施晶晶 黄燕鹏 胡洁晶 董雪红 卢晓芹 戴清玉 黄建明

[摘要] 目的 探討KAP干预模式联合贝克认知疗法对桡骨远端骨巨细胞瘤患者术后负性情绪及生活质量的影响。 方法 选取2014年3月～2017年4月解放军第一七四医院行桡骨远端骨巨细胞瘤手术患者46例，依据入院时间顺序分为两组，每组各23例。两组均行带血管蒂的腓骨移植治疗；于此基础上，对照组予以贝克认知疗法，实验组予以KAP干预模式联合贝克认知疗法。统计两组护理满意度，比较干预前后两组负性情绪[抑郁（HDMA）、焦虑（HAMA）]及生活质量评分。 结果 干预前，两组负性情绪、生活质量评分差异无统计学意义（P > 0.05）。干预后，实验组HDMA、HAMA评分均低于对照组，生活质量各维度评分均高于对照组，差异有统计学意义（P < 0.05）；实验组护理满意率高于对照组，差异有统计学意义（P < 0.05）。 结论 对行桡骨远端骨巨细胞瘤手术患者予以KAP干预模式联合贝克认知疗法，可显著改善患者负性情绪及生活质量，进一步提高护理满意度。

[关键词] KAP干预模式；贝克认知疗法；桡骨远端骨巨细胞瘤；负性情绪；生活质量

[中图分类号] R473.73 [文献标识码] A [文章编号] 1673-7210（2018）05（b）-0129-04

Influence of KAP intervention model combined with beck cognitive therapy on postoperative negative emotion and quality of life in patients with giant cell tumor of distal radius

SHI Jingjing HUANG Yanpeng HU Jiejing DONG Xuehong LU Xiaoqin DAI Qinguyu HUANG Jianming

Ward Ⅰ of Orthopedic Center， 174th Hospital of PLA， Fujian Province， Xiamen 361003， China

[Abstract] Objective To investigate the influence of KAP intervention model combined with Beck cognitive therapy on postoperative negative emotion and quality of life in patients with giant cell tumor of the distal radius. Methods From March 2014 to April 2017， in 174th Hospital of PLA， 46 patients with giant cell tumor of the distal radius were selected. They were divided into two groups according to the order of admission time， with 23 cases in each group. The two groups treated with fibula transplantation with vascular pedicle， the control group was given Beck cognitive therapy， and the experiment group was given KAP intervention model combined with Beck cognitive therapy. The nursing satisfaction of two groups was counted. The negative emotion [depression （HDMA）， anxiety （HAMA）] and quality of life scores in the two groups before and after intervention were compared. Results There was no statistically significant difference in the negative emotion and quality of life scores between the two groups before intervention （P > 0.05）. Compared with the control group， the scores of HDMA and HAMA were lower in the experiment group， and the scores of quality of life in each dimension were higher in the experiment group， the differences were statistically significant （P < 0.05）. The nursing satisfaction in the experiment group was higher than the control group， the difference was statistically significant （P < 0.05）. Conclusion The KAP intervention mode combined with Beck cognitive therapy in the treatment of giant cell tumor of the distal radius can improve the negative emotion and quality of life significantly， and it can further improve the nursing satisfaction.

[Key words] KAP intervention model； Beck cognitive therapy； Giant cell tumors of the distal radius； Negative emotion； Quality of life

骨巨细胞癌为临床常见原发性骨肿瘤，其中桡骨远端骨巨细胞瘤可达到全身骨巨细胞癌10%左右，仅次于近端胫骨与远端股骨，位居第三位[1]。目前，手术仍为桡骨远端骨巨细胞瘤首选治疗措施，其中带血管蒂的腓骨移植术较为常用，其可有效改善桡骨远端骨巨细胞瘤切除后骨缺损，重建腕关节，效果较为显著[2]。但由于桡骨远端骨巨细胞瘤患者对疾病及其治疗方案缺乏认知，过于担心手术，围术期易产生紧张、焦虑及抑郁等负性情绪，严重影响患者手术顺利进行及术后康复进程[3]。因此，围术期对桡骨远端骨巨细胞瘤患者予以适当护理干预尤为重要。贝……