自我管理对胃癌患者术后心理困扰及应对方式的影响

目的探讨自我管理对胃癌患者术后心理困扰及应对方式的影响。方法将87例手术治疗的胃癌患者随机分为两组。对照组43例予以术后常规护理，干预组44例在此基础上予自我管理干预措施。术后第2天及出院前1d发放心理困扰管理量表（DM）及癌症应对方式问卷（CCMQ），评定干预前后心理困扰程度及应对方式状态。结果干预前干预组与对照组、心理困扰及应对方式方面得分差异无统计学意义（P〉0．05）。干预后，干预组心理困扰得分（3．27±1．853）低于对照组（4．03±1．825）分，得分差异有统计学意义（t=-2．117，P〈0．05）。应对方式各维度中，干预组面对维度得分（19．86±3．965）高于对照组（17．48±3．328），差异有统计学意义（t=4．301，P〈0．01），干预组回避压抑得分（10．16±3．277）、屈服得分（8．15±2．542），幻想维度得分（6．71zl：2．494）均低于对照组（11．40±2．642），（8．75±2．564），（8．36±2．386）分，差异有统计学意义（t值分别为-2．334，-1．069，-3．621；P〈0．05）。结论自我管理干预措施可以降低胃癌患者术后心理困扰程度、优化其应对方式，具备临床实践可行性。

Effect of self-management on the psychological distress and coping style in postoperative gastric cancer patients

Objective To explore the effect of self-management on the psychological distress and coping style in postoperative gastric cancer patients. Methods Totals of 87 gastric cancer patients were randomly divided into control group（ n = 43 ） and intervention group （n = 44 ）. The control group received the routine care and the intervention group received self - management. Distress Management and Cancer Coping Modes Questionnaire were used to investigate the psychological distress and coping style of patients in the second day after operation and the day before discharge, respectively. Results There was no difference in the general information, distress and coping style between the two groups （ P 〉 0.05 ）. After the intervention, psychological distress scores of the intervention group was lower than that of the control group （ 3.27 ± 1.85 ） vs （4.03 ± 1.83） 1, and the difference was statically significant （t = -2. 117, P 〈 0.05 ）. In the dimension of coping style, confrontation scores in the intervention group was higher than that in the control group （19.86 ± 3.97） vs （ 17.48 ± 3.33 ） ] , and the difference was statistically significant （ t = 4. 301, P 〈 0.01 ）. Avoidance and suppression, resignation and fantasy scores in intervention group were lower than those in the control group （10.16±3.277） vs （11.40±2.642）, （8.15 ±2.542） vs （8.75 ±2.564）,（6.71 ±2.494） vs （8.36± 2.386）, respectively], and the difference was statistically significant （t = -2. 334, -1. 069, -3. 621, respectively ;P 〈 0.05 ）. Conclusions Self-management coping style of gastric cancer patients afer operation.