【作者】 刘姣林； 巴彩霞； 丁莲英；

【Author】 Liu Jiao-Lin Ba Cai-Xia Ding Lian-Ying Baotou Tumour Therapy Hospital, third Internal Medicine Baotou 014030,China

【机构】 包头市肿瘤医院内三科；

【摘要】 目的:探讨心理行为干预对乳腺癌术后拒绝化疗患者的影响。方法:将42例乳腺癌术后拒绝化疗患者随机分成干预组(22例)和对照组(20例),两组在性别、年龄、文化程度、职业分布、拒绝化疗原因等情况比较差异均无显著性(P>0．05)。同时对患者拒绝化疗的原因进行了调查,主要原因有心理状态、对化疗毒副作用的耐受性、社会支持等三个方面,对患者难以忍受化疗毒副作用反应的原因也进行了调查分析,认为毒副作用的发生与心理因素是有很大关系的。对照组给予常规介绍化疗的目的、意义和方法、以及如何配合化疗,并且对患者提出的问题给予解释;干预组在对照组基础上给予心理行为干预,采用(1)心理支持:热情接待患者, 给患者提供安全、舒适的治疗环境。与患者建立良好的、互相信任的、互相尊重的冶疗性人际关系,耐心倾听其诉说,并做出必要的反应。针对存在的问题提出建议和指导,帮助患者建立自信,摆脱心理困惑,而了解自我,从而消除顾虑,积极配合治疗。(2)提高认知能力:根据患者的文化程度,向他们解释药物的作用机制等有关知识,使其明白化疗的毒副作用虽不可完全避免,但通过积极中西医对症治疗、心理行为调整、辅助药物应用等可减轻症状。(3)行为强化,矫正训练:行为矫正是行为治疗的一种基本方法,最常见方法是让患者进行松弛现象训练,通过训练,能减轻患者的心理困惑,增加患者对疾病的控制感,减轻化疗引起的生理、心理反应,积极配合治疗。结果:干预组总有效率为90．9％,对照组总有效率为60 ％,干预组主动配合要求化疗者明显高于对照组(P<0．05)。结论:心理行为干预在缓解乳腺癌术后患者拒绝化疗方面是一种有效的手段,对减轻化疗的不良反应,帮助患者顺利完成化疗疗程,恢复良好的心理及社会功能具有积极的作用, 在临床治疗中应予以重视。更多还原

【Abstract】 Objective: This paper investigates PBI of influene about refusal chemotherapy patient of postoperative MC. Methods: Forty-two refusal chemotherapy patients share in intervenient group (22 cases) and matched group (20 cases).Two groups comparision difference have not significance (P>0.05)in sex, age, educational level, occupational classification and causation of refusal chemotherapy. Investigate causations of refusal chemotherapy, and are mental state, toleration of chemotherapy toxic action and social support. Analyse patients hard to endure the reaction of chemotherapy toxic action, and consider its occurrence to be concerned in psychological factor. Matched group introdces chemotherapy of its purpose, meaning, method and coordination, and explicates questions of patient Intervenient group shows PBI for patients in the base of matched group. Use: a) Mental support: Gives patients with cordial reception, therapeutic environment of safety and ease, and builds interpersonal relation of therapy, well, each other trust and respect, and listens to their worries with patience. Proposing and guiding to be aimed at their questions .Help patients to build self-confidence, to eliminate misgivings, to shake off mental aporia, to understand oneself, to cooperate treatment actively. b)Raise cognitive ability: Tell them about medicines’ mechanism of action, and makes patients to understand chemotherapy toxic action to exist actually, and abates MC symptom by expectant treatment of combination of Chinese traditional and Western medicine, by psychological behavior modulation, by auxiliary medicine application. c) Behavior correction training: Behavior modification is a basic method of behavior treatment, and lets patients to proceed to do behavior correction training. Reduces mental aporia of patients, and increases patients’ disease control sensation, and reduces chemotherapy physiological response and psychic reaction, and cooperates treatment. Results: Intervenient group effective rate 90.9%, matched group 60%. A is taller than B(P<0. 05).Conclusion: PBI is an effective means in reduces chemotherapy adverse reaction, in help to finish chemotherapy course, in has positive actions for recovering good mind and social function. Must attach importance to PBI in clinical treatment.更多还原