乳腺癌患者疾病接纳干预方案的构建及可行性研究

doi:10.3761/j.issn.1672-9234.2020.10.002

摘要/Abstract

摘要：

目的构建乳腺癌患者疾病接纳干预方案并评价其可行性。方法采用文献综述、描述性研究、理论研究、专家论证等方法开发乳腺癌患者疾病接纳干预方案,并邀请5名专家进行修订,该干预方案以接纳承诺疗法为主要干预策略,包括与“爱”同在、正念生活、接纳疾病、伴“爱”成长4个主题,每个主题60~70 min。招募到11例患者实施干预,通过可行性评价指标和医院焦虑抑郁量表、接纳与行动问卷Ⅱ、疾病认知问卷、乳腺癌患者生存质量测定量表、领悟社会支持量表评估干预方案的可行性及初步效果。结果研究期间,该项目的招募率为65%,留存率为82%,作业依从率为50%~64%,干预方案接受率为100%。干预后,患者的疾病认知中接纳维度、心理灵活性、生存质量、感知社会支持得分较干预前均提高（P<0.05）;接纳与行动问卷Ⅱ得分低于干预前（P<0.05）。结论疾病接纳团体干预方案具有科学性、系统性,在乳腺癌患者治疗期应用具有可行性。

关键词: 乳腺肿瘤, 可行性研究, 心理疗法, 疾病接纳

Abstract:

Objective To develop the psychological intervention to promote illness acceptance for breast cancer patients,and evaluate its feasibility and preliminary effectiveness. Methods The psychological intervention was developed by means of literature review,descriptive study,related theories and experts’ consultation. And the expert’s demonstration and revision were carried out. The Acceptance and Commitment therapy-based psychological intervention were formed,including 4 modules：living with it;mindful life;accepting it;developing with it. Each module lasted 60 to 70 min. The intervention was carried out in one group. The feasibility was accessed and the Hospital Anxiety and Depression Scale,Acceptance and Action Questionnaire Ⅱ,the Illness Cognition Questionnaire,Functional Assessment of Cancer Therapy-Breast,and Perceived Social Support Scale were used to evaluate the effectiveness. Results For the feasibility study,the recruitment rate was 65%,the retention rate was 82%,the adherence rate for homework were from 50% to 64%,and the acceptability rate was 100%. The score of acceptance of illness,psychological flexibility,quality of life and perceived social support were statistically increased pre-to post-intervention（P<0.05）. The score of Acceptance and Action Questionnaire Ⅱ was statistically decreased pre-to post-intervention （P<0.05）. Conclusion This psychological intervention for illness acceptance was scientific and systematic,and it was feasible among breast cancer patients during their treatment period.

Key words: Breast Neoplasms, Feasibility Studies, Psychotherapy, Illness acceptance

韩静,张莉,汪宝银,邱慧,苏娅丽,刘均娥. 乳腺癌患者疾病接纳干预方案的构建及可行性研究[J]. 中华护理教育, 2020, 17(10): 874-879.

HAN Jing,ZHANG Li,WANG Bao-yin,QIU Hui,SU Ya-li,LIU Jun-e. The development of disease acceptance intervention and its feasibility evaluation for patients with breast cancer[J]. Chinese Journal of Nursing Education, 2020, 17(10): 874-879.

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