摘要
目的:观察健康信念模式(HBM)配合心理干预对老年膀胱癌尿流改道腹壁造口患者负性情绪及生活质量的影响。方法:将我院2013年1月-2017年1月收治的100例膀胱癌尿流改道腹壁造口患者随机分为观察组(常规干预+健康信念模式干预,n=50)与对照组(常规干预,n=50),观察两组干预前后造口自护能力与负性情绪,比较两组免疫功能、并发症率与生活质量。结果:干预后,观察组造口认识(t=5.73,P<0.05),造口装置拆卸(t=4.85,P<0.05)、造口装置安装(t=5.56,P<0.05)、造口直径测量(t=4.22,P<0.05)、底盘修剪(t=1.49,P<0.05)、尿袋排空(t=2.17,P<0.05)、引流袋处理(t=2.75,P<0.05)、周边皮肤处理(t=2.32,P<0.05)及总分(t=13.79,P<0.05)均显著高于对照组;观察组焦虑自评量表(SAS)得分(t=-4.44,P<0.05)、抑郁自评量表(SDS)得分(t=-4.57,P<0.05)均显著低于对照组;观察组CD3^+(t=2.45,P<0.05)、CD4^+(t=2.00,P<0.05)、CD4^+/CD8^+(t=3.05,P<0.05)水平均显著高于对照组,CD8^+(t=-1.99,P<0.05)显著低于对照组;观察组心理功能(PSD)(t=3.04,P<0.05)、社会功能(SOD)(t=2.28,P<0.05)、躯体功能(PHD)(t=2.52,P<0.05)、共性症状及副作用(SSD)(t=2.21,P<0.05)、尿路症状(UTS)(t=2.70,P<0.05)、特异躯体症状(SPS)(t=2.24,P<0.05)、特异心理反应(SPR)(t=2.02,P<0.05)、尿袋问题(UBP)(t=2.51,P<0.05)、性功能(SEP)(t=2.03,P<0.05)以及总分(t=11.03,P<0.05)均显著高于对照组;观察组、对照组并发症率分别为8.00%和24%(χ~2=4.76,P<0.05)。结论:HBM联合心理干预可有效提高尿流改道腹壁造口患者造口自护能力、降低造口相关并发症率,并显著改善其负性情绪,提高患者免疫功能与生活质量,值得临床推广。
Objective:To observe the effects of health belief model(HBM)combined with psychological intervention on negative emotions and quality of life in elderly patients with urinary diversion and abdominal stoma of bladder cancer.Methods:100 cases of patients with urinary diversion and abdominal stoma of bladder cancer admitted to our hospital from January 2013 to January 2017 were randomly divided into observation group(conventional intervention and health belief model intervention,n=50)and control group(conventional intervention,n=50).The stoma self-care ability and negative emotions were observed in the two groups before and after intervention,and the immune function,complications rate and quality of life were compared between the two groups.Results:After intervention,the scores of stoma recognition(t=5.73,P<0.05),stoma device removal(t=4.85,P<0.05),stoma device installation(t=5.56,P<0.05),stoma diameter measurement(t=4.22,P<0.05),chassis trim(t=1.49,P<0.05),urine bag emptying(t=2.17,P<0.05),drainage bag treatment(t=2.75,P<0.05),peripheral skin care(t=2.32,P<0.05)and the total score(t=13.79,P<0.05)in observation group were significantly higher than those in control group.The self-rating anxiety scale(SAS)score(t=-4.44,P<0.05)and self-rating depression scale(SDS)score(t=-4.57,P<0.05)in observation group were significantly lower than those in control group.The levels of CD3^+(t=2.45,P<0.05),CD4^+(t=2.00,P<0.05) and CD4^+/CD8^+(t=3.05,P<0.05)in observation group were significantly higher than those in control group while the CD8^+level(t=-1.99,P<0.05)was significantly lower than that in control group.The scores of psychological domain(PSD)(t=3.04,P<0.05),social domain(SOD)(t=2.28,P<0.05),physical domain(PHD)(t=2.52,P<0.05),common symptoms and side domain(SSD)(t=2.21,P<0.05),urinary tract symptoms(UTS)(t=2.70,P<0.05),specific physical symptoms(SPS)(t=2.24,P<0.05),specific psychological response(SPR)(t=2.02,P<0.05),urine bag problem(UBP)(t=2.51,P<0.05)and sexual function(t=2.03,P<0.05)and the total score(t=11.03,P<0.05)in
作者
朱继萍
成巧梅
徐静
ZHU Jiping;CHENG Qiaomei;XU Jing(Henan People's Hospital,Zhengzhou 450003,China)
出处
《中国健康心理学杂志》
2019年第5期688-693,共6页
China Journal of Health Psychology
基金
湖北省自然科学基金(编号:2015CKC756)
关键词
健康信念模式
心理干预
老年膀胱癌尿流改道腹壁造口
负性情绪
生活质量
Health belief model
Psychological intervention
Urinary diversion and abdominal stoma of bladder cancer
Negative emotion
Quality of life
