Effects of one-core-multiple hospice care on cancer-induced fatigue, hope level, and depression in advanced patients with lung cancer
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摘要:
目的 在肺癌晚期患者中应用“一核多元”安宁疗护模式，探究患者癌因性疲乏、希望水平及抑郁情绪的变化。 方法 选取2021年9月—2023年9月山东省第一医科大学第一附属医院收治的60例晚期肺癌患者，采用随机数表法均分为观察组(“一核多元”安宁疗护)及对照组(常规安宁疗护)，各30例。比较2组干预前及干预6周后癌因性疲乏[癌症疲乏量表(CFS)]、希望水平[Herth希望量表(HHI)]、焦虑抑郁情绪[汉密尔顿抑郁量表评分(HAMD)，汉密尔顿焦虑量表评分(HAMA)]、生命意义[生命意义量表(MiLS)]、生活质量[国际肿瘤患者生命质量测定表(QOL-C30)]。 结果 2组干预6周后CFS、HAMD、HAMA均低于干预前，观察组MiLS高于干预前(P < 0.01)，干预6周后观察组CFS低于对照组，MiLS高于对照组，调整干预前各指标水平后，2组比较差异有统计学意义(P < 0.01); 干预6周后，观察组希望水平中高水平比例为66.67%(20/30)，对照组为36.67%(11/30)，观察组生命意义中高水平比例为53.33%(16/30)，对照组为26.67%(8/30)，观察组希望水平、生命意义中高水平比例均高于对照组(Z=2.237、4.444，P=0.025、0.035)。 结论 “一核多元”安宁疗护用于肺癌晚期患者能够降低患者癌因性疲乏及焦虑抑郁情绪水平，提升希望水平、生命意义及生活质量水平。 Abstract:Objective To investigate the effects of one-core-multiple hospice care on cancer-induced fatigue, hope level, and depression in patients with advanced lung cancer. Methods From September 2021 to September 2023, 60 patients with advanced lung cancer were enrolled at the First Affiliated Hospital of Shandong First Medical University. They were randomly assigned to the observation group (n=30, receiving one-core-multiple hospice care) and the control group (n=30, receiving routine care). Cancer-induced fatigue (cancer fatigue scale, CFS), hope level (Herth hope inventory, HHI), anxiety and depression (Hamilton depression scale score, HAMD; Hamilton anxiety scale score, HAMA), meaning of life (meaning of life scale, MiLS), and quality of life (international quality of life for cancer patients, QOL-C30) were compared between the two groups before and 6 weeks after intervention. Results After 6 weeks of intervention, both groups showed reduced CFS, HAMD, and HAMA scores. The observation group had a significant increase in MiLS scores after intervention than before (P < 0.01). CFS in the observation group was lower than that in the control group, while MiLS was higher after 6 weeks of intervention, after adjustment for baseline values (P < 0.01). After 6 weeks of intervention, the medium to high level proportion of hope and life meaning in the observation group was 66.67% (20/30) and 53.33% (16/30), respectively. In contrast, the control group had 36.67% (11/30) for hope and 26.67% (8/30) for life meaning. The medium to high level proportion of hope and life meaning in the observation group were higher than those in the group (Z=2.237, 4.444, P=0.025, 0.035). Conclusion One-core-multiple hospice care for advanced lung cancer patients can reduce the level of cancer-related fatigue, anxiety and depression, while improving the level of hope, life meaning, and life quality. -
Key words:
- Lung cancer /
- Advanced /
- One-core-multiple /
- Hospice care /
