心理护理对直肠癌结肠造口患者影响.docVIP

心理护理对直肠癌结肠造口患者影响 　　【摘要】 目的 探讨心理护理对直肠癌结肠造口患者的心理状态和生活质量的影响。方法 将90例直肠癌结肠造口患者随机分为对照组和干预组,各45例。对照组接受常规治疗和护理,观察组在此基础上实施为期3个月的综合性心理护理干预。比较两组患者干预前后的焦虑自评量表(SAS)、抑郁自评量表(SDS)和生活质量各维度评分。结果 干预后干预组的SDS和SAS评分明显低于对照组,且其社会、心理维度评分明显高于对照组,差异有统计学意义,(P0.05)。结论 心理护理干预可明显改善直肠癌结肠造口患者的心理健康状况,并提高其生活质量。 　　【关键词】 直肠癌;结肠造口;心理状况;生活质量;心理护理 　　 　　Effect of Psychological Nursing Care on Patients with Rectal Cancer Undergoing Colonic Fistula 　　LI Can-hui. 　　Yiyang Clinical Institute of Xiangya Medical College of Central South University, Yiyang 413000, China 　　【Abstract】 Objective To explore the effect of psychological nursing care on mental status and quality of life in patients with rectal cancer undergoing colonic fistula. Methods Ninety cases of rectal cancer undergoing colonic fistula were randomly divided into the control and interventional group, each consisting of 45 cases. The control group received routine therapy and nursing care, while the interventional group received integrated psychological nursing care for 3 months in addition. The scores of SAS, SDS and all dimensions of quality life were compared between both two groups. Results After intervention, the scores of SAS and SDS were markedly lower in the interventional group than in the control group, and the scores of the dimensions of society and psychology were much higher, with significant differences, all P0.05. Conclusion Psychological nursing care can considerably improve the mental status and enhance the quality of life in patients with rectal cancer undergoing colonic fistula. 　　【Key words】 Rectal cancer; Colonic fistula; Mental status; Quality of life; Psychological nursing 　　 　　直肠癌是消化道常见的恶性肿瘤,严重危害人类健康。经腹会阴联合直肠癌根治术(Mile’s术)是目前治疗低位直肠癌的主要手术方式,术后常需在腹壁做永久性的结肠造口。这种术式改变了患者原有的正常排便方式且不能随意控制,对患者的生活方式及社交生活有较大的影响,容易造成患者自尊低下和社交障碍等心理变化,严重影响其生活质量[1]。作者通过对45例直肠癌结肠造口患者实施了包括健康教育、支持性心理护理、认知行为治疗和社会支持在内的综合性心理护理干预,旨在进一步探讨心理护理干预对直肠癌结肠造口患者心理健康状况和生活质量的影响,为临床上实施相应的护理措施提供参考依据。 　　1 资料与方法 　　1.1 一般资料 选取自2006年12月至2008年12月入住本院拟行直肠癌根治伴结肠造口术的患者90例