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姑息护理对晚期胰腺癌患者癌因性疲乏及负性情绪的影响

作者:豆 艳

所属单位:河南省人民医院肿瘤内科二病区 (河南 郑州 450003)

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摘要

目的 探究姑息护理对晚期胰腺癌患者癌因性疲乏及负性情绪的影响。方法 选取2015年12月-2017年12月我院收治 的102例晚期胰腺癌患者为研究对象,按抽签法平均分为试验组与对照组,每组各51例。对照组给予常规护理,试 验组在对照组基础上采取姑息护理措施。分别于护理干预前、护理干预1个月后采用PIPER-疲乏量表(PFS)、汉密尔 顿焦虑评价量表(HAMA)与汉密尔顿焦虑抑郁评价量表(HAMD)评估患者主观疲劳不适感及负性情绪。结果 护理干预1 个月后,试验组中重度疲乏率、HAMA和HAMD得分均较干预前明显降低,且低于于同期对照组(P均<0.05);对照组 护理干预前后中重度疲乏率、HAMA和HAMD得分变化均不明显(P均>0.05)。结论 姑息护理有助于改善晚期胰腺癌患 者的癌因性疲乏及负性情绪。

Objective To explore the effects of palliative care on cancer-related fatigue and negative emotions in patients with advanced pancreatic cancer. Methods A total of 102 patients with advanced pancreatic cancer admitted to our hospital from December 2015 to December 2017 were selected for the study and were divided into experimental group and control group according to the lottery method, with 51 cases in each group. Control group was given routine care, and experimental group was given palliative care measure on the basis of control group. The subjective fatigue discomfort and negative emotions were evaluated by PIPER-Fatigue Scale (PFS), Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) before nursing intervention and after 1 month of nursing intervention. Results After 1 month of nursing intervention, the moderate-severe fatigue rate and scores of HAMA and HAMD in experimental group were significantly lower than those before intervention, and were lower than those in control group at the same time period (all P<0.05). There were no significant changes in the moderate-severe fatigue rate and scores of HAMA and HAMD in control group before and after nursing intervention (all P>0.05). Conclusion Palliative care can improve the cancer-related fatigue and negative emotions in patients with advanced pancreatic cancer.

【关键词】姑息护理;晚期胰腺癌;癌因性疲乏;负性情绪

【中图分类号】R735.9;R473.73

【文献标识码】A

【DOI】10.3969/j.issn.1009-3257.2019.01.029

前言

胰腺癌作为消化系统临床常见恶性肿瘤,恶性程 度高、预后差,多数初诊患者已发展到晚期,确诊后 1年内死亡率高达95%[1],对确诊患者及其家属的心理 和精神形成巨大打击。晚期癌症患者负性情绪水平 高,其中焦虑与抑郁[3]尤为突出。癌因性疲乏亦是晚 期癌症常见症状,持续时间长,患者主观感觉乏力、 精神不振,休息时间延长,影响患者治疗效果与生活 质量。因此有必要对晚期胰腺癌患者进行积极干预, 减轻负性情绪与癌因性疲乏。姑息护理是一种为疾 病无法治愈的患者提供的多学科综合性护理模式,以 维护患者尊严及生活质量作为工作核心,以有效控制疼痛及其他临床症状,缓解负性情绪,并对家属予以 支持。为探究姑息护理对晚期胰腺癌患者癌因性疲乏 及负性情绪的影响,本研究特选取102例患者进行试 验,结果报道如下。