文章摘要

正念减压训练对结直肠癌永久性造口患者病耻感、应对方式及生活质量的影响

作者: 1王瑶, 1王楠, 1邹擎
1 哈尔滨医科大学附属第一医院日间病房,哈尔滨 150086
通讯: 邹擎 Email: 1778179094@qq.com
DOI: 10.3978/j.issn.2095-6959.2021.08.012
基金: 黑龙江省自然科学基金(2016023256)。

摘要

目的:探讨结直肠癌永久性造口患者采用正念减压训练(mindfulness-based stress reduction,MBSR)对其病耻感、应对方式及生活质量的改善作用。方法:采用便利抽样法选取2017年7月至2019年12月在哈尔滨医科大学附属第一医院行永久性结肠造口的结直肠癌患者178例,采用随机数字表法分为MBSR治疗组与对照组,每组各89例。对照组给予常规护理干预,MBSR治疗组在对照组基础上给予MBSR干预。分别在干预前及干预8周后,采用社会影响量表(Social Impact Scale,SIS)评定病耻感,简易应对方式问卷(Simplified Coping Style Questionnaire,SCSQ)评定应对方式,生命质量调查问卷(Quality of Life Questionnaire core 30,QLQ-C30)生活质量量表评定生活质量。结果:两组干预前SIS评分比较差异无统计学意义(P>0.05),干预8周后SIS评分中社会排斥、社会隔离、经济歧视和内在羞耻感评分均低于干预前(P<0.05),且MBSR治疗组低于对照组(P<0.05);两组干预前SCSQ评分比较差异无统计学意义(P>0.05),两组干预8周积极应对SCSQ评分高于干预前(P<0.05),消极应对SCSQ评分低于干预前(P<0.05),且MBSR治疗组干预8周积极应对SCSQ评分高于对照组,消极应对SCSQ评分低于对照组(P<0.05);两组干预前QLQ-C30生活质量量表评分比较差异无统计学意义(P>0.05),两组干预8周QLQ-C30生活质量量表评分中角色功能,情绪功能,社会功能,认知功能和总体健康评分均高于干预前(P<0.05),且MBSR治疗组高于对照组(P<0.05)。结论:MBSR能减轻结直肠癌永久性造口患者病耻感,改善应对方式,提高生活质量。
关键词: 永久性造口;正念减压训练;病耻感;应对方式;生活质量

Effect of mindfulness-based stress reduction on the stigma, coping style and quality of life in patients with permanent ostomy for colorectal cancer

Authors: 1WANG Yao, 1WANG Nan, 1ZOU Qing
1 Day Ward, First Affiliated Hospital of Harbin Medical University, Harbin 150086, China

CorrespondingAuthor: ZOU Qing Email: 1778179094@qq.com

DOI: 10.3978/j.issn.2095-6959.2021.08.012

Foundation: This work was supported by the Natural Science Foundation of Heilongjiang Province, China (2016023256).

Abstract

Objective: To explore the effect of mindfulness-based stress reduction (MBSR) on improving stigma, coping style and quality of life in patients with permanent ostomy for colorectal cancer. Methods: A total of 178 patients with colorectal cancer who received permanent colostomy in the First Affiliated Hospital of Harbin Medical University from July 2017 to December 2019 were selected by convenience sampling method, which were divided into a MBSR treatment group and a control group with 89 cases in each group by random number table method. The patients in the control group were given routine nursing intervention, and the MBSR treatment group was given MBSR intervention based on the control group. Before the intervention and 8 weeks after intervention, the social impact scale (SIS) was used to assess stigma, the simplified coping style questionnaire (SCSQ) to assess coping style, and the QLQ-C30 quality of life scale to assess quality of life. Results: There was no significant difference in SIS scores between the two groups before intervention (P>0.05). The scores of social exclusion, social isolation, economic discrimination, and intrinsic shame in the 8-week SIS scores of the two groups were lower than those before intervention (P<0.05), and the scores of the MBSR treatment group were lower than those of the control group (P<0.05). There was no statistically significant difference in the SCSQ scores between the two groups before intervention (P>0.05). The SCSQ score of the positive coping style of the two groups after 8 weeks of intervention was higher than that before intervention (P<0.05), and the SCSQ score of the negative coping style of the two groups after 8 weeks of intervention was lower than that before intervention (P<0.05). The SCSQ score of the positive coping style of the MBSR treatment group after 8 weeks of intervention was higher than that of the control group. The SCSQ score of negative coping style was lower than that of the control group (P<0.05). There was no significant difference between two groups in scores of the QLQ-C30 quality of life scale before interventions (P>0.05). The role function, emotional function, social function, cognitive function and general health scores of QLQ-C30 quality of life scale in both groups after 8 weeks intervention were higher than those before intervention (P<0.05), and the score of the MBSR treatment group was higher than that of the control group (P<0.05). Conclusion: MBSR can reduce the stigma, improve the coping style, and improve the quality of life of patients with permanent ostomy for colorectal cancer.
Keywords: permanent ostomy; mindfulness-based stress reduction; stigma; coping style; quality of life

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