- Cancer-induced fatigue /
- Hope level /
- Depression
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表 1 2组晚期肺癌患者CFS比较(x±s，分)
Table 1. Comparison of CFS in 2 groups of advanced lung cancer patients(x±s, points)
组别 例数 躯体疲乏 t值 P值 情绪疲乏 t值 P值 认知疲乏 t值 P值 干预前 干预6周后 干预前 干预6周后 干预前 干预6周后 观察组 30 18.47±3.41 12.55±1.72 8.490 < 0.001 9.31±2.31 6.54±1.08 5.950 < 0.001 10.13±2.28 6.82±1.43 6.736 < 0.001 对照组 30 18.14±3.38 14.20±2.51 5.126 < 0.001 9.47±2.11 7.49±1.25 4.422 < 0.001 10.35±2.10 7.90±1.63 5.048 < 0.001 统计量 0.376a 2.970b 0.280a 3.150b 0.389a 2.728b P值 0.708 0.004 0.780 0.003 0.699 0.008 注：a为t值，b为F值。 
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表 2 2组晚期肺癌患者希望水平比较[例(%)]
Table 2. Comparison of hope levels between two groups of advanced lung cancer patients[cases (%)]
组别 例数 干预前 干预6周后 低水平 中等水平 高水平 低水平 中等水平 高水平 观察组 30 20(66.67) 9(30.00) 1(3.33) 10(33.33) 16(53.33) 4(13.33) 对照组 30 21(70.00) 7(23.33) 2(6.67) 19(63.33) 9(30.00) 2(6.67) Z值 0.164 2.237 P值 0.870 0.025
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表 3 2组晚期肺癌患者HAMA及HAMD比较(x±s，分)
Table 3. Comparison of HAMA and HAMD scores in 2 groups of advanced lung cancer patients(x±s, points)
组别 例数 HAMA t值 P值 HAMD t值 P值 干预前 干预6周后 干预前 干预6周后 观察组 30 21.55±4.08 16.28±2.27 6.182 < 0.001 22.47±4.47 17.24±2.11 5.795 < 0.001 对照组 30 21.38±4.15 19.10±2.41 2.602 0.012 22.84±4.02 19.10±2.29 4.428 < 0.001 统计量 0.160a 4.665b 0.337a 3.272b P值 0.873 < 0.001 0.737 0.002 注：a为t值，b为F值。
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表 4 2组晚期肺癌患者生命意义情况比较[例(%)]
Table 4. Comparison of life meaning between two groups of patients with advanced lung cancer.
组别 例数 低水平 中高水平 干预前 干预6周后 干预前 干预6周后 观察组 30 23(76.67) 14(46.67) 7(23.33) 16(53.33) 对照组 30 24(80.00) 22(73.33) 6(20.00) 8(26.67) Z值 0.098 4.444 P值 0.754 0.035
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表 5 2组晚期肺癌患者QOL-C30比较(x±s，分)
Table 5. Comparison of QOL-C30 scores between 2 groups of advanced lung cancer patients(x±s, points)
组别 例数 躯体功能 t值 P值 角色功能 t值 P值 干预前 干预6周后 干预前 干预6周后 观察组 30 59.57±7.15 65.12±7.06 3.025 0.004 61.07±5.41 64.15±6.12 2.065 0.043 对照组 30 59.68±7.01 60.24±7.69 0.295 0.769 60.14±5.38 59.20±5.21 0.687 0.495 统计量 0.060a 2.560b 0.668a 3.373b P值 0.952 0.013 0.507 0.001 组别 例数 认知功能 t值 P值 情绪功能 t值 P值 干预前 干预6周后 干预前 干预6周后 观察组 30 56.37±7.32 61.41±7.98 2.549 0.014 60.12±7.04 64.52±6.11 2.585 0.012 对照组 30 56.54±7.44 56.82±6.93 0.151 0.881 59.85±7.18 61.57±5.00 1.077 0.286 统计量 0.089a 2.379b 0.147a 2.047b P值 0.929 0.021 0.884 0.045 组别 例数 社会功能 t值 P值 整体生命质量 t值 P值 干预前 干预6周后 干预前 干预6周后 观察组 30 64.05±5.86 69.02±6.12 3.213 0.002 58.41±6.40 63.57±6.18 3.177 0.002 对照组 30 63.92±5.71 63.35±5.75 0.385 0.701 58.59±6.46 59.67±6.35 0.653 0.516 统计量 0.087a 3.698b 0.108a 2.411b P值 0.931 < 0.001 0.914 0.019 注：a为t值，b为F值。
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