家庭为基础的心理护理干预对改善手术切除下咽癌患者睡眠质量和心理健康的作用：一项随机试验。

Home-based psychological nursing interventions for improvement of sleep quality and psychological health in patients with hypopharyngeal carcinoma undergoing surgical resections: a randomized trial.

机构信息

Teaching and Research Section of Clinical Nursing, Xiangya Hospital of Central South University, Changsha, China.

出版信息

Ann Palliat Med. 2021 Dec;10(12):12347-12357. doi: 10.21037/apm-21-3029.

DOI:10.21037/apm-21-3029

PMID:35016426

Abstract

BACKGROUND

The primary aim of this study was to determine the efficacy of a psychological nursing intervention for improving sleep quality and alleviating anxiety and depression among hypopharyngeal carcinoma patients undergoing surgical resections.

METHODS

A total of 140 hypopharyngeal carcinoma patients undergoing surgical resections in our hospital from January 2017 to December 2020 were included and randomly assigned to a standard nursing group or psychological nursing group, with 70 cases per group. Sleep quality was assessed using the Pittsburgh sleep quality index (PSQI). The severity of anxiety symptoms and depressive disorders were evaluated using Zung's self-rating anxiety scale (SAS) and self-rating depression scale (SDS). The functional assessment of cancer therapy-general scale (FACT-G) tool was used to evaluate the quality of life. Fear of progression (FoP) was also scored.

RESULTS

Participants with hypopharyngeal carcinoma in the psychological nursing group demonstrated greater improvements in the primary outcome of global sleep quality (P=0.002) at postintervention compared to the participants in the standard nursing group. The psychological nursing group participants showed remarkably greater improvements in the subscale scores of global sleep quality characteristics (secondary outcomes) including daytime dysfunction (P<0.001), subjective sleep quality (P=0.029), and sleep latency (P=0.006) at postintervention compared to those receiving standard nursing. Psychological nursing group participants had lower SAS and SDS scores compared to those in the standard nursing group (P<0.001). The results revealed that participants who received psychological nursing intervention exhibited higher scores of all FACT-G subscales and lower scores of FoP compared to participants receiving standard nursing intervention (both P<0.001). The global sleep quality scores shared positive associations with scores of SAS, SDS, and FoP (r=0.518, r=0.572, and r=0.395, respectively, P<0.001).

CONCLUSIONS

These data provide evidence that home-based psychological nursing intervention could improve sleep quality and alleviate anxiety and depression among hypopharyngeal carcinoma patients undergoing surgical resections.

TRIAL REGISTRATION

Chinese Clinical Trial Registry ChiCTR2100051463.

摘要

背景

本研究的主要目的是确定心理护理干预对改善接受手术切除的下咽癌患者睡眠质量、减轻焦虑和抑郁的疗效。

方法

选取我院 2017 年 1 月至 2020 年 12 月行手术切除的下咽癌患者 140 例，随机分为标准护理组和心理护理组，每组 70 例。采用匹兹堡睡眠质量指数（PSQI）评估睡眠质量。采用zung 焦虑自评量表（SAS）和抑郁自评量表（SDS）评估焦虑症状和抑郁障碍严重程度。采用癌症治疗功能评估-一般量表（FACT-G）评估生活质量。恐惧进展（FoP）评分。

结果

与标准护理组相比，心理护理组下咽癌患者的总体睡眠质量（主要结局）在干预后有更大的改善（P=0.002）。心理护理组患者在总体睡眠质量特征（次要结局）的各亚量表评分方面，包括日间功能障碍（P<0.001）、主观睡眠质量（P=0.029）和睡眠潜伏期（P=0.006），均有显著改善。与标准护理组相比，心理护理组患者的 SAS 和 SDS 评分较低（P<0.001）。结果显示，接受心理护理干预的患者在所有 FACT-G 子量表上的评分均较高，而在 FoP 量表上的评分较低，与接受标准护理干预的患者相比（均 P<0.001）。总体睡眠质量评分与 SAS、SDS 和 FoP 评分呈正相关（r=0.518、r=0.572 和 r=0.395，均 P<0.001）。