乳腺癌病人经验性回避与认知融合现状及关系框架分析

目的:探讨乳腺癌病人经验性回避和认知融合现状,分析两者的关系框架,为乳腺癌病人治疗与康复中的心理护理提供科学依据。方法:采用方便抽样的方法,使用自行设计的一般资料调查表、中文版接纳与行动问卷第二版(AAQ-Ⅱ)和中文版认知融合问卷(CFQ)对符合纳入排除标准的135例乳腺癌病人进行问卷调查。结果:乳腺癌病人经验性回避总分为10~47(30.79±7.69)分,认知融合总分为14~60(41.10±9.21)分,经验性回避和认知融合总分呈正相关(r=0.831,P<0.01)。认知融合各条目得分与经验性回避总分呈正相关(r值为0.574~0.736,P均<0.01),经验性回避各条目得分与认知融合总分呈正相关(r值为0.505~0.719,P均<0.01)。典型相关模型结果显示,2对典型变量通过显著性检验(α=0.05),其中第一组关系中条目AAQ2、AAQ1、AAQ5对V1的影响最大,而条目CFQ2、CFQ7对U2的影响较大;第二组关系中条目AAQ3、AAQ1、AAQ5对V2的影响最大,而条目CFQ6、CFQ9、CFQ7对U2的影响最大。结论:乳腺癌病人经验性回避和认知融合呈“相互推演”的关系框架。因此,在临床工作中应积极采用心理护理措施,帮助病人降低癌症相关认知融合水平,从而改善病人的经验性回避状态,使其能够以积极的心态面对疾病。

Analysis of the status quo and relationship framework of experiential avoidance and cognitive fusion in patients with breast cancer

Objective:The aim of this study is to investigate the status quo of experiential avoidance and cognitive fusion in patients with breast cancer,to analyze the relationship framework between them,and to provide scientific basis for the application of psychological care in breast cancer patients.Methods:A total of 135 breast cancer patients who met the inclusion criteria were recruited by convenience sampling and investigated by the self-designed general information questionnaire,the second version of the Chinese version of the Acceptance and Action Questionnaire(AAQ-Ⅱ)and the Chinese version of the Cognitive Fusion Questionnaire(CFQ).Results:The total score of experiential avoidance in patients with breast cancer was 10-47(30.79±7.69),and the total score of cognitive fusion was 14-60(41.10±9.21).The total score of experiential avoidance and cognitive fusion was positively correlated(r=0.831,P<0.01).The scores of the cognitive fusion items were positively correlated with the total scores of experiential avoidance(The r value was 0.574-0.736,all P<0.01),and the scores of the experiential avoidance items were positively correlated with the total scores of cognitive fusion(The r value was 0.505-0.719,all P<0.01).The results of canonical correlation model showed that 2 pairs of canonical variables pass the significance test(α=0.05).In the first group,the items AAQ2,AAQ1 and AAQ5 had the greatest contribution on V1,while the items CFQ2 and CFQ7 had the greatest contribution on U2.In the second group,items AAQ3,AAQ1 and AAQ5 had the greatest contribution on V2,while the items CFQ6,CFQ9 and CFQ7 had the greatest contribution on U2.Conclusions:The experiential avoidance and cognitive fusion of breast cancer patients present a synergic-effect relationship framework.Therefore,psychological nursing interventions should be actively adopted in clinical work to help patients reduce the level of cancer-related cognitive fusion,so as to improve the patient′s experiential avoidance state and enable them to face the disease with a more positive attitude.