疼痛与心理护理共同应用于晚期肿瘤癌痛患者的效果研究

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目的:探讨疼痛与心理护理共同应用于晚期肿瘤癌痛患者的效果。方法:选取郑州大学附属肿瘤医院2019年3月至2020年3月收治的晚期肿瘤癌痛患者80例。以简单随机化法分为对照组和观察组,40例每组。对照组男∶女=19∶21,年龄(59.22±7.36)岁,肺癌9例、肠癌13例、胃癌12例、其他6例;观察组男∶女=18∶22,年龄(58.37±7.24)岁,肺癌8例、肠癌11例、胃癌14、其他7例。对照组接受心理护理,观察组接受规范化疼痛护理联合心理护理,对比两组护理效果,包括疼痛程度[视觉模拟评分法(Visual Analogue Scale,VAS)]、负面情绪[抑郁自评量表(Self-rating Depression Scale,SDS)、焦虑自评量表(Self-rating Anxiety Scale,SAS)]、睡眠质量[匹兹堡睡眠质量指数问卷(Pittsburgh Sleep Quality Index,PSQI)]及生活质量[恶性肿瘤患者生活质量通用量表(Functional Assessment of Cancer Therapy-Generic Scale,FACT-G)]。计量资料组间比较采用独立样本n t检验,组内比较采用配对n t检验;计数资料采用n χ2检验。n 结果:护理后,两组VAS评分较护理前均下降(均n P<0.05),且观察组评分(1.87±0.21)分低于对照组的(2.15±0.27)分(n P<0.05)。护理后,两组SDS、SAS评分较护理前均下降(均n P<0.05),且观察组的(46.64±4.19)、(42.38±4.05)分低于对照组的(49.42±5.90)、(45.71±4.96)分(均n P<0.05)。护理后,观察组PSQI的入睡时间、睡眠时间、睡眠质量、睡眠效率、日间功能、睡眠障碍、催眠药物评分为(1.28±0.30)、(1.39±0.33)、(1.56±0.37)、(1.41±0.27)、(1.31±0.26)、(1.44±0.31)、(1.38±0.34)分,均明显低于对照组的(1.51±0.32)、(1.58±0.36)、(1.77±0.41)、(1.66±0.35)、(1.49±0.29)、(1.68±0.39)、(1.65±0.41)分(均n P<0.05)。护理后,两组FACT-G的社会/家庭状况、生理状况、情感状况以及功能状况评分较护理前均升高(均n P<0.05),且观察组各项评分(25.08±6.21)、(24.11±6.34)、(22.67±6.18)、(24.18±6.19)分,高于对照组的(21.74±5.63)、(20.27±4.98)、(19.81±5.32)、(20.51±5.52)分(均n P<0.05)。n 结论:对晚期肿瘤癌痛患者,采用规范化疼痛护理联合心理护理干预,可显著减轻患者疼痛程度及负面情绪,提高患者睡眠质量和生活质量,应用价值高。“,”Objective:To explore the effect of combined application of pain and psychological care on patients with advanced cancer pain.Methods:A total of 80 patients with advanced cancer pain admitted to Affiliated Cancer Hospital of Zhengzhou University from March 2019 to March 2020 were selected. By the simple randomization, they were divided into a control group and an observation group with 40 cases in each group. In the control group, the ratio of male: female was 19:21, aged (59.22±7.36) years, including 9 cases of lung cancer, 13 cases of colon cancer, 12 cases of gastric cancer, and 6 cases of others. In the observation group, the ratio of male: female was 18:22, aged (58.37±7.24) years, including 8 cases of lung cancer, 11 cases of colon cancer, 14 cases of gastric cancer, and 7 cases of others. The control group received psychological care, and the observation group received standardized pain nursing and psychological care. The nursing effects of the two groups were compared, including pain degree [Visual Analogue Scale (VAS)], negative moods [Self-rating Depression Scale (SDS) and Self-rating Anxiety Scale (SAS)], sleep quality [Pittsburgh Sleep Quality Index (PSQI)], and quality of life [Functional Assessment of Cancer Therapy-Generic Scale (FACT-G)]. Independent samplen t test was used for inter-group comparison of measurement data, paired n t test was used for intra-group comparison of measurement data, and χn 2 test was used for count data.n Results:After nursing, the VAS score in both groups decreased compared with those before nursing (both n P<0.05), and the VAS score of the observation group [(1.87±0.21) points] was lower than that of the control group [(2.15±0.27) points] (n P<0.05). After nursing, the SDS and SAS scores of the two groups decreased compared with those before nursing (alln P<0.05), and the SDS and SAS scores of the observation group [(46.64±4.19) and (42.38±4.05) points] were lower than those of the control group [(49.42±5.90) and (45.71±4.96) points] (bothn P<0.05). After nursing, the scores of sleep latency, sleep duration, sleep quality, sleep efficiency, daytime function, sleep disorder, and hypnotic drugs of PSQI in the observation group were (1.28±0.30), (1.39±0.33), (1.56±0.37), (1.41±0.27), (1.31±0.26), (1.44±0.31), and (1.38±0.34) points, which were significantly lower than those in the control group [(1.51±0.32), (1.58±0.36), (1.77±0.41), (1.66±0.35), (1.49±0.29), (1.68±0.39), and (1.65±0.41) points] (alln P<0.05). After nursing, the scores of social/family status, physiological status, emotional status, and functional status of FACT-G in both groups increased compared with those before nursing (alln P<0.05), and the scores of the observation group were (25.08±6.21), (24.11±6.34), (22.67±6.18), and (24.18±6.19) points, which were higher than those in the control group [(21.74±5.63), (20.27±4.98), (19.81±5.32), and (20.51±5.52) points] (alln P<0.05).n Conclusion:For patients with advanced cancer pain, standardized pain nursing combined with psychological nursing intervention can significantly reduce patients\' pain course and negative emotions, improve their quality of sleep and life, with a high application value.
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