Department of Respiratory and Critical Care Medicine, Zibo First Hospital, 255200 Zibo, Shandong, China.
Department of Oncology and Immunology, The Fourth Hospital of Hebei Medical University, 050011 Shijiazhuang, Hebei, China.
Actas Esp Psiquiatr. 2024 Oct;52(5):716-723. doi: 10.62641/aep.v52i5.1674.
Post-traumatic stress disorder (PTSD) due to lung cancer seriously affects the mood state of patients. Intensive cognitive management is a structured management method based on cognitive behavioral therapy, which can correct cognitive distortions and regulate adverse emotions. This study mainly explored the effect of intensive cognitive management on the mood state of patients with PTSD due to lung cancer.
A retrospective analysis was conducted on the clinical data of 169 patients with PTSD due to lung cancer admitted to our hospital from June 2020 to June 2021. Based on different clinical management schemes, these patients were divided into the reference group (RG, n = 87, routine management) and the study group (SG, n = 82, routine management+intensive cognitive management). The sleep status and degree of depression and anxiety were evaluated using the Pittsburgh Sleep Quality Index (PSQI), Self-rating Anxiety Scale (SAS), Depression Scale (D), and Post-traumatic Stress Disorder Check List (PCL).
After 2 weeks (T1) and 4 weeks (T2) of nursing, the scores on the PSQI (p < 0.001), SAS (T0-T1: p < 0.001; T0-T2: p < 0.001) and D (T0-T1: p = 0.026, p < 0.001; T0-T2: p < 0.001), as well as three PCL factors (p < 0.001) of the two groups were significantly lower than those before nursing (T0). At the T1 and T2 stages, difference scores for the PSQI (difference score 1: p = 0.003; difference score 2: p = 0.006), SAS (difference score 1: p = 0.002; difference score 2: p = 0.007), and D (difference score 1: p < 0.001; difference score 2: p = 0.002) were higher in the SG compared with the RG. At the T1 stage, the difference score of the PCL high-alert factor (p = 0.008) was higher in the SG compared with the RG, with no significant difference in difference scores of other two factors (p > 0.05). At the T2 stage, the SG had higher difference scores for the three PCL factors compared with the RG (p < 0.001, p = 0.011, p < 0.001).
Intensive cognitive management can effectively improve sleep quality and adverse emotions and has potential for clinical management of PTSD in patients with lung cancer.
肺癌所致创伤后应激障碍（PTSD）严重影响患者的情绪状态。强化认知管理是一种基于认知行为疗法的结构化管理方法，可纠正认知扭曲，调节不良情绪。本研究主要探讨强化认知管理对肺癌 PTSD 患者情绪状态的影响。
回顾性分析 2020 年 6 月至 2021 年 6 月我院收治的 169 例肺癌 PTSD 患者的临床资料。根据不同的临床管理方案，将这些患者分为对照组（RG，n=87，常规管理）和研究组（SG，n=82，常规管理+强化认知管理）。采用匹兹堡睡眠质量指数（PSQI）、焦虑自评量表（SAS）、抑郁量表（D）和创伤后应激障碍检查表（PCL）评估睡眠状况及抑郁和焦虑程度。
护理 2 周（T1）和 4 周（T2）后，两组 PSQI 评分（p<0.001）、SAS 评分（T0-T1：p<0.001；T0-T2：p<0.001）和 D 评分（T0-T1：p=0.026，p<0.001；T0-T2：p<0.001）以及 PCL 的三个因子（p<0.001）均显著低于护理前（T0）。在 T1 和 T2 阶段，SG 的 PSQI 差值（差值 1：p=0.003；差值 2：p=0.006）、SAS 差值（差值 1：p=0.002；差值 2：p=0.007）和 D 差值（差值 1：p<0.001；差值 2：p=0.002）均高于 RG。在 T1 阶段，SG 的 PCL 高敏因子差值（p=0.008）高于 RG，其他两个因子的差值无统计学差异（p>0.05）。在 T2 阶段，SG 的三个 PCL 因子差值均高于 RG（p<0.001，p=0.011，p<0.001）。
强化认知管理可有效改善睡眠质量和不良情绪，对肺癌 PTSD 患者具有潜在的临床管理作用。
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