目的 探讨集束化认知行为干预对脑胶质瘤患者疾病恐惧及心理安全感的影响.方法 选取2022年1月—2023年6月接受手术治疗的脑胶质瘤患者92例为研究对象,按照入组顺序分为研究组(44例)和对照组(48例).对照组患者接受常规医疗护理干预,研究组患者在常规医疗护理干预基础上进行为期4周的脑胶质瘤集束化认知行为干预.分别在入组时、干预2周后、干预4周后,采用恐惧疾病进展简化量表(fear of progression questionnaire short form,FoP-Q-SF)、安全感问卷(safety questionnaire,SQ)、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating de-pression scale,SDS)对所有被试进行评估.采用SPSS 26.0软件进行统计分析,采用重复测量方差分析比较两组患者干预前后FoP-Q-SF、SQ、SAS、SDS的评分.结果 (1)两组患者FoP-Q-SF总分及生理健康维度、社会家庭维度评分干预前后交互效应显著(F=254.839,52.738,122.237,均P＜0.05).进一步简单效应分析,在干预2周和4周后,研究组FoP-Q-SF评分[干预2周后:(33.80±4.94)分,(36.48±4.04)分;干预4周后:(31.25±4.55)分,(35.94±4.47)分]、社会家庭维度[干预2周后:(15.32±2.56)分,(17.06±2.14)分;干预 4 周后:(14.05±2.59)分,(16.96±1.99)分]评分低于对照组(均P＜0.05),生理健康维度评分干预4周后低于对照组[干预4周后:(17.30±2.92)分,(19.06± 2.38)分](P＜0.05).研究组干预4周后,FoP-Q-SF评分、生理健康维度评分、社会家庭维度评分均低于干预2周后和干预前(均P＜0.05).(2)两组患者SQ总分、人际安全感维度评分、确定控制感评分干预前后均交互效应显著(F=193.129,54.706,44.015,均P＜0.05).进一步简单效应检验,在干预2周和4周后,研究组SQ总分、人际安全感评分均高于对照组(均P＜0.05),研究组确定控制感评分在干预4周后高于对照组(P＜0.05).研究组干预2周后、干预4周后SQ总分、人际安全感评分和确定控制感评分均高于干预前(均P＜0.05),干预4周后SQ总分、人际安全感评分均高于干预2周后(均P＜0.05).(3)两组患者SAS评分、SDS评分干预前后交互效应显著(F=237.867,282.882,均P＜0.05).进一步简单效应分析,在干预2周后和干预4周后,研究组SAS评分、SDS评分均低于对照组(均P＜0.05).研究组干预2周后、干预后4周SAS评分、SDS评分均低于干预前(均P＜0.05),干预4周后SAS评分、SDS评分均低于干预2周后(均P＜0.05).结论 集束化认知行为干预能够改善脑胶质瘤患者疾病恐惧及负性情绪,增强心理安全感.
Effects of bunched cognitive behavior intervention on disease fear and psychological security in glio-ma patients
Objective To investigate the effects of bunched cognitive behavior intervention on dis-ease fear and psychological security in patients with glioma.Methods A total of 92 patients with glioma who underwent surgical treatment from January 2022 to June 2023 were selected.According to the order of enroll-ment,all subjects were divided into research group(n=44)and control group(n=48).The patients in control group received routine medical and nursing intervention,and patients the research group adopted glioma bunched cognitive behavior intervention on the basis of routine medical and nursing intervention,including 4 intervention cycles.At enrollment,2 weeks after intervention,and 4 weeks after intervention,all subjects were evaluated by the fear of progression questionnaire-short form(FoP-Q-SF),safety questionnaire(SQ),self-rating anxiety scale(SAS)and self-rating depression scale(SDS).All the data in this study were processed by SPSS 26.0 statistical software.The scores of FoP-Q-SF,SQ,SAS and SDS before and after intervention were compared by repeated measures ANOVA between the two groups.Results(1)The total FoP-Q-SF score,physiological health dimension scores,and social family dimension scores of the two groups showed sig-nificant interaction effects before and after intervention(F=254.839,52.738,12.237,all P＜0.05).Further simple effect analysis showed that after 2 and 4 weeks of intervention,the FoP-Q-SF scores of the research group(2 weeks after intervention:33.80±4.94,36.48±4.04;4 weeks after intervention:31.25±4.55,35.94±4.47)and social family dimensions(2 weeks after intervention:15.32±2.56 points,17.06±2.14;4 weeks after intervention:14.05±2.59,16.96±1.99)were lower than those of the control group(all P＜0.05).The physiological health dimension score of the research group was lower than that of the control group after 4 weeks of intervention(4 weeks after intervention:17.30±2.92,19.06±2.38)(P＜0.05).Af-ter 4 weeks of intervention,the FoP-Q-SF score,physiological health dimension score,and social family di-mension score of the research group were all lower than those at 2 weeks after intervention and before inter-vention(all P＜0.05).(2)The total SQ score,interpersonal security dimension score and the determined control score of the two groups showed significant interaction effects before and after intervention(F=193.129,54.706,44.015,all P＜0.05).Further simple effect testing showed that after 2 and 4 weeks of in-tervention,the total SQ score and interpersonal security score of the research group were higher than those of the control group(all P＜0.05).The determined control score of the research group was higher than that of the control group after 4 weeks of intervention(P＜0.05).After 2 and 4 weeks of intervention,the total SQ score,interpersonal security score,and determination control score of the research group were higher than be-fore intervention(all P＜0.05),and the total SQ score and interpersonal security score of the research group were higher than 2 weeks after intervention(both P＜0.05).(3)The SAS score and SDS score of the two groups showed significant interaction effects before and after intervention(F=237.867,282.882,both P＜0.05).Further simple effect analysis showed that after 2 and 4 weeks intervention,the SAS and SDS scores of the research group were lower than those of the control group(all P＜0.05).The SAS and SDS scores of the research group were lower after 2 weeks and 4 weeks intervention than before intervention(all P＜0.05).The SAS and SDS scores of the research group at 4 weeks after intervention were lower than those at 2 weeks after intervention(both P＜0.05).Conclusion Bundled cognitive behavioral intervention can improve dis-ease fear and negative emotions in patients with glioma,and enhance psychological security.
Bunched cognitive behavior interventionGliomaFear of diseasePsychological securityAnxietyDepression
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