周玲　孔红武

[摘要] 目的 探討心理护理干预对乳腺癌手术患者负性情绪及生活质量的影响。 方法 将我院2016年1月～2017年1月间收治的72例乳腺癌手术患者作为研究对象，均行改良根治术，术后均经病理证实，所有患者采用随机数字表法分为干预组和对照组，每组各36例，对照组采用常规护理，干预组在对照组的基础上分别于术前、术中及术后联合心理护理干预。比较两组患者的焦虑、抑郁心理评分、疼痛程度及生活质量评分。 结果 与干预前比较，干预后干预组的焦虑、抑郁心理评分明显降低，干预组干预后的SAS评分为（31.42±6.38）分、SDS评分为（32.65±7.30）分，两组干预后比较差异有统计学意义（P<0.05）。干预组患者轻度疼痛、中度疼痛的比率分别显著高于对照组，差异有统计学意义（P<0.05）。与干预前比较，干预后两组的GQOLI-74量表评分中的躯体功能、心理功能、社会功能、物质功能明显升高，干预组干预后的GQOLI-74量表评分中的躯体功能、心理功能、社会功能、物质功能分别为（51.2±9.3）分、（53.2±11.5）分、（55.7±11.6）分、（51.2±14.3）分，两组干预后比较差异有统计学意义（P<0.05）。 结论 对乳腺癌手术患者实施心理护理干预，不仅有利于缓解患者的抑郁、焦虑等不良情绪，同时有利于减轻患者的疼痛程度，提高患者的生活质量，从而进一步有利于促进患者的身体及社会功能的恢复。

[关键词] 心理护理；乳腺癌手术患者；负性情绪；生活质量

[中图分类号] R473.73 [文献标识码] B [文章编号] 1673-9701（2017）36-0151-04

[Abstract] Objective To investigate the effect of psychological nursing intervention on negative emotions and quality of life in breast cancer patients. Methods A total of 72 patients with breast cancer surgery treated in our hospital from January 2016 to January 2017 were selected as study objects. All patients underwent improved radical resection and were confirmed by postoperative pathology. All patients were randomly divided into intervention group and control group， with 36 cases in each group. The control group was treated with routine nursing. the intervention group was treated by preoperative， intraoperative and postoperative psychological nursing based on the treatment of the control group. The score of anxiety， depression score， pain degree and quality of life score were compared between the two groups. Results The anxiety， depression psychological scores in the intervention group after the intervention were significantly lower than those before intervention（P<0.05）. The score of SAS in the intervention group was （31.42±6.38） points and the score of SDS was（32.65±7.30） points， and the difference was statistically significant（P<0.05）. The ratio of mild pain and moderate pain in the intervention group was significantly higher than that in the control group， with statistically significant difference（P<0.05）. The body function， psychological function， social function and substance function of GQOLI-74 scale score in the two groups after intervention were significantly higher than those before intervention. The body function， psychological function， social function and substance function were（51.2±9.3）， （53.2±11.5），（55.7±11.6） and（51.2±14.3）， respectively. There was statistically significant difference between the two groups after intervention（P<0.05）. Conclusion Psychological nursing intervention applied in patients with breast cancer surgery is not only beneficial to alleviate the depression and anxiety of patients with breast cancer surgery， but also to reduce the pain degree of patients and improve the quality of life of patients， so as to further promote the recovery of physical and social function of patients with breast cancer.

[Key words] Psychological nursing； Breast cancer surgery patients； Negative emotions； Quality of life

乳腺癌是女性最常见的恶性肿瘤之一，近年来发病率越来越高，且日趋年轻化。手术是治疗乳腺癌首选的治疗方法，手术方法包括乳腺根治术、乳腺改良根治术、全乳切除、全乳切除合并淋巴结清扫等[1]，但无论采取哪种手术方法，均可不同程度地造成患者乳腺缺失，导致女性出现形体上的缺失感，使其对自我形象产生不满，失去生活的信心，同时术后胸部外形的改变及疼痛，给患者带来了巨大的心理压力，使患者常出现焦虑、抑郁、悲观绝望、自卑等负性心理，从而严重影响患者的生活质量。心理干预是指在护理工作中，运用心理学理论的指导，通过各种积极方式干预患者的心理认知、情绪和态度，对患者的心理施加积极影响，以促进疾病的康复[2]。……