目的 对口腔癌手术患者应用赋能教育结合激励式心理干预,观察其情绪状态及生活质量的变化.方法 选取2023年1月至2023年12月于郑州大学第一附属医院收治的口腔癌患者80例,均行手术治疗.根据入院顺序及组间基本资料具可比性的原则,将患者分为对照组(2023年1月至2023年5月,n=40)和观察组(2023年6月至2023年12月,n=40).两组患者均予以标准化疾病管理,在此基础上对照组予以常规健康宣教和心理干预,观察组予以赋能教育结合激励式心理干预,两组均干预至出院后3个月.于干预前(入院)、干预后(出院后3个月)分别采用中文版Mishel疾病不确定感量表、抑郁自评量表(self-rating depression scale,SDS)、焦虑自评量表(self-rating anxiety scale,SAS)、特质应对方式问卷(trait coping style questionnaire,TCSQ)、一般自我效能感量表(general self efficacy scale,GSES)和第四版华盛顿大学生存质量评估问卷(University of Washington quality of life assessment questionnaire-4,UW-QoLv4)对两组患者疾病不确定感、情绪状态、应对方式、自我效能和生活质量进行评估;于干预结束后采用本院自制依从性调查表对患者依从性进行评估;记录两组术后并发症发生情况.基于SPSS 24.0统计学软件对两组间(组内)差异进行独立样本t检验、配对t检验和卡方检验.结果 (1)干预前,两组疾病不确定感量表、SAS、SDS、TCSQ、GSES和UW-QoLv4评分均差异无统计学意义(均P＞0.05).(2)干预后,观察组疾病不确定感量表[(91.56±7.49)分]、SAS[(49.83±7.63)分]、SDS[(50.54±6.51)分]、TCSQ-消极应对[(30.21±3.37)分]评分均低于对照组[(100.18±8.52)分,(56.95±8.11)分,(58.14±7.36)分,(32.19±2.36)分,t=4.806,4.044,4.892,3.044,均P＜0.05],TCSQ 积极应对[(34.25±2.13)分]、GSES 量表[(29.25±2.83)分]评分均高于对照组[(31.14±2.06)分,(25.70±3.14)分,t=6.638,5.311,均 P＜0.001].(3)观察组饮食管理、康复训练、术后复查依从性均优于对照组(x2=4.114,6.646,5.165,均P＜0.05).(4)观察组皮瓣坏死发生率低于对照组[5.00％(2/40)比22.50％(9/40),x2=5.165,P＜0.05].(5)干预后,观察组UW-QoLv4[(863.28±24.87)分]评分高于对照组[(751.26±38.94)分,t=15.334,P＜0.01].结论 赋能教育结合激励式心理干预可有效改善口腔癌手术患者情绪状态,提高生活质量.
Effects of empowerment education combined with motivational psychological intervention on emo-tional state and quality of life in patients with oral cancer surgery
Objective To observe the changes of emotional state and quality of life in patients with oral cancer surgery after empowerment education combined with motivational psychological intervention.Methods A total of 80 patients with oral cancer who underwent surgical treatment in the First Affiliated Hospital of Zhengzhou University were enrolled from January to December 2023.According to order of ad-mission and comparability principle of inter-group basic data,the subjects were divided into control group(from January to May 2023,n=40)and observation group(from June to December 2023,n=40).On basis of standardized disease management,control group was given routine health education and psychological inter-vention,while observation group was given empowerment education combined with motivational psychological intervention.All patients were intervened till 3 months after discharge.Before intervention(admission)and after intervention(3 months after discharge),disease uncertainty,emotional state,coping styles,self-effica-cy,compliance and quality of life were evaluated by Mishel uncertainty in illness scale-adult(MUIS-A),self-rating depression scale(SDS),self-rating anxiety scale(SAS),trait coping style questionnaire(TCSQ),general self-efficacy scale(GSES)and University of Washington quality of life questionnaire-4(UW-QoLv4),respectively.The differences between the two groups(intra-group)were analyzed by SPSS 21.0 statistical software,including independent sample t-test,paired t-test and Chi-square test.Results(1)The scores of MUIS-A,SDS,SAS,TCSQ,GSES and UW-QoLv4 were not significantly different between the two groups before intervention(all P＞0.05).(2)After intervention,scores of MUIS-A,SDS,SAS and TCSQ-neg-ative coping in observation group were 91.56±7.49,49.83±7.63,50.54±6.51 and 30.21±3.37,lower than those in control group(100.18±8.52,56.95±8.11,58.14±7.36,32.19±2.36,t=4.806,4.044,4.892,3.044,all P＜0.05).The scores of TCSQ-positive coping and GSES in observation group(34.25±2.13 and 29.25±2.83)were higher than those in control group(31.14±2.06,25.70±3.14,t=6.638,5.311,both P＜0.001).(3)The compliance of dietary management,rehabilitation training and postoperative reexamination in observation group were better than those in control group(x2=4.114,6.646,5.165,all P＜0.05).(4)The incidence of flap necrosis in observation group was lower than that in control group(5.00％(2/40)vs 22.50％(9/40),x2=5.165,P＜0.05).(5)After intervention,UW-QoLv4 score in observation group was higher than that in control group(863.28±24.87 vs 751.26±38.94,t=15.334,P＜0.05).Conclusion Empowerment education combined with motivational psychological intervention can effectively improve the emotional state and quality of life of patients with oral cancer surgery.
Oral cancerEmpowerment educationMotivational psychological interventionEmotional stateQuality of life
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