目的:探究家庭赋权护理联合心理行为干预提高骨肉瘤患者术后家庭生活质量的疗效。方法:本研究选择自2017年1月1日~2019年6月1日入我院骨科进行保守治疗的患者,100例,按照数字表法随机分组,分成对照组50例和观察组50例。观察组采用家庭赋权护理联合心理行为干预骨肉瘤患者的治疗,对照组采用常规护理方案。利用焦虑自评量表(SAS),抑郁自评量表(SDS)测量患者和家属的负面情绪。结果:两组患者的一般基准资料无统计学差异(P > 0.05);两组患者和患者家属入院时SAS评分和SDS评分比较无统计学差异(P > 0.05);手术后24 h,出院时和出院后2个月SAS评分和SDS评分比较具有统计学差异(P < 0.01)。两组患者家属的赋权心理护理,自我支持维护和情感支持维护比较具有统计学差异(P < 0.01)。结论:家庭赋权护理联合心理干预护理方案有助于骨肉瘤患者术后的社会属性的回归,促进家庭关系和谐,提高生活质量。 Objective: To explore the effect of family empowerment nursing combined with psychological and behavioral intervention to improve the quality of family life of patients with osteosarcoma. Methods: From January 1, 2017 to June 1, 2019, 100 patients were randomly divided into control group (n = 50) and observation group (n = 50). The observation group was treated with family empowerment nursing combined with psychological and behavioral intervention, while the control group was given routine nursing. Self rating Anxiety Scale (SAS) and self rating Depression Scale (SDS) were used to measure the negative emotions of patients and their families. Results: There was no significant difference in the general baseline data between the two groups (P > 0.05); there was no significant difference in SAS score and SDS score between the two groups and their family members at admission (P > 0.05); there were significant differences in SAS score and SDS score at 24 h after operation, at discharge and 2 months after discharge (P < 0.01). There were significant differences in empowerment psychological care, self support maintenance and emotional support maintenance between the two groups (P < 0.01). Conclusion: The family empowerment nursing combined with psychological intervention nursing program is helpful to the regression of social attributes of patients with osteosarcoma after operation, promote the harmony of family relationship and improve the quality of life.
目的:探究家庭赋权护理联合心理行为干预提高骨肉瘤患者术后家庭生活质量的疗效。方法:本研究选择自2017年1月1日~2019年6月1日入我院骨科进行保守治疗的患者,100例,按照数字表法随机分组,分成对照组50例和观察组50例。观察组采用家庭赋权护理联合心理行为干预骨肉瘤患者的治疗,对照组采用常规护理方案。利用焦虑自评量表(SAS),抑郁自评量表(SDS)测量患者和家属的负面情绪。结果:两组患者的一般基准资料无统计学差异(P > 0.05);两组患者和患者家属入院时SAS评分和SDS评分比较无统计学差异(P > 0.05);手术后24 h,出院时和出院后2个月SAS评分和SDS评分比较具有统计学差异(P < 0.01)。两组患者家属的赋权心理护理,自我支持维护和情感支持维护比较具有统计学差异(P < 0.01)。结论:家庭赋权护理联合心理干预护理方案有助于骨肉瘤患者术后的社会属性的回归,促进家庭关系和谐,提高生活质量。
家庭赋权护理,心理行为干预,骨肉瘤,家庭关系和谐
Luyao Ruan
Department of Orthopedics, Hengdian Wenrong Hospital, Jinhua Zhejiang
Received: Dec. 3rd, 2020; accepted: Dec. 23rd, 2020; published: Dec. 30th, 2020
Objective: To explore the effect of family empowerment nursing combined with psychological and behavioral intervention to improve the quality of family life of patients with osteosarcoma. Methods: From January 1, 2017 to June 1, 2019, 100 patients were randomly divided into control group (n = 50) and observation group (n = 50). The observation group was treated with family empowerment nursing combined with psychological and behavioral intervention, while the control group was given routine nursing. Self rating Anxiety Scale (SAS) and self rating Depression Scale (SDS) were used to measure the negative emotions of patients and their families. Results: There was no significant difference in the general baseline data between the two groups (P > 0.05); there was no significant difference in SAS score and SDS score between the two groups and their family members at admission (P > 0.05); there were significant differences in SAS score and SDS score at 24 h after operation, at discharge and 2 months after discharge (P < 0.01). There were significant differences in empowerment psychological care, self support maintenance and emotional support maintenance between the two groups (P < 0.01). Conclusion: The family empowerment nursing combined with psychological intervention nursing program is helpful to the regression of social attributes of patients with osteosarcoma after operation, promote the harmony of family relationship and improve the quality of life.
