高兰

【摘要】 目的：探討激励式护理干预对结直肠癌永久性肠造口患者癌因性疲乏、心理应激及希望水平的影响。方法：选择2017年6月-2018年6月在本院接受治疗的结直肠癌永久性肠造口患者94例作为研究对象，采用随机数字表法将其分为对照组和观察组，各47例。对照组采用常规护理干预，观察组采用激励式护理干预。采用简易疲乏量表（BFI）、焦虑自评量表（SAS）、抑郁自评量表（SDS）、Herth希望量表（herth hope index，HHI）对两组干预前后的癌因性疲乏、心理应激及希望水平进行比较。结果：护理后，观察组的癌因性疲乏程度情况明显低于对照组，差异有统计学意义（字2=4.398，P<0.05）。护理前两组患者SAS和SDS评分比较，差异均无统计学意义（P>0.05），护理后观察组SAS与SDS评分均明显低于对照组，差异均有统计学意义（t=3.725、3.738，P<0.05）。观察组的希望水平总分高于对照组，差异有统计学意义（P<0.05）。结论：对结直肠癌永久性肠造口患者进行激励式护理干预，有助于改善患者的癌因性疲乏程度，缓解焦虑及抑郁，提高希望水平，为患者建立良好的心理水平，促进患者早日康复。

【关键词】 激励式护理; 结直肠癌; 永久性肠造口; 癌因性疲乏; 心理应激; 希望水平

【Abstract】 Objective：To investigate the effect of incentive nursing intervention on cancer-related fatigue，psychological stress and hope level in colorectal cancer with permanent colostomy.Method：From June 2017 to June 2018，94 cases of permanent stoma of colorectal permanent cancer in our hospital were selected as the subjects.The subjects were divided into control group and observation group by random number table method，47 cases in each group.The control group was treated with routine nursing intervention，and the observation group adopted the incentive nursing intervention.Brief fatigue inventory，self-rating anxiety scale（SAS），self-rating depression scale（SDS），and herth hope index（HHI） were used to evaluate the cancer-induced fatigue，psychological stress and hope level before and after the intervention of the two groups.Result：After the nursing，the cancer-related fatigue degree in the observation group was significantly lower than that of the control group（字2=4.398，P<0.05）.The scores of SAS and SDS before nursing in the two groups were not statistically significant（P>0.05），but the SAS and SDS scores of the observation group were significantly lower than those in the control group，there were statistically significant differences between the two groups（t=3.725，3.738，P<0.05）.The total score of hope level in the observation group was higher than that in the control group（P<0.05）.Conclusion：The incentive nursing intervention for patients with colorectal cancer with permanent colostomy can help to improve the degree of cancer-related fatigue，relieve anxiety and depression，improve the level of hope which can set up a good psychological level for the patients，and promote the early recovery of the patients.

【Key words】 Incentive nursing; Colorectal cancer; Permanent colostomy; Cancer-related fatigue;Psychological stress; Hope level

First-authors address：Macheng Peoples Hospital，Macheng 438300，China

doi：10.3969/j.issn.1674-4985.2019.08.024

结直肠癌（colorectal cancer，CRC）是常见的恶性肿瘤之一，临床好发部位为直肠及直肠与乙状结肠交界处，主要症状为大便形态改变、便血、肠梗阻及腹痛等，发病年龄多在45岁左右，现青年人发病率也在逐步上升[1]。据统计，我国结直肠癌发病率、死亡率在胃肠道肿瘤中均位居第二位[2]。目前，临床上结直肠癌的根治性治疗的基础是手术，而永久性肠造口手术是治疗结直肠癌最常见、最有效的方式。将大肠内容物通过腹壁的开口排入袋子，形成人工肛门，改变了正常的排便方式，导致患者排便不能自控，产生负面情绪，降低生存希望。通常癌因性疲乏程度、心理应激及希望水平都极大地影响着患者康复，最终影响着患者的生存质量[3]。……