摘要
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.
Abstract
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.
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