正念减压法在乳腺癌患者睡眠质量、癌因性疲乏及心理痛苦中的效果研究

叶良姬 林朝春 严明芳

[摘要] 目的 评价正念减压法对乳腺癌化疗患者的睡眠质量、癌因性疲乏及心理痛苦的影响。 方法 将2018年4月至2019年8月在福建省肿瘤医院收治的118例乳腺癌化疗患者纳入研究，随机分为对照组（n=61）和正念减压组（n=57）。对照组进行常规护理措施，正念减压组在常规护理措施基础上进行为期8周的正念减压法。在干预前（化疗前1 d）和干预8周后对患者的睡眠质量、癌因性疲乏及心理痛苦进行评估。 结果 干预前正念减压组患者的睡眠障碍、癌因性疲乏及心理痛苦得分分别为（7.7±2.9）分、（3.1±1.1）分和（3.4±1.3）分，与对照组的（7.9±2.8）分、（3.2±1.2）分和（3.5±1.3）分比较，差异无统计学意义（P>0.05）。正念减压组在干预8周后睡眠障碍、癌因性疲乏及心理痛苦得分为（8.9±2.6）分、（3.9±1.1）分和（4.4±1.1）分，均低于对照组的（10.9±3.3）分、（5.2±1.2）分和（5.3±1.2）分（P<0.05）。 结论 正念减压法可显著减轻患者的癌因性疲乏、心理痛苦及改善睡眠质量，是乳腺癌化疗患者简单、有效的心理干预措施。

[关键词] 乳腺癌;正念减压法;癌因性疲乏;心理痛苦;睡眠质量

[中图分类号] R473.6          [文献标识码] B          [文章编号] 1673-9701（2021）30-0156-04

[Abstract] Objective To evaluate the effect of mindfulness-based stress reduction （MBSR） on sleep quality， cancer-related fatigue and psychological pain of patients with breast cancer （BC） undergoing chemotherapy. Methods A total of 118 BC patients undergoing chemotherapy admitted to Fujian Provincial Cancer Hospital from April 2018 to August 2019 were included in the study. They were randomly divided into the control group （n=61） and the MBSR group（n=57）.The control group received the conventional nursing， while the MBSR group received MBSR for 8 weeks on the basis of conventional nursing. The sleep quality， cancer-related fatigue and psychological pain of the patients were evaluated before intervention（1 day before chemotherapy） and 8 weeks after the intervention. Results Before intervention， the score of sleep disorder， cancer-related fatigue and psychological pain in the MBSR group were（7.7±2.9）points， （3.1±1.1）points and （3.4±1.3）points， respectively， which were not significantly different from those in the control group [（7.9±2.8）points， （3.2±1.2）points and（3.5±1.3）points] （P>0.05）. The score of sleep disorder， cancer-related fatigue and psychological pain in the MBSR group were （8.9±2.6）points、（3.9±1.1）points and （4.4±1.1）points，respectively. Eight weeks after intervention， which were all lower than those in the control group （10.9±3.3）points， （5.2±1.2）points and （5.3±1.2）points（P<0.05）. Conclusion MBSR can significantly reduce cancer-related fatigue and psychological pain of patients and improve sleep quality. It is a simple and effective psychological intervention measure for BC patients undergoing chemotherapy.

[Key words] Breast cancer; Mindfulness-based stress reduction; Cancer-related fatigue; Psychological pain; Sleep quality

乳腺癌是全世界妇女中最常见的恶性肿瘤，2018年新发病例数为200万，死亡数为60万[1]。化疗是乳腺癌重要治疗手段之一，可明显提高生存率[2]。然而，化疗期间患者常出现周围神经病变、恶心、呕吐、癌因性疲乏、心理问题、睡眠障碍等不良癥状，降低患者的生活质量[3]。当前，“以患者为中心”的治疗模式替代“以疾病为中心”，不仅要求疾病的治愈，更需要重视患者的身心健康。正念减压法是以一种不加评判或接受的方式将一个人的全部注意力集中在此时此刻的体验上。……