| Objective: The objective of this work was to evaluate the self-perceived burden, medicalcoping methods and quality of life for the patients of cancer with chemotherapy, and to detectthe influence of psychological support intervention on the self-perceived burden, medicalcoping methods and quality of life of the patient of cancer with chemotherapy. Also, based onthe clinical practice investigation, another objective was to identify the effects ofpsychological support nursing on decreasing the self-perceived burden for the patients ofcancer with chemotherapy, and to form effective intervention plans, thus providing a directway for clinical nurses to perform psychological support intervention.Methods:1. Influencing factors analysis on self-perception. In order to realize the influencingfactors on the self-perceived burden for the patients, based on the convenience samplingmethod, a self-regulating questionnaire and self-perceived burden scale were used. FromDecember of2011to May of2012, some diagnosed patients (108) with lung cancer, gastriccancer or colorectal cancer from a hospital of ShangHai were selected and treated to be theobjectives.2. To perform psychological support intervention. Based on the amount of referencesand influencing factors analysis, the quasi-experimental research method was used.30cancerpatients (lung cancer patients:13, gastric cancer patients:12, and colorectal cancer patients:5)from a hospital of ShangHai during the range of March of2012to June of2012were selectedby the convenience sampling to be intervention group. From October of2012to January of2013, another30cancer patients (lung cancer patients:15, gastric cancer patients:11, andcolorectal cancer patients:4) from the same department were treated to be control group.There was no statistical significance between the patients from the two groups by varying age,degree of education, state of patients, situation of caregivers and etc. During the process ofintervention, the intervention team mainly consisted of medical worker, family members,psychological counselor and volunteers was created. The sustainable and progressiveintervention topic was identified depending on the team work. By means of health education,relaxation training, experience exchangement, declaration study of anti-cancer and othermethods, three months intervention was performed for the cancer patients with chemotherapy in the hospital. A total of6times and90min for each time intervention were carried out oncea fortnight. The telephone interview for once a week was carried out when the patients werein home, aiming to resolve the practical problems of the patients. For the control group,besides chemotherapy, the intervention by through psychological counselor was performedonce psychological problems were found for the patients. The evaluation of the self-perceivedburden, medical coping methods and quality of life for both the groups before and afterintervention was carried out. The effect of psychological support nursing was analyzed.Results:1、According to the influencing factors analysis, the score of the self-perceived burdenfor the patients with chemotherapy was90±12.20. It indicated that the patients were undermoderate level of self-perceived burden. Single factor analyzing results showed that thescores of SPB were much related to the degree of education of patients, vocational status,whether to accept surgery, number of chemotherapy, primary caregivers’ status and healthcondition of caregivers. Multiple stepwise regression analysis revealed that the SPB ofpatients was negatively correlated to the health condition of caregivers, whereas positivelyrelated to the primary caregivers’ status, vocational status and number of chemotherapy.2、Evaluation of the effect of intervention on SPB: Based on the Mann-Whitney U testingmethod of non-parametric statistics, results indicated that before intervention there was noobvious difference for the total scores of SPB for the intervention and control group. Also,there was no obvious difference for financial burden, emotional burden, social burden, familyburden and psychological burden (P>0.05), but there are some difference in physical careburden. Based on the repeated measurement variance analysis, each dimension score and thechange of total scores of SPB before and after intervention was compared. Results showedthat the remarkable time effect and intervention effect on the financial burden, emotionalburden, psychological burden and self-perceived burden was observed (P<0.05). Theintervention effect on the physical care burden, social burden as well as family burden wasnot obvious (P>0.05); There was some interaction for the scores of financial burden,emotional burden, family burden, psychological burden and self-perceived burden (P<0.05).However, no interaction was found for the physical care burden and social burden (P>0.05).The interactive profile indicated that during the intervention process, with the change ofintervention time, the total scores of self-perceived burden as well as each dimension score of the physical care burden, financial burden, emotional burden, family burden, psychologicalburden and social burden for the