摘要
目的分析接纳与承诺疗法(ACT)在甲状腺癌患者术后延续护理中的应用效果。方法选取2022年3月至2024年10月郑州大学附属郑州市中心医院收治的98例甲状腺癌患者作为研究对象,依据随机数表法分为研究组及对照组各49例。对照组患者采用常规延续护理干预,研究组患者在常规护理基础上采用基于ACT的延续护理干预,两组患者护理出院后均再干预3个月。比较两组患者出院时及干预3个月后的接纳与行动问卷(AAQ-Ⅱ)评分、心理痛苦温度计(DT)评分、头颈部肿瘤患者生命质量测评量表(FACT-HN)评分、自我护理能力测定量表(ESCA)评分、遵医行为评分、肩关节功能评分和颈部活动度(前屈、旋转、后伸及侧屈)。结果出院时,两组患者的AAQ-Ⅱ评分、DT评分、FACT-HN评分比较差异均无统计学意义(P>0.05);干预3个月后,两组患者的AAQ-Ⅱ评分、DT评分均低于出院时,且研究组患者的AAQ-Ⅱ评分、DT评分分别为(18.01±2.60)分、(3.44±0.63)分,明显低于对照组的(23.17±2.55)分、(4.50±0.72)分,而两组患者的FACT-HN评分均高于出院时,且研究组患者的FACT-HN评分为(114.37±8.36)分,明显高于对照组的(103.20±7.55)分,差异均有统计学意义(P<0.05)。出院时,两组患者的ESCA评分、遵医行为评分比较差异均无统计学意义(P>0.05);干预3个月后,两组患者的ESCA评分、遵医行为评分均高于出院时,且研究组患者的ESCA评分、遵医行为评分分别为(149.80±8.32)分、(82.11±6.55)分,明显高于对照组的(113.20±10.44)分、(74.20±7.36)分,差异均有统计学意义(P<0.05)。出院时,两组患者的肩关节功能评分、颈部活动度比较差异均无统计学意义(P>0.05);干预3个月后,两组患者的肩关节功能评分、颈部活动度均高(大)于出院时,且研究组患者的肩关节功能评分、颈部前屈、旋转、后伸及侧屈活动度分别为(85.30±5.44)分、(36.80±1.44)°、(56.80±3.15)°、(34.55±2.40)°、(37.13±1.35)°,明显高(大)于对照组的(79.41±4.85)分、(32.02±1.75)°、(51.22±3.46)°、(30.12±2.17)°、(32.14±1.73)°,差异均有统计学意义(P<0.05)。结论ACT联合延续护理能减轻甲状腺癌患者术后的心理痛苦,提高生活质量,改善自我护理能力及遵医行为,促进身体功能恢复。
Objective To analyze the application effect of Acceptance and Commitment Therapy(ACT)in postoperative continuing care for thyroid cancer patients.Methods A total of 98 thyroid cancer patients treated at Zhengzhou Central Hospital Affiliated to Zhengzhou University from March 2022 to October 2024 were selected as the study subjects.They were divided into a study group and a control group,each with 49 patients,using a random number table method.The control group received routine continuing care,while the study group received ACT-based continuing care in addition to routine care.All the patients were followed up for 3 months after discharge.The Acceptance and Ac-tion Questionnaire-Ⅱ(AAQ-Ⅱ)scores,Distress Thermometer(DT)scores,Functional Assessment of Cancer Thera-py-Head and Neck(FACT-HN)scores,Exercise of Self-Care Agency(ESCA)scores,compliance behavior scores,shoul-der function scores,and neck mobility(flexion,rotation,extension,and lateral flexion)were compared between the two groups at discharge and after 3 months of intervention.Results At discharge,there were no significant differences in AAQ-Ⅱscores,DT scores,or FACT-HN scores between the two groups(P>0.05).After 3 months of intervention,both groups showed lower AAQ-Ⅱand DT scores compared to discharge,with the study group having significantly lower scores than the control group:(18.01±2.60)points and(3.44±0.63)points vs(23.17±2.55)points and(4.50±0.72)points.The FACT-HN scores in both groups were higher than at discharge,with the study group scoring significantly higher than the control group:(114.37±8.36)points vs(103.20±7.55)points,P<0.05.At discharge,there were no significant differenc-es in ESCA scores or compliance behavior scores between the two groups(P>0.05).After 3 months of intervention,both groups showed higher ESCA and compliance behavior scores compared to discharge,with the study group scoring signifi-cantly higher than the control group:(149.80±8.32)points and(82.11±6.55)points vs(113.20±10.44)points and(74.20±7.36)points(P<0.05).At discharge,there were no significant differences in shoulder function scores or neck mobility be-tween the two groups(P>0.05).After 3 months of intervention,both groups showed higher shoulder function scores and greater neck mobility compared to discharge,the shoulder function score and neck mobility(flexion,rotation,extension,and lateral flexion)in the study group were(85.30±5.44)points,(36.80±1.44)°,(56.80±3.15)°,(34.55±2.40)°,and(37.13±1.35)°,respectively,which were significantly higher than(79.41±4.85)points,(32.02±1.75)°,(51.22±3.46)°,(30.12±2.17)°,and(32.14±1.73)°in the control group(P<0.05).Conclusion ACT combined with continuing care can alleviate psychological distress,improve quality of life,enhance self-care ability and compliance behavior,and promote physical function recovery in thyroid cancer patients after surgery.
作者
任瑞瑞
闫杰
宋婷
REN Rui-rui;YAN Jie;SONG Ting(Department of Thyroid Surgery,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450007,Henan,CHINA;Educational Affairs Office,Henan Provincial Health Executive College,Zhengzhou 450000,Henan,CHINA)
出处
《海南医学》
2025年第8期1186-1190,共5页
Hainan Medical Journal
基金
河南省卫生和计划生育委员会科研项目(编号:2018020789)。
关键词
甲状腺癌
延续护理
接纳与承诺疗法
心理痛苦
生活质量
Thyroid cancer
Continuing care
Acceptance and Commitment Therapy
Psychological distress
Quality of life
