区智凤 霍婷婷 黄铭杰 曾嘉欢 刘育敏

【摘要】 目的：探讨全程心理干预模式对恶性骨肿瘤患者焦虑抑郁情绪的影响。方法：选取2019年6月-2020年1月笔者所在医院收治的恶性骨肿瘤患者48例，按照随机数字表法分为对照组和观察组，每組24例。对照组给予常规护理，观察组在此基础上实施全程心理干预。比较两组护理前后的焦虑自评量表（SAS）、抑郁自评量表（SDS）、自尊量表（SES）、症状自评量表（SCL-90）评分，并评估患者的依从性。结果：护理前，两组SAS、SDS、SCL-90、SES评分比较差异无统计学意义（P>0.05）;护理后，两组SAS、SDS、SCL-90评分均较护理前显著降低（P<0.05），且护理后观察组的SAS、SDS、SCL-90评分均显著低于对照组（P<0.05）;护理后，两组SES评分均较护理前显著升高（P<0.05），且护理后观察组的SES评分显著高于对照组（P<0.05）;护理后，观察组的依从性显著高于对照组（P<0.05）。结论：全程心理干预可以改善恶性骨肿瘤患者的负性情绪和心理状态，提高自尊心和依从性，值得临床推广。

【关键词】 全程心理护理 恶性骨肿瘤 负性情绪 依从性

doi：10.14033/j.cnki.cfmr.2020.20.030 文献标识码 B 文章编号 1674-6805（2020）20-00-03

Effect of Whole Course Psychological Intervention Mode on Anxiety and Depression of Patients with Malignant Bone Tumors/OU Zhifeng， HUO Tingting， HUANG Mingjie， ZENG Jiahuan， LIU Yumin. //Chinese and Foreign Medical Research， 2020， 18（20）： -78

[Abstract] Objective： To explore the effect of the whole psychological intervention mode on the anxiety and depression of patients with malignant bone tumors. Method： Forty-eight patients with malignant bone tumors who treated in our hospital from June 2019 to January 2020 were randomly divided into the control group and the observation group， with 24 cases in each group. Patients in the control group were given basic routine care， and patients in the observation group were given psychological intervention on the basis of the control group. The anxiety self-assessment scale （SAS）， self-depression scale （SDS）， self-esteem scale （SES）， and symptom self-assessment scale （SCL-90） scores between the two groups of patients before and after nursing were compared， and the patients compliance was evaluated. Result： Before nursing， there were no significant differences in SAS， SDS， SCL-90， and SES scores between the two groups （P>0.05）. After nursing， the SAS， SDS， SCL-90 scores of the two groups of patients decreased significantly （P<0.05）， and the SAS， SDS， and SCL-90 scores of the observation group were significantly lower than those of the control group （P<0.05）. After nursing， the SES scores of the two groups of patients increased significantly （P<0.05）， and the SES score of the observation group after nursing was significantly higher than that of the control group （P<0.05）. The compliance of the observation group after nursing was significantly higher than that of the control group （P<0.05）. Conclusion： Whole-course psychological intervention can improve the negative emotion and psychological state of patients with malignant bone tumors， improve self-esteem and compliance， and is worthy of clinical promotion.

[Key words] Full-course psychological care Malignant bone tumors Negative emotions Compliance

First-authors address： Foshan Hospital of Traditional Chinese Medicine， Foshan 528000， China

恶性骨肿瘤起病隐匿，进展迅速，致残率和致死率极高[1]，主要采用手术、化疗、放疗等，预后较差[2]。由于对疾病的担忧、医疗费用压力、自尊心等原因，患者容易产生焦虑、抑郁、恐惧、紧张、担忧、悲伤等负性情绪，而且手术和放化疗带来的副作用造成的躯体痛苦放大了患者的负性情绪[3]。据调查，82.5%恶性骨肿瘤患者出现显著心理困扰[4]。负性情绪不仅降低患者的生活质量和社交活动，造成失眠，影响疾病的康复，甚至可以直接导致患者自杀[5]。随着生物-心理-社会模式的出现，临床上治疗恶性骨肿瘤不仅重视手术和放化疗等，对心理状态的评估和干预同样重要[6]。全程心理干预是在入院时、术前、术后、出院时对患者进行针对性的心理護理，可以改善患者的负性情绪，但是目前相关研究较少[7]。本研究采用随……