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接受伽玛刀手术的肺癌幸存者对支持性团体心理治疗的反应。

Responses of lung cancer survivors undergoing gamma knife surgery to supportive group psychotherapy.

作者信息

Peng Wanxiu, Zhang Hui, Li Zhongguo

机构信息

No. 3 Clinical Department.

Clinical Laboratory, the Third Hospital of Lanzhou City, Lanzhou.

出版信息

Medicine (Baltimore). 2019 Mar;98(9):e14693. doi: 10.1097/MD.0000000000014693.

Abstract

An increasingly important concern for clinicians who care for patients with cancers is their psychological problems and quality of life. The present study examined the efficacy of supportive group psychotherapy (SGP) on anxiety, depression and overall quality of life in patients with lung cancer undergoing gamma knife surgery (GKS).160 patients with lung cancer undergoing GKS were randomly divided into SGP group (n = 82) and care as usual (CAU) group (n = 78). Patients in SGP group received 90 minutes' group psychotherapy intervention once a week for 8 weeks, while patients in CAU group received usual care. Outcome measures were administered before and after the intervention and at 3-months follow-up. The primary outcome measures were the 14-item Hospital Anxiety and Depression Scale (HADS) and the secondary outcome measures were the 30-item European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30).Demographic characteristics between SGP and CAU groups showed no difference in sex, age, course of disease, years of education, marital status and profession. Psychological characteristics evaluated by HADS revealed that levels of both depression and anxiety in SGP group were significantly improved compared with that in CAU group at the end of the treatment and the improvement remained at the 3-months follow-up. In addition, EORTC QLQ-C30 demonstrated that functional scales including emotion, cognition and society in SGP group were significantly higher than that in CAU group at the end of the treatment and maintained till 3-months follow-up. EORTC QLQ-C30 also showed that symptom scales including fatigue, nausea/vomiting, pain, syspnea, insomnia, loss of appetite and financial problems in the former group were significantly lower than that in the latter group and maintained till 3-months follow-up. Furthermore, compared with that in SGP group before treatment, these variables in both HADS and EORTC QLQ-C30 showed obvious improvement in the same group after treatment and at the 3-months follow-up.The results suggested that SGP can alleviate anxiety and depression in patients with lung cancer following GKS and improve the overall quality of life.

摘要

对于照顾癌症患者的临床医生而言,一个日益重要的关注点是患者的心理问题和生活质量。本研究探讨了支持性团体心理治疗(SGP)对接受伽玛刀手术(GKS)的肺癌患者焦虑、抑郁及总体生活质量的疗效。160例接受GKS的肺癌患者被随机分为SGP组(n = 82)和常规护理(CAU)组(n = 78)。SGP组患者每周接受1次90分钟的团体心理治疗干预,共8周,而CAU组患者接受常规护理。在干预前后及3个月随访时进行结果测量。主要结果测量指标为14项医院焦虑抑郁量表(HADS),次要结果测量指标为30项欧洲癌症研究与治疗组织生活质量核心问卷(EORTC QLQ-C30)。SGP组和CAU组的人口统计学特征在性别、年龄、病程、受教育年限、婚姻状况和职业方面无差异。通过HADS评估的心理特征显示,治疗结束时SGP组的抑郁和焦虑水平与CAU组相比均显著改善,且在3个月随访时仍保持改善。此外,EORTC QLQ-C30表明,治疗结束时SGP组的功能量表,包括情绪、认知和社会功能,显著高于CAU组,并维持至3个月随访。EORTC QLQ-C30还显示,前一组的症状量表,包括疲劳、恶心/呕吐、疼痛、呼吸困难、失眠、食欲不振和经济问题,显著低于后一组,并维持至3个月随访。此外,与SGP组治疗前相比,HADS和EORTC QLQ-C30中的这些变量在治疗后及3个月随访时在同一组中均有明显改善。结果表明,SGP可减轻GKS术后肺癌患者的焦虑和抑郁,提高总体生活质量。

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