摘要目的 探讨青年癌症患者标准化沟通系统的设置及应用,以改善青年癌症患者的心理痛苦等负性情绪,提升青年癌症患者的社会支持与生活质量.方法 初步构建适合中国国情的青年癌症患者标准化沟通系统,并于2016年8月至9月从中南大学湘雅三医院和湖南省肿瘤医院就诊的486例青年癌症患者中逐步筛选,选取共171例受试者,运用随机数字表法将171例受试者随机分配至沟通组(n=57)、音乐组(n=57)和常规组(n=57),进行随机对照试验.分别以心理痛苦温度计(DT)、医院焦虑抑郁量表(HADS)、社会支持评定量表(SSRS)、简明健康状况问卷(SF-36)作为评价指标,观察三组受试者在干预前、干预后(立即)、干预后1个月和干预后3个月的心理痛苦、情绪、社会支持、生存质量等情况.结果 干预后3个月随访时,共有38例失访,沟通组失访14例(最终n=43),音乐组失访11例(最终n=46)和常规组失访13例(最终n=44).沟通组、音乐组及常规组三组在干预前的测评指标比较差异无统计学意义(P＞0.05);干预前与干预后立即、干预后1个月、3个月三组在心理痛苦、焦虑抑郁、社会支持的得分比较差异均有统计学意义(P＜0.05);沟通组干预后1个月的心理痛苦、焦虑抑郁、社会支持和生活质量得分与音乐组、常规组比较差异均有统计学意义(P＜0.05).结论 标准化沟通系统对改善青年癌症患者的心理痛苦具有明显效果,该方法优于音乐疗法和常规照护,并能提升青年癌症患者的社会支持水平与生活质量.标准化沟通系统的临床验证,可为癌症患者的心理康复提供参考.

abstractsObjective To set up and apply a standardized communication system of adolescents and young adults (AYAs) cancer patients,in order to improve AYAs cancer patients' psychological distress and other negative emotions,as well as promote social support and quality of life of patients.Methods A AYAs cancer patients standardized communication system,suitable for China's national conditions,was preliminarily built.Using randomized controlled trials,a total of 171 subjects,selected from 486 cases of AYAs cancer patients,in the Third Xiangya Hospital of Central South University and Hunan Cancer Hospital from August to September in 2016,were intervened with a set of standardized communication system.The Mental Distress Thermometer (DT),Hospital Anxiety and Depression Scale (HADS),Social Support Rating Scale (SSRS) and Concise Health Status Questionnaire (SF-36) were used as evaluation indexes to observe the psychological distress,emotion,social support and quality of life of the three groups of subjects before intervention,immediately after intervention,1 month after intervention and 3 months after intervention.Results At the follow-up of 3 months after intervention,38 cases were lost,14 cases in communication group (final n =43),11 cases in music therapy group (final n =46),and 13 cases in routine group (final n =44)..There was no significant difference in the evaluation indexes between the communication group,music treatment group and the routine group before intervention (P ＞ 0.05).There were statistically significant differences in scores of psychological pain,anxiety and depression,and social support in the 3 groups,before and immediately after intervention,1 month and 3 months after intervention (P ＜ 0.05).The scores of psychological pain,anxiety and depression,social support and quality of life in the communication group 1 month after intervention were statistically significant compared with those in the music group and the routine group (P ＜ 0.05).Conclusions Compared to music therapy and regular care,the standardized communication system has significant effect on improving the psychological distress of AYAs with cancer,and can also improve their social support level and quality of life.The clinical validation of the standardized communication system can provide reference for psychological rehabilitation of cancer survivors.