摘要
目的 探讨激励式信念干预联合早期康复指导对脑胶质瘤术后患者应激反应、负性情绪及生活质量的影响.方法 依据干预方法的不同将92例脑胶质瘤患者分为对照组和观察组,每组46例,对照组患者在常规干预的基础上给予早期康复指导,观察组患者在对照组基础上给予激励式信念干预.比较两组患者的应激反应指标[促肾上腺皮质激素(ACTH)、去甲肾上腺素(NE)、皮质醇]、负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、神经功能缺损情况[美国国立卫生院卒中量表(NIHSS)]和生活质量[生活质量综合评定问卷(GQOLI-74)].结果 术后3天,两组患者ACTH、NE、皮质醇水平均高于本组术前,观察组患者ACTH、NE、皮质醇水平均低于对照组,差异均有统计学意义(P﹤0.05).术后1个月,两组患者SAS、SDS、NIHSS评分均低于本组术前,观察组患者SAS、SDS评分均低于对照组,差异均有统计学意义(P﹤0.05),但两组患者NIHSS评分比较,差异无统计学意义(P﹥0.05).术后1个月,两组患者躯体功能、社会功能、角色功能、心理功能评分和总分均高于本组术前,观察组患者躯体功能、社会功能、角色功能、心理功能评分和总分均高于对照组,差异均有统计学意义(P﹤0.05).结论 激励式信念干预联合早期康复指导可降低脑胶质瘤术后患者的应激反应指标,改善负性情绪和神经功能缺损情况,提高生活质量.
Abstract
Objective To explore the effects of motivational belief intervention combined with early rehabilitation guidance on stress response,negative emotions,and quality of life in postoperative glioma patients.Method A total of 92 glioma patients were divided into control group and observation group based on different intervention methods,with 46 patients in each group.The control group received early rehabilitation guidance on the basis of routine intervention,while the observation group received motivational belief intervention on the basis of the control group.The stress re-sponse indicators[adrenocorticotropic hormone(ACTH),norepinephrine(NE),cortisol],negative emotions[self-rating anxiety scale(SAS),self-rating depression scale(SDS)],neurological deficits[National Institutes of Health stroke scale(NIHSS)],and quality of life[generic quality of life inventory-74(GQOLI-74)]were compared between the two groups.Result Three days after surgery,the levels of ACTH,NE,and cortisol in both groups were higher than those before sur-gery,but the levels of ACTH,NE,and cortisol in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).One month after surgery,the SAS,SDS,and NIHSS scores of both groups were lower than those before surgery,the SAS and SDS scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05),however,there was no statistically signifi-cant difference in NIHSS scores between the two groups(P>0.05).One month after surgery,the scores of physical func-tion,social function,role function,psychological function and total scores of both groups were higher than those before surgery,the scores of physical function,social function,role function,psychological function and total score of the obser-vation group were higher than those of the control group,and the differences were statistically significant(P<0.05).Con-clusion Motivational belief intervention combined with early rehabilitation guidance can reduce stress response indica-tors,improve negative psychological states and neurological deficits,and improve the quality of life in postoperative glio-ma patients.
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