Keywords:Family Empowerment Nursing, Psychological and Behavioral Intervention, Osteosarcoma, Harmonious Family Relationship
Copyright © 2020 by author(s) and Hans Publishers Inc.
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骨肉瘤也叫成骨肉瘤,是较常见的发生在20岁以下的青少年或儿童的一种恶性骨肿瘤,在小儿骨恶性肿瘤中最多见,约为小儿肿瘤的5%,骨肉瘤多发生在骨骼生长发育的旺盛时期,其恶性程度又较高,因此是严重影响劳动生产力并危及生命的重要肿瘤之一 [
本研究为前瞻性研究,以自2017年1月1日~2019年6月1日入我院骨科进行保守治疗的患者100例,按照数字表法随机分组,分成对照组50例和观察组50例。对照组年龄为32~45岁,平均年龄为(36.77 ± 6.89)岁;BMI为(16.73 ± 2.83) kg/cm2;观察组年龄为33~42岁,平均年龄为(37.09 ± 5.99)岁;BMI为(17.09 ± 4.08) kg/cm2;全部患者均经过病理学检查后确认骨肉瘤。
1) 初次诊断的骨肉瘤患者;2) 无心理障碍的患者,比如精神抑郁的患者,焦虑症患者;3) 所有患者以及家属均签署知情同意书。
1) 多次治疗的骨肉瘤患者;2) 具有心理障碍的患者;3) 未签署手术知情同意书的患者;4) 医从性差的患者。
1) 家庭赋权护理模式 [
2) 心理行为干预模式 [
1) CCFNI量表 [
2) 焦虑自评量表 [
3) 抑郁自评量表 [
4) 统计学方法
本研究采用SPSS 16.0统计软件进行分析,计数资料采用卡方检验,计量资料采用X ± S,比较采用t检验,以P < 0.05为差异有统计学意义。
100例患者均获得随访,随访率为100%。本研究统计了实验组和对照组共100例患者的一般基准资料。结果显示,两组患者的一般基准资料无统计学差异(P > 0.05)。如表1所示。
两组患者入院时SAS评分和SDS评分比较无统计学差异(P > 0.05);手术后24 h,出院时和出院后2个月SAS评分和SDS评分比较具有统计学差异(P < 0.01)。如表2所示。
项目 | 患者 | P值 | 患者家属 | P值 | ||
---|---|---|---|---|---|---|
对照组(n = 50) | 观察组(n = 50) | 对照组(n = 50) | 观察组(n = 50) | |||
年龄 | ||||||
30~35岁 | 31 | 29 | >0.05 | 30 | 33 | >0.05 |
36~50岁 | 10 | 11 | 14 | 12 | ||
>50岁 | 9 | 10 | 6 | 5 | ||
文化程度 | ||||||
初中及以下 | 17 | 19 | >0.05 | 21 | 25 | >0.05 |
高中及中专 | 14 | 15 | 9 | 7 | ||
本科及以上 | 19 | 16 | 20 | 18 | ||
婚姻状况 | ||||||
已婚 | 49 | 48 | >0.05 | 49 | 47 | >0.05 |
未婚或者离婚 | 1 | 2 | 1 | 3 | ||
与患者关系 | ||||||
父母 | 2 | 3 | >0.05 | 1 | 1 | >0.05 |
夫妻 | 47 | 46 | 38 | 39 | ||
子女 | 1 | 1 | 1 | 0 | ||
医疗付费支付方式 | ||||||
公费 | 14 | 13 | >0.05 | 15 | 16 | >0.05 |
医保 | 26 | 27 | 25 | 25 | ||
自费 | 10 | 10 | 10 | 9 |
表1. 两组患者的一般基准情况
组别 | SAS评分 | SDS评分 | ||||||
---|---|---|---|---|---|---|---|---|
入院时 | 手术后24 h | 出院时 | 出院后2个月 | 入院时 | 手术后24 h | 出院时 | 出院后2个月 | |
