阶段性认知干预对保护性医疗肺癌病人C型行为模式的干预研究

目的探讨阶段性认知干预对保护性医疗围手术期肺癌病人的C型行为模式的改善情况。方法选择2018年6-12月中国科学技术大学附属第一医院普胸外科新入院的住院肺癌病人及家庭照顾者为研究对象，最终干预组（病人+照顾者组）肺癌病人及其照顾者各40例；干预组（病人组）40例；对照组最后有效病例40例。比较3组干预前后的C型行为模式。结果3组病人入院时干预前C型行为模式各分量表得分差异均无统计学意义（P > 0.05），3组干预后C型行为模式焦虑、抑郁、愤怒、乐观、社会支持5个维度的差异均有统计学意义（P < 0.05~P < 0.01），干预后3组C型行为模式愤怒向内、愤怒向外、理智、控制4个维度的差异均无统计学意义（P > 0.05），干预后各组焦虑、抑郁、愤怒向内、愤怒向外4个维度得分下降程度:对照组 < 病人组 < 病人+照顾者组（P < 0.05~P < 0.01）；干预后各组乐观和社会支持2个维度得分上升程度:对照组 < 病人组 < 病人+照顾者组（P < 0.05~P < 0.01）。结论阶段性认知干预对保护性医疗肺癌围手术期病人C型行为模式的改善是有效的，而家庭照顾者同步的阶段性认知干预效果则要更优于仅针对病人的阶段性认知干预。

Intervention study of C-type behavior pattern of staged cognitive intervention in lung cancer patients with protective medicine

ObjectiveTo investigate the improvement of C-type behavior patterns of staged cognitive intervention in perioperative lung cancer patients with protective medicine.MethodsNew lung cancer patients and family caregivers in Department of Thoracic Surgery of The First Affiliated Hospital of University of Science and Technology of China between June 2018 and December 2018 were enrolled as the study subjects.Forty lung cancer patients and 40 caregivers, 40 patients and 40 last effective cases were divided into the final intervention group, intervention group and control group, respectively.The C-type behavior patterns among 3 groups were compared before and after intervention.ResultsThere was no statistical significance in the scores of subscales of C-type behavior pattern before intervention among three groups at admission(P > 0.05), and the differences of the anxiety, depression, anger, optimist and social support of C-type behavior patterns among three groups were statistically significant after intervention(P < 0.05 to P < 0.01).After intervention, the differences of anger, intrinsic anger, extrinsic anger, reason and control of C-type behavior patterns among three groups were not statistically significant(P > 0.05), the decreasing degree of anxiety, depression, anger inward and anger scores in the control group, intervention group and final intervention group were gradually increased(P < 0.05 to P < 0.01), and the increasing degree of optimist and social support scores in the control group, intervention group and final intervention group were gradually increased(P < 0.05 to P < 0.01).ConclusionsThe staged cognitive intervention in improving the C-type behavior patterns of perioperative lung cancer patients with protective medicine is effective, and the effects of family caregivers synchronous cognitive intervention is more better than that of patients cognitive intervention only.