Moeini Mahin, Taleghani Fariba, Mehrabi Tayebeh, Musarezaie Amir
Department of Adult Health Nursing, Nursing and Midwifery Care Research Center, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Psychiatric Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran.
Iran J Nurs Midwifery Res. 2014 Jan;19(1):88-93.
Leukemia is the most common and fatal cancer among young adults. Among all malignancies, it has the greatest effects on emotional and mental aspects of the patients. While 25-33% of patients with non-hematological malignancies suffer from anxiety disorder, some studies have reported the rate among patients with leukemia as high as 50%. Anxiety can negatively affect other important characteristics and parameters in patients with cancer. Furthermore, cancer increases the patients' spiritual needs. Therefore, spirituality has a significant role in adapting to leukemia and coping with its consequent mental disorders such as anxiety. This study was hence performed to determine the effects of a spiritual care program on anxiety of patients with leukemia.
This randomized clinical trial was conducted in Sayyed-Al-Shohada Hospital affiliated to Isfahan University of Medical Sciences (Isfahan, Iran) in 2012. Sixty four adult patients with leukemia were randomly divided into the experiment and control groups. The spiritual care program including supportive presence and support for religious rituals was implemented for 3 days. Anxiety subscale from the 42-item depression, anxiety and stress scale was completed before and after the intervention for both groups. Data was analyzed using descriptive and inferential statistical methods (Chi-square, paired and independent t-tests) in SPSS18.
There was no significant difference between the two groups before the intervention. However, after the intervention, mean score of anxiety were significantly lower in the experiment group than in the control group (P < 0.01). There was also a significant difference in the scores of the experiment group before and after the intervention (P < 0.01). Such a difference was absent in the control group.
Our spiritual care program could successfully decrease anxiety levels in patients with leukemia. Therefore, in cases of refractory diseases such as cancer, nurses have to apply a holistic care approach with emphasis on spiritual care.
白血病是年轻成年人中最常见且致命的癌症。在所有恶性肿瘤中,它对患者的情绪和心理方面影响最大。虽然25% - 33%的非血液系统恶性肿瘤患者患有焦虑症,但一些研究报告称白血病患者中的这一比例高达50%。焦虑会对癌症患者的其他重要特征和参数产生负面影响。此外,癌症增加了患者的精神需求。因此,精神性在适应白血病及应对随之而来的诸如焦虑等精神障碍方面具有重要作用。因此,本研究旨在确定一项精神关怀计划对白血病患者焦虑的影响。
本随机临床试验于2012年在伊朗伊斯法罕医科大学附属的赛义德 - 阿尔 - 肖哈达医院进行。64名成年白血病患者被随机分为实验组和对照组。包括支持性陪伴和宗教仪式支持的精神关怀计划实施3天。两组在干预前后均完成了42项抑郁、焦虑和压力量表中的焦虑分量表。数据在SPSS18中使用描述性和推断性统计方法(卡方检验、配对和独立t检验)进行分析。
干预前两组之间无显著差异。然而,干预后,实验组的焦虑平均得分显著低于对照组(P < 0.01)。实验组干预前后的得分也有显著差异(P < 0.01)。对照组则不存在这种差异。
我们的精神关怀计划能够成功降低白血病患者的焦虑水平。因此,在癌症等难治性疾病的情况下,护士必须采用整体护理方法,重点是精神关怀。