对照组(n = 50) | 58.09 ± 5.97 | 58.09 ± 5.97 | 58.09 ± 5.97 | 58.09 ± 5.97 | 58.09 ± 5.97 | 58.09 ± 5.97 | 58.09 ± 5.97 | 58.09 ± 5.97 |
观察组(n = 50) | 58.09 ± 5.97 | 58.09 ± 5.97 | 58.09 ± 5.97 | 58.09 ± 5.97 | 58.09 ± 5.97 | 58.09 ± 5.97 | 58.09 ± 5.97 | 58.09 ± 5.97 |
t值 | 1.98 | 4.77 | 4.89 | 5.98 | 1.09 | 3.92 | 5.93 | 4.97 |
P值 | >0.05 | <0.01 | <0.01 | <0.01 | >0.05 | <0.01 | <0.01 | <0.01 |
表2. 两组患者干预前后SAS评分和SDS评分比较结果
两组患者家属干预入院时SAS评分和SDS评分比较无统计学差异(P > 0.05);手术后24 h,出院时和出院后2个月SAS评分和SDS评分比较具有统计学差异(P < 0.01)。如表3所示。
组别 | SAS评分 | SDS评分 | ||||||
---|---|---|---|---|---|---|---|---|
入院时 | 手术后24 h | 出院时 | 出院后2个月 | 入院时 | 手术后24 h | 出院时 | 出院后2个月 | |
对照组(n = 50) | 49.27 ± 3.57 | 37.21 ± 3.14 | 36.97 ± 6.09 | 30.54 ± 7.01 | 48.47 ± 3.18 | 38.11 ± 4.54 | 30.09 ± 3.19 | 28.14 ± 2.88 |
观察组(n = 50) | 48.99 ± 4.03 | 47.33 ± 3.15 | 40.21 ± 4.88 | 38.99 ± 3.14 | 48.12 ± 2.74 | 41.07 ± 2.19 | 40.14 ± 4.07 | 37.24 ± 1.27 |
t值 | 0.99 | 4.55 | 4.19 | 5.14 | 1.22 | 3.78 | 5.14 | 3.07 |
P值 | >0.05 | <0.01 | <0.01 | <0.01 | >0.05 | <0.01 | <0.01 | <0.01 |
表3. 两组患者家属干预前后SAS评分和SDS评分比较结果
两组患者家属的赋权心理护理,自我支持维护和情感支持维护比较具有统计学差异(P < 0.01)。如表4所示。
组别 | 人数 | 赋权家属心理护理 | 自我支持维护 | 情感支持维护 |
---|---|---|---|---|
对照组 | 50 | 4.23 ± 0.23 | 4.59 ± 0.34 | 4.09 ± 0.59 |
观察组 | 50 | 3.89 ± 0.42 | 3.38 ± 0.49 | 3.19 ± 0.35 |
t值 | - | 4.08 | 3.69 | 4.11 |
P值 | - | <0.01 | <0.01 | <0.01 |
表4. 两组患者家属的赋权心理护理和自我支持维度的得分
肿瘤对于大多数人而言是一种“绝症”的存在,在无专业知识支撑的人群中,他们认为,肿瘤就意味着死亡。而其,骨肉瘤患者多见于年轻人,所以,他们本身的压力和家庭成员的压力均比较大 [
在常规护理中,以患者的身体生理各项机能指标为导向,注重调节患者体内的激素水平,机体电解质是否平衡,营养状况如何 [
骨肉瘤患者具有年轻化的特点,具有敏感,情感波动大的特点,所以,骨肉瘤患者的焦虑和抑郁的发生率要明显高于其他肿瘤患者 [
综上所述,家庭赋权护理联合心理干预护理方案有助于骨肉瘤患者社会属性的回归,促进家庭关系和谐,提高生活质量。
阮璐瑶. 家庭赋权护理联合心理行为干预提高骨肉瘤患者术后家庭生活质量的疗效观察Effect of Family Empowerment Nursing Combined with Psychological and Behavioral Intervention on Improving Family Life Quality of Patients with Osteosarcoma after Operation[J]. 医学诊断, 2020, 10(04): 254-259. https://doi.org/10.12677/MD.2020.104040