【摘要】 目的 探讨基于计划行为理论的激励式护理对甲状腺癌手术患者癌因性疲乏及身心应激反应的影响。方法 选取2022年7月—2024年1月在医院接受手术治疗的196例甲状腺癌患者作为研究对象，按照组间基本特征均衡可比的原则分为对照组和观察组，每组98例。对照组接受常规护理，观察组接受基于计划行为理论的激励式护理。干预时间为术前至患者出院后3周。比较干预前与术后第2天两组患者的身心应激反应，以及干预前与出院后3周两组患者的癌因性疲乏、应对方式、健康行为、希望水平、舒适度，记录两组患者的护理满意程度。结果 观察组患者收缩压和心率的差值小于对照组，差异有统计学意义（P<0.05）。术后第2天，观察组患者焦虑自评量表（SAS）和抑郁自评量表（SDS）评分低于对照组，差异有统计学意义（P<0.05）。出院后3周，观察组患者Piper疲乏修订自评量表中的情感、行为及严重程度、认知及情绪和感觉评分均低于对照组（P<0.05）。出院后3周，观察组患者应对方式中的面对评分高于对照组，而回避及屈服评分低于对照组，差异有统计学意义（P<0.05）。出院后3周观察组患者健康行为各个维度评分均高于对照组，差异有统计学意义（P<0.05）。出院后3周观察组患者希望水平及Kolcaba舒适状况量表（GCQ）评分均高于对照组，差异有统计学意义（P<0.05）。观察组患者护理满意程度高于对照组，差异有统计学意义（P<0.05）。结论 基于计划行为理论的激励式护理可有效减轻甲状腺癌手术患者身心应激反应和癌因性疲乏，改善患者的应对方式及健康行为，提高患者的希望水平和舒适度，进而提高患者护理满意程度。更多还原

【Abstract】 Objective To investigate the effects of motivational nursing based on the theory of planned behaviour on cancer-related fatigue and psychosomatic stress responses in patients undergoing thyroid cancer surgery.Methods A total of 196 patients with thyroid cancer who underwent surgical treatment at the hospital from July 2022 to January 2024were selected as study subjects.In accordance with the principle of balancing and ensuring comparability of baseline characteristics between groups,they were divided into a control group and an intervention group,with 98 patients in each group.The control group received routine nursing care,the observation group received motivational nursing based on the theory of planned behaviour.The intervention period spanned from preoperative to three weeks discharge.To compare the physical and psychological stress responses of patients in two groups before the intervention and on the 2nd postoperative,as well as cancer-related fatigue,coping strategies,health behaviours,levels of hope,comfort level,to record patients’ nursing satisfaction between the two groups before the intervention and three weeks after discharge.Results On the 2nd day of postoperative,the gap between systolic blood pressure and heart rate was lower in the observation group than in the control group,the difference was statistically significant(P<0.05),and scores on the Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS) were lower in the observation group than in the control group,with statistically significant differences(P<0.05).Three weeks after discharge,patients in the observation group had lower scores than the control group on the Piper Fatigue Revised Self-Assessment Scale for emotional,behavioural and severity,cognitive,and emotional and sensory dimensions(P<0.05).After 3 weeks of dischrge,In terms of coping strategies,patients in the observation group had higher scores for confrontation and lower scores for avoidance and submission compared with the control group,with statistically significant differences(P<0.05).After 3 weeks of discharge,patients in the observation group scored higher than those in the control group across all dimensions of health behaviour,with statistically significant differences(P<0.05).After 3 weeks of discharge,patients in the observation group also scored higher than those in the control group on measures of hope and the Kolcaba General Comfort questionaire(GCQ) scale,with statistically significant differences(P<0.05).Patients in the observation group present a higher levels of satisfaction with nursing care than those in the control group,with statistically significant differences(P<0.05).Conclusion Motivational nursing based on the theory of planned behaviour can effectively alleviate physical and psychological stress responses and cancer-related fatigue in patients undergoing thyroid cancer surgery,improve patients’ coping strategies and health behaviours,enhance patients’ levels of hope and comfort,and consequently increase patients’ satisfaction with nursing care.更多还原