ISSN 2097-6054（网络） ISSN 1672-9234（印刷） CN 11-5289/R
主管：中国科学技术协会　主办：中华护理学会
出版：中华护理杂志社
收录：中国科学引文数据库（CSCD）来源期刊
　　　中国期刊全文数据库
　　　中国核心期刊（遴选）数据库
　　　Scopus
中华护理教育

中华护理教育 >

2020 , Vol. 17 >Issue 10: 874 - 879

DOI: https://doi.org/10.3761/j.issn.1672-9234.2020.10.002

论著

乳腺癌患者疾病接纳干预方案的构建及可行性研究

  • 韩静 ,
  • 张莉 ,
  • 汪宝银 ,
  • 邱慧 ,
  • 苏娅丽 ,
  • 刘均娥
展开
  • 221004 徐州市 徐州医科大学护理学院（韩静,张莉,汪宝银）;北京市 首都医科大学护理学院（邱慧,刘均娥）;北京市 首都医科大学附属天坛医院乳腺科（苏娅丽）
韩静：女,博士,讲师,E-mail： jingandyang@163.com

收稿日期: 2020-06-05

  网络出版日期: 2020-10-29

基金资助

2020年度江苏高校哲学社会科学研究重大项目(2020SJZDA126)

收起

The development of disease acceptance intervention and its feasibility evaluation for patients with breast cancer

  • Jing HAN ,
  • Li ZHANG ,
  • Bao-yin WANG ,
  • Hui QIU ,
  • Ya-li SU ,
  • Jun-e LIU
Expand
  • School of Nursing Xuzhou Medical University,Xuzhou,221004,China

Received date: 2020-06-05

  Online published: 2020-10-29

Fold

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

本文引用格式

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 . DOI: 10.3761/j.issn.1672-9234.2020.10.002

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

参考文献

[1] World Health Organization. Cancer today:data visualization tools for exploring the global cancer burden in 2018[EB/OL]. [2020-06-24]. http://gco.iarc.fr/today/home.
[2] Mehnert A, Br?hler E, Faller H, et al. Four-week prevalence of mental disorders in patients with cancer across major tumor entities[J]. J Clin Oncol, 2014,32(31):3540-3546.
[3] 陈静, 刘均娥, 苏娅丽, 等. 住院乳腺癌患者心理痛苦及其相关因素调查[J]. 护理管理杂志, 2012,12(3):158-161.
[4] Mitchell AJ, Kaar S, Coggan C, et al. Acceptability of common screening methods used to detect distress and related mood disorders-preferences of cancer specialists and non-specialists[J]. Psycho-Oncology, 2008,17(3):226-236.
[5] Stanton AL, Danoff-Burg S, Huggins ME. The first year after breast cancer diagnosis:hope and coping strategies as predictors of adjustment[J]. Psycho-Oncology, 2002,11(2):93-102.
[6] Carver CS. You want to measure coping but your protocol’s too long:consider the brief COPE[J]. Int J Behav Med, 1997,4(1):92-100.
[7] Elumelu TN, Asuzu CC, Akin-Odanye EO. Impact of active coping,religion and acceptance on quality of life of patients with breast cancer in the department of radiotherapy,UCH,Ibadan[J]. BMJ Support Palliat Care, 2015,5(2):175-180.
[8] 薛翠翠, 刘均娥, 苏娅丽, 等. 乳腺癌康复者自我形象的团体接纳与承诺干预方案构建及其初步验证[J]. 中国护理管理, 2015,15(1):8-12.
[9] Hsu SC, Wang HH, Chu SY, et al. Effectiveness of informational and emotional consultation on the psychological impact on women with breast cancer who underwent modified radical mastectomy[J]. J Nurs Res, 2010,18(3):215-226.
[10] Chen SQ, Liu JE, Zhang ZX, et al. Self-acceptance and associated factors among Chinese women with breast cancer[J]. J Clin Nurs, 2017,26(11/12):1516-1523.
[11] Chen SQ, Liu JE, Li Z, et al. The process of accepting breast cancer among Chinese women:a grounded theory study[J]. Eur J Oncol Nurs, 2017,28:77-85.
[12] Han J, Liu JE, Qiu H, et al. Illness cognitions and the associated socio-demographic and clinical factors in Chinese women with breast cancer[J]. Eur J Oncol Nurs, 2018,32:33-39.
[13] Lazarus RS, Folkman S. Transactional theory and research on emotions and coping[J]. Eur J Pers, 1987,1(3):141-169.
[14] Hayes SC, Luoma JB, Bond FW, et al. Acceptance and commitment therapy:model,processes and outcomes[J]. Behav Res Ther, 2006,44(1):1-25.
[15] Hayes SC, Strosahl KD, Wilson KG Bond FW. 接受承诺疗法正念改变之道[M]. 祝卓宏,张婍,辛久岭,等,译. 北京: 知识产权出版社, 2016.
[16] Hayes SC, Strosahl K, Wilson KG, et al. Measuring experiential avoidance:a preliminary test of a working model[J]. Psychol Rec, 2004,54(4):553-578.
[17] 曹静, 吉阳, 祝卓宏. 接纳与行动问卷第二版中文版测评大学生的信效度[J]. 中国心理卫生杂志, 2013,27(11):873-877.
[18] Evers AW Kraaimaat FW van Lankveld W, et al. Beyond unfavorable thinking:the illness cognition questionnaire for chronic diseases[J]. J Consult Clin Psychol, 2001,69(6):1026-1036.
[19] Hill G. Nursing research-generating and assessing evidence for nursing practice[J]. Nurse Res, 2010,17(2):88-90.
[20] Snaith RP. The hospital anxiety and depression scale[J]. Br J Gen Pract, 1990,40(336):305.
[21] Cella DF, Tulsky DS, Gray G, et al. The Functional Assessment of Cancer Therapy scale:development and validation of the general measure[J]. J Clin Oncol, 1993,11(3):570-579.
[22] 万崇华, 张冬梅, 汤学良, 等. 乳腺癌患者生命质量测定量表FACT-B中文版介绍[J]. 中国肿瘤, 2002(6):10-12.
[23] Blumenthal JA, Burg MM, Barefoot J, et al. Social support,type A behavior,and coronary artery disease[J]. Psychosom Med, 1987,49(4):331-340.
[24] 黄丽, 姜乾金, 任蔚红. 应对方式、社会支持与癌症病人心身症状的相关性研究[J]. 中国心理卫生杂志, 1996(4):160-161.
[25] Cochrane BB, Lewis FM, Griffith KA. Exploring a diffusion of benefit:does a woman with breast cancer derive benefit from an intervention delivered to her partner?[J]. Oncol Nurs Forum, 2011,38(2):207-214.
[26] Rissanen R, Arving C, Ahlgren J, et al. Group versus individual stress management intervention in breast cancer patients for fatigue and emotional reactivity:a randomised intervention study[J]. Acta Oncol, 2014,53(9):1221-1229.
[27] Ussher JM, Kirsten L, Butow P, et al. A qualitative analysis of reasons for leaving,or not attending,a cancer support group[J]. Soc Work Heal Care, 2008,47(1):14-29.
[28] Ottenbacher AJ, Day RS, Taylor WC, et al. Exercise among breast and prostate cancer survivors:what are their barriers?[J]. J Cancer Surviv, 2011,5(4):413-419.
Options
文章导航

/

〈 〉