治療性溝通及干預對乳腺癌手術患者術后恢復、心理應激及希望水平的影響

詹敏

[摘要] 目的 探討治療性溝通及干預對乳腺癌手術患者術后恢復、心理應激及希望水平的影響。方法 收集2012年5月～2016年1月在自貢市第三人民醫院接受手術治療的90例乳腺癌患者，按照隨機數表法分為觀察組（n=45）和對照組（n=45）。對照組患者接受常規護理，觀察組患者在常規護理基礎上加入治療性溝通干預。記錄兩組患者的術后臥床時間、切口引流時間、總住院時間，采用肩關節Neer評分評價術后肢體功能，采用焦慮自評量表（SAS）、抑郁自評量表（SDS）評估兩組患者的負面情緒，采用心理彈性量表（CD-RISC）評價患者的心理彈性；采用Herth希望量表（HHI）評估患者對于疾病康復的希望狀態。 結果 觀察組患者的術后臥床時間、切口引流時間、總住院時間均短于對照組（P < 0.05），出院后1、3、6個月肩關節Neer評分值均顯著高于對照組（P < 0.05）。術前，兩組患者的SAS、SDS、CD-RISC、HHI評分值差異無統計學意義（P > 0.05）。術后1周，兩組SAS、SDS評分值低于術前，CD-RISC、HHI評分值高于術前（P < 0.05）；且觀察組SAS、SDS評分值低于對照組，CD-RISC、HHI評分值高于對照組（P < 0.05）。 結論 治療性溝通及干預可促進乳腺癌患者的術后康復、增強希望水平，降低心理應激。

[關鍵詞] 乳腺癌；治療性溝通；術后恢復；心理應激；希望水平

[中圖分類號] R47 [文獻標識碼] A [文章編號] 1673-7210（2017）04（a）-0177-04

[Abstract] Objective To investigate the effect of therapeutic communication and intervention on postoperative recovery， psychological stress and hope level of patients with breast cancer. Methods 90 patients with breast cancer who underwent surgery in Zigong Third People′s Hospital from January 2012 to January 2016 were divided into observation group （n=45） and control group （n=45） according to random number table. The patients in control group were given to routine nursing and the patients in observation group were given to therapeutic communication and intervention combined with routine nursing. Then postoperative bed time， drainage time， total hospitalization time of two groups were recorded， shoulder joint function was assessed by Neer score； negative emotions were evacuated by self-rating anxiety scale （SAS）and self-rating depression scale （SDS）， resiliency was assessed by CD-RISC； hope state was assessed by HHI. Results Postoperative bed time， drainage time and total hospitalization time of observation group were shorter than those of control group （P < 0.05）. 1， 3， 6 months after discharge， the shoulder Neer score of observation group was significantly higher than that of control group （P < 0.05）. Before operation， the SAS，SDS，CD-RISC，HHI scores of two groups had no significant difference（P > 0.05）. One week after operation， the SAS，SDS，CD-RISC，HHI scores of two groups were better than those before operation； the SAS score and SDS score of observation group were significantly lower than those of control group， and CD-RISC， HHI scores of observation group were significantly higher than those of control group （P < 0.05）. Conclusion Therapeutic communication and intervention can promote the recovery of patients with breast cancer， enhance the level of hope， reduce the psychological stress.