intervention group was lower than that for the control group;Multivariate variance analysis for the scores of each dimension of the two groups indicatedthat there was a statistical significance for the change of total scores of self-perceived burden(P<0.05) after3times intervention. Also, after6times intervention, there was a statisticalsignificance for the change of total scores of physical care burden, financial burden,emotional burden, social burden, family burden, psychological burden and self-perceivedburden (P<0.05).3、Evaluation of the intervention effect of MCMQ: Based on the Mann-Whitney Utesting method of non-parametric statistics, results indicated that before intervention therewas no obvious difference for scale scores of MCMQ involved facing, evading andsurrendering (P>0.05) for the intervention and control group. Based on the repeatedmeasurement variance analysis, the change of each scale score before and after interventionwas compared. Results showed that the remarkable time effect and intervention effect on thefacing was observed.There was no interactive effect between time factor and group factor forthe scales of evading and surrendering. The interactive profile indicated that during theintervention process, with the change of intervention time, the scale scores of facing wasremarkably higher for the intervention group than that for the control group, however, anopposite trend was observed for the scale scores of surrendering. Multivariate varianceanalysis for the scores of each scale of the two groups indicated that for the interventiongroup, there was a statistical significance for the change of scores of facing scale (P<0.05).Also, there was no statistical significance for the change of scores of facing scale, evadingscale and surrendering scale in the control group (P>0.05). Further, results indicated that afterintervention, the coping mode for the patients in the intervention group was tended to befacing.4、Evaluation of the intervention effect of QLQ-CCC: Based on the Mann-Whitney Utesting method of non-parametric statistics, results indicated that before intervention therewas no statistical significance for the total scores of QLQ-CCC and score differences forsymptoms related items, emotions related items and relationship items with others (P>0.05)for the intervention and control group. Based on the repeated measurement variance analysis,the change of each item score and the total scores of the intervention and control group beforeand after intervention was analyzed. Results showed that the remarkable interaction of time effect and intervention effect on the total scores of QLQ-CCC, symptoms related items andemotions related items was observed (P<0.05). Also, there was no interaction for the score ofrelationship items with others (P>0.05). The interactive profile indicated that during theintervention process, with the change of intervention time, the total scores of QLQ-CCC andscores of symptoms related items and emotions related items were remarkably higher for theintervention group than that for the control group. Multivariate variance analysis for thescores of each scale and the total scores of the two groups indicated that after3timeintervention the total scores of QLQ-CCC and the scores of symptoms related items wereremarkably improved. Also, the difference had a statistical significance (P<0.05); After6timeintervention, the difference of the total scores of QLQ-CCC and the scores of symptomsrelated items and emotions related items had a statistical significance (P<0.05). Meanwhile,there was no statistical significance for the unobvious difference of the scores of relationshipitems with others (P>0.05) not only after3times intervention but6times intervention.Conclusions:1、Generally, the cancer patients with chemotherapy have a SPB experience, which wasinfluenced by multiple factors. This point should attach importance by the medical staff.2、The psychological support intervention can effectively decrease the SPB of the cancerpatients. By means of psychological support intervention, the financial burden, emotionsburden, family burden and psychological burden for the cancer patients were remarkablydecreased.3、Before and after intervention, there was some change for choice of the medical copingstyles for the patients. The patients in the intervention group were tended to choose thepositive coping style of facing. There were few patients to choose the styles of evading andsurrendering. Also, in the control group, there was no obvious change for this trend.4、After psychological support intervention, the various functional status, symptomsstatus and emotions status for the cancer patients were improved at a certain degree. However,there was no statistical significance for the unobvious difference of the scores of relationshipitems with others.5、It was feasible and valuable to perform psychological support intervention for thepatients with chemotherapy by integrating the social power, constructing intervention teams and depending on the team work. This research could provide a reference for the clinicalconduction of psychological nursing. |
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