lower than the control group, and the difference was statistically significant (P<0.05 );After 8 weeks of intervention through modified mindfulness decompression therapy,the degree of fatigue in the observation group was better than that in the control group, and the difference was statistically significant..Conclusion? ?Improved mindfulness decompression therapy can effectively reduce the cancer-related fatigue and improve the sleep quality of patients with lung cancer.

【Key words】Chemotherapy patients;Lung cancer;Mindful decompression therapy;Cancer fatigue factor;Sleep quality

肺癌是呼吸系統(tǒng)常見腫瘤,化療是晚期肺癌的主要治療手段,但化療的不良反應(yīng)多,常見的癥狀為惡心嘔吐、疼痛、疲乏和睡眠障礙,不僅給患者帶來了生理上的巨大痛苦,而且會導(dǎo)致患者心理壓力增大,易出現(xiàn)絕望、焦慮等不良情緒,嚴重影響了患者的心理健康。正念脫胎于佛教,是一種自我調(diào)節(jié)的精神訓(xùn)練方式,強調(diào)人們只是單純地關(guān)注當(dāng)下而不去加以評判和干預(yù),正念減壓療法(Mindfulness—based stress reduction,MBSR)是由美國麻省理工學(xué)院的醫(yī)學(xué)博士卡巴金于1979年提出的,目的是幫助患者處理心理壓力和病痛[1]。正念減壓療法是在冥想的基礎(chǔ)上對患者采取的心理治療方式,但由于化療帶來的不良反應(yīng),肺癌化療患者往往難以維持持續(xù)8h的冥想練習(xí)[2]。基于此,本研究小組基于正念減壓療法的理論框架,對正念減壓療法的干預(yù)方案進行改良,調(diào)整具體干預(yù)措施,并應(yīng)用于肺癌化療患者,本研究旨在探索改良正念減壓療法對肺癌化療患者的干預(yù)效果,以期為國內(nèi)相關(guān)研究提供參考。

以往的護理強調(diào)腫瘤患者多休息,疲勞是由于患者的日?;顒右l(fā)的,據(jù)本次研究結(jié)果,傳統(tǒng)的常規(guī)護理方案也有助于改善患者的疲乏情況,但效果沒有觀察組顯著。通過改良正念減壓療法,患者在醫(yī)務(wù)人員和專業(yè)心理治療醫(yī)師的幫助和心理支持下更易積極主動地參與改善疲乏的過程,通過病情相似的患者之間展開交流討論,有助于患者增強康復(fù)信心。此方法簡便快捷,成本花費低,值得在臨床推廣應(yīng)用。

綜上所述,改良正念減壓療法能有效降低肺癌患者癌因性疲乏和改善患者睡眠質(zhì)量的影響。

參考文獻

[1] 吳桂香.正念減壓療法對老年喪偶肺癌化療患者癌因性疲乏和心理健康狀況的影響[J].臨床與病理雜志,2020,40(02):430-436.

[2] 劉? ?婷,韓明輝,梁軍利,等.正念減壓療法對肺癌化療患者自我效能及正念水平的影響[J].護理學(xué)報,2019,26(02):66-70.

[3] Holzel B K,Carmody J,Evans K C,et al. Stress reduction correlates with structural changes in the amygdala[J].Soc Cogn Affect Neurosci,2010,5(1):11-17.

[4] 楊佐琴,靳素萍,秦爾奇,等.電針結(jié)合耳穴貼壓對圍絕經(jīng)期失眠患者睡眠及生活質(zhì)量的影響[J].上海中醫(yī)藥雜志,2020,54(03):72-75.

[5] 徐? ?謙,石丹丹.醫(yī)學(xué)生睡眠在心理壓力與情緒障礙間的中介效應(yīng)與調(diào)節(jié)效應(yīng)分析[J].長春大學(xué)學(xué)報,2019,29(12):67-70.

[6] Mendoza T R,Wang X S,Cleeland C S,et al.The rapid assessment of fatigue severity in cancer patients:use of the Brief Fatigue Inventory[J].Cancer,1999,85(5):1186-1196.

[7] Lengacher C A,Reich R R,Paterson C L,et al.The effects of mindfulness-based stress reduction on objective and subjective sleep parameters in women with breast cancer:a randomized controlled trial[J].Psychooncology,2015,24(4):424-432.

[8] 龔湖萍,魏清風(fēng),張世慧,等.正念減壓訓(xùn)練對腸造口患者睡眠質(zhì)量和生活質(zhì)量影響的效果評價[J].護理學(xué)報,2017,24(6):5-8.

[9] 王? ?芹,章新瓊,王秋萍,等.正念減壓法對癌癥患者知覺壓力與睡眠障礙干預(yù)效果的系統(tǒng)評價[J].重慶醫(yī)學(xué),2017(25):3547-3550.

[10] 王? ?蘋,黃鵬飛,張淑彥,等.基于正念減壓的護理干預(yù)對肺癌患者癌因性疲乏的影響[J].中華現(xiàn)代護理雜志,2017(35):4478-4481.

[11] 李? ?婧,顧立學(xué),劉永闖,等.正念減壓訓(xùn)練對乳腺癌患者配偶焦慮抑郁情緒的影響[J].中華行為醫(yī)學(xué)與腦科學(xué)雜志,2016(12):1104-1108.

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