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醫(yī)學(xué)論文范文:綜合心理干預(yù)在老年晚期非小細(xì)胞肺癌化療中的應(yīng)用研究
【摘要】 目的 研究綜合心理行為干預(yù)對(duì)老年晚期非小細(xì)胞肺癌(non-small cell lung cancer, NSCLC)化療患者生存質(zhì)量及依從性的影響。方法 采用隨機(jī)、對(duì)照、配對(duì)的研究方法，將61名老年晚期非小細(xì)胞肺癌患者，分為對(duì)照組(n=31)及綜合心理行為干預(yù)組(治療組，n=30)，使用癌癥生命質(zhì)量核心量表EORTIC QLQ-C30(version 3)、焦慮自評(píng)量表(SAS)、抑郁自評(píng)量表(SDS)等進(jìn)行測(cè)評(píng)，于干預(yù)前后行配對(duì)、對(duì)照評(píng)定。結(jié)果 與對(duì)照組比較患者的生活質(zhì)量量表中的情緒功能、軀體功能、社會(huì)功能、整體健康狀況得分提高，乏力癥狀有所緩解，依從性提高。結(jié)論 綜合心理行為干預(yù)可提高老年晚期非小細(xì)胞肺癌患者的生存質(zhì)量，提高1年生存率，減輕焦慮和抑郁，糾正患者消極的認(rèn)知,提高其對(duì)化療的依從性。
【關(guān)鍵詞】 非小細(xì)胞肺癌; 老年;心理治療; 化療
The investigation of the application of comprehensive psychological intervention
in chemotherapy in elderly patients with non-small cell lung cancer
NI Bingqiang, ZHANG Zhihong, ZHENG Liangcheng, WU Meijuan, HUA Yuanchun
(Department of Oncology, The Fifth School of Clinical Medicine, Guangxi Medical University, Liuzhou, Guangxi 545006, China)
Abstract： Objective To investigate the influence of comprehensive therapy of psycho-behavioral intervention on the quality of life and the compliance with treatment among elderly patients with non-small cell lung cancer (NSCLC) who underwent chemotherapy. Methods 61 elderly patients with advanced non-small cell lung cancer were randomized into two groups: 30 cases in the comprehensive psycho-behavioral intervention group combined with chemotherapy and 31 cases in the control group with chemotherapy alone. The EORTIC QLQ-C30 (version 3), Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) scores were evaluated by paired-control before and after treatment. Results The scores of the life quality including the emotional function, cognitive function, social function, holistic health status, fatigue symptoms and compliance of the patients in the comprehensive intervention group were significantly different from those of patients in the control group. Conclusion The combination of comprehensive psycho-behavioral intervention and chemotherapy can improve the quality of life among elderly NSCLC patients, mitigate anxiety and depression and correct the negative cognitions so as to improve the compliance with chemotherapy.
Key words：non-small cell lung cancer (NSCLC); elderly patients; psychotherapy; chemotherapy醫(yī).學(xué)全.在.線(xiàn)網(wǎng)站f1411.cn
老年晚期非小細(xì)胞肺癌(non-small cell lung cancer,NSCLC)患者常常體質(zhì)差且伴其他慢性疾病，同時(shí)存在重要臟器功能衰退等。Ⅲb、Ⅳ期非小細(xì)胞肺癌術(shù)后及放療后復(fù)發(fā)轉(zhuǎn)移者，治療大多采用以化療為主的綜合治療方法�；煂�(duì)Ⅲb、Ⅳ期非小細(xì)胞肺癌的作用已得到肯定，但其存在高癥狀負(fù)荷和高流失率等[1]，因此我們利用心理干預(yù)配合化療以期緩解癥狀，提高生存質(zhì)量，增加患者對(duì)化療的依從性，取得了較好效果，現(xiàn)報(bào)道如下。
1 資料和方法
1.1 一般資料 選擇2005年1月—2008年2月住院的經(jīng)X線(xiàn)、CT、MRI等影像學(xué)及組織、細(xì)胞學(xué)證實(shí)的Ⅲb、Ⅳ期非小細(xì)胞肺癌老年患者61例，分成治療組(n=30)和對(duì)照組(n=31)。兩組性別、年齡、病理分型、分期及化療方法等經(jīng)統(tǒng)計(jì)學(xué)處理均無(wú)差異(表1)。
