【作者】 朱红卫；

【Author】 Zhu Hong-Wei The Fourth Hospital of Hebei medical university & Hebei provincial tumor hospital, Shijiazhuang, 050011, China

【机构】 河北医科大学第四医院暨河北省肿瘤医院；

【摘要】 目的:探讨青年宫颈癌患者放射治疗期间存在的心理问题,并寻求解决其心理问题的护理方法。方法:对我科 2004年12月-2005年12月收治的45例Ⅱb期以上,45岁以下宫颈癌患者进行问卷调查,自行设计心理状态调查表,内容包括:文化程度、职业、住院时间及焦虑、恐惧、孤独、抑郁、绝望、否认等方面的心理问题的形象性描述及发生原因的调查。发放45份,全部收回。经过分析,将患者的心理问题及原因分别归类,统计出各种心理问题发生的例数和各占的比例如下:①焦虑恐惧心理是最为突出的问题,共35例, 占77．78％。面对突如其来的癌症诊断以及应对接踵而来的治疗,内心感受和外在事实发生冲突而产生的反应。由于年轻家庭的责任感,其求生的欲望非常强烈,对自身生活质量是否受到影响,包括性生活及女生生理特点而使患者焦虑不安。②孤独心理共32例,占71．11％。由于患病使患者社会角色发生转变,她们远离熟悉的生活、工作环境,被迫住到病房进行治疗,接触的是陌生人和陌生的环境,因此,感到孤独,情绪低落。③抑郁心理共20例,占44．44％。病人担心疾病治疗效果,为前途担忧,为经济问题担忧,并且随着放射剂量的增多,局部反应相继表现出来,如皮肤色素沉着、脱发、白细胞降低、放射性直肠炎等使病人缺乏信心,闷闷不乐,唉声叹气。④否认心理共8例,占17．78％。患者坚信自己无病或是医生误诊,病情不适时自找一些理由解释而不积极配合治疗。针对宫颈癌患者这些心理特点,我们采取的措施:①给予患者创造一切可能的机会,使病人宣泄内心的悲伤,诱导她们说出内心的感受。②请同病患者介绍其亲身体验,自身感受。③与患者的家属共同做好患者的沟通工作, 建立良好的家庭支持系统,给予患者关心爱护。④主动热情地与病人接触,运用语言和非语言的方式表达关心,进行抚慰,建立良好的护患关系。⑤介绍同病室的病友,组织大家听音乐,开联欢会,缩小彼此的距离,消除陌生感。⑥利用宣传栏,广播咨询方式,放疗期间的临床护理及各种治疗时,将各方面的知识用通俗易懂的语言进行健康宣教。⑦说明患者病情确实很重,经过治疗一定能够缓解病痛,但要委婉表达,使患者重视,正视病情,由“否认”到“承认”,积极配合治疗与护理。结果:针对不同心理问题开展不同的心理护理引导, 加强沟通使其配合治疗、护理,达到了有效的治疗目的。结论:护理人员应该有责任加强对各种不良心理反应的识别,并通过有针对性的心理干预,提高患者的心理承受能力,摆脱不良情绪,以达到最好的治疗效果。更多还原

【Abstract】 Objective: Discuss about the young cervical cancer sufferers’ psychologic problems during their radiation cure period and look for the nursing ways which can solve their psychologic problems. Methods: Our section made the psychology state investigation forms by questionary and investigating the 45-b cancer sufferers who were cured by our section during December,2004 ecember, 2005. The forms include the specific description of the patients’ education levels, jobs, anxiety, fear, solitude, gloom,despair, denying and other psychologic problems when they were in hospital. The 45 pieces of investigation forms have been collected back. By analyzing the forms, we classified the reasons for the patients’ psychologic problems and added up all kinds of psychologic problems examples. They are: 1The most serious problems are anxiety and fear, the percentage is 77.78%. There are 35 cases. The patients react to the sudden cancer diagnosis, the cure and the conflict between feelings and the fact. Their desire for living is very strong. Because they are young and they are responsible for their families . They feel anxious, because the disease influences their quality of living including their sex life and physiological characteristics of women. 2Solitude prombles are 32 cases. The percentage is 71.11%. The illness changes the sufferers’ social roles. They part from their familiar living and working environment and they are forced to live in hospital to be cured. They contact strangers and the environment is not familiar to them. So they feel lonely and they are in low spirits. 3Gloom problems are 20 cases. The percentage is 44.44%. The patients are very worried about the result of cure, their future and economy problems. With the increase of the dosage, their reaction appear in succession. For example, their deposition of skin pigment, hair falling, decrease of leucocyte, rectum inflammation and so on. They make the patients lose their confidence, unhappy and sigh. 4Denying problems are 8 cases and the percentage is 17.78%. The patients strongly believe they are not ill and the doctors make wrong diagnose. They look for some reasons when they feel uncomfortable, but they don’t cooperate with the doctors actively. According to such psychology characteristics of the patients, we should do as follows: 1Give the patients all possible chances to let them vent their grief and induce them to spea out their feelings. 2Let the patients who have the same illness introduce their experience and feelings. 3Do the job of communication well with the patients’ family numbers and make a good system of family support to show concern to the patients. 4Communicate with the patients actively and sincerely. Express your concer to the patients. Console the patients by language or other things to establish good relation with them. 5Introduce the wardmates to each other in the same room. Organize them to listen music and have parties to make their distance short and eliminate更多还原