对甲状腺癌患者的心理援助

G. Tkachenko, T. Grushina, Y. Alymov, S. Podvyaznikov
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Mean patient age was 44.5 ± 1.1 years. The patients were randomly divided into 2 groups matched by age, disease stage and type of surgical intervention: treatment and control groups. The treatment group (n = 24) included patients who underwent psychological training in the postoperative period, the control group (n = 18) included patients who did not receive psychological help. Mental state was evaluated using the Hospital Anxiety and Depression Scale (HADS). The patients’ mental state was evaluated dynamically: 1st testing was performed after surgery, 2nd testing 12 months after surgery. Psychological training was performed in the postoperative period and included 5 individual classes teaching self-regulation skills.Results. After the surgery, HADS scale showed insignificant increase in anxiety in both groups. Analysis of repeat testing showed decreased anxiety levels in patients in the treatment group from 7.7 ± 0.2 to 6.3 ± 0.2, i. e. to normal level. In the control group, anxiety significantly increased from 7.8 ± 0.2 to 9.2 ± 0.2 (Student’s t-test = 5.17; p = 0.000168). Additionally, 12 months after surgical treatment statistically significant differences in anxiety levels between groups were observed: 6.3 ± 0.2 and 9.0 ± 0.2, respectively (Student’s t-test = 9.55; р <0.05). Primary examination showed subthreshold depression in patients of both groups: 7.9 ± 0.1 and 8.1 ± 0.2, respectively. No statistically significant differences between the groups were observed (Student’s t-test = 0.89; р >0.05). Repeat examination showed decreased depression level (in treatment group from 7.9 ± 0.1 to 7.4 ± 0.2, in the control group from 8.1 ± 0.2 to 7.7 ± 0.1), however it remained in the range of mean values. No statistically significant differences between the groups were observed (Student’s t-test = 1.34; р >0.05).Conclusion. 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摘要

介绍。甲状腺癌预后良好,但长期存在焦虑、抑郁等心理困扰,影响社会适应。研究表明,在诊断和治疗这种恶性肿瘤2-4年后,大多数患者报告对家庭关系不满意,日常活动困难。这些数据证明了康复治疗的必要性,目的是使患者在治疗完成后适应日常生活。心理帮助是康复的一个重要方面。评价心理帮助在甲状腺癌患者中的效果。材料和方法。该研究包括42名患有甲状腺癌的女性,I-III期,Т1-3N0-1М0。患者平均年龄44.5±1.1岁。将患者按年龄、疾病分期、手术干预方式随机分为治疗组和对照组。治疗组(n = 24)包括术后接受心理训练的患者,对照组(n = 18)包括未接受心理帮助的患者。采用医院焦虑抑郁量表(HADS)评价患者的精神状态。动态评估患者的精神状态:第一次在术后进行,第二次在术后12个月进行。术后进行心理训练,包括5个自我调节技巧个课。术后HADS量表显示两组患者焦虑水平均无明显升高。重复测试分析显示,治疗组患者焦虑水平由7.7±0.2降至6.3±0.2,即恢复正常水平。在对照组中,焦虑从7.8±0.2显著增加到9.2±0.2(学生t检验= 5.17;P = 0.000168)。此外,术后12个月组间焦虑水平差异有统计学意义:分别为6.3±0.2和9.0±0.2(学生t检验= 9.55;р0.05)。重复检查显示抑郁水平下降(治疗组从7.9±0.1降至7.4±0.2,对照组从8.1±0.2降至7.7±0.1),但仍保持在平均值范围内。各组间差异无统计学意义(学生t检验= 1.34;р.Conclusion > 0.05)。术后早期采用自我调节技术进行心理训练可使甲状腺癌患者的焦虑水平正常化,并防止其长期升高。
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Psychological assistance to patients with thyroid cancer
Introduction. Thyroid cancer has a favorable prognosis but in long term patients are observed to be in psychological distress manifesting through elevated anxiety and depression which disrupt social adaptation. Studies have shown that 2–4 years after diagnosis and treatment of this malignant tumor, the majority of patients report dissatisfaction with family relationships and difficulties in performing everyday activities. These data demonstrate the necessity of rehabilitation aimed at patient adaptation to everyday life after therapy completion. Psychological help is an important aspect of rehabilitation.Aim. To evaluate the effectiveness of psychological help in patients with thyroid cancer.Materials and methods. The study included 42 women with thyroid cancer, stages I–III, Т1–3N0–1М0. Mean patient age was 44.5 ± 1.1 years. The patients were randomly divided into 2 groups matched by age, disease stage and type of surgical intervention: treatment and control groups. The treatment group (n = 24) included patients who underwent psychological training in the postoperative period, the control group (n = 18) included patients who did not receive psychological help. Mental state was evaluated using the Hospital Anxiety and Depression Scale (HADS). The patients’ mental state was evaluated dynamically: 1st testing was performed after surgery, 2nd testing 12 months after surgery. Psychological training was performed in the postoperative period and included 5 individual classes teaching self-regulation skills.Results. After the surgery, HADS scale showed insignificant increase in anxiety in both groups. Analysis of repeat testing showed decreased anxiety levels in patients in the treatment group from 7.7 ± 0.2 to 6.3 ± 0.2, i. e. to normal level. In the control group, anxiety significantly increased from 7.8 ± 0.2 to 9.2 ± 0.2 (Student’s t-test = 5.17; p = 0.000168). Additionally, 12 months after surgical treatment statistically significant differences in anxiety levels between groups were observed: 6.3 ± 0.2 and 9.0 ± 0.2, respectively (Student’s t-test = 9.55; р <0.05). Primary examination showed subthreshold depression in patients of both groups: 7.9 ± 0.1 and 8.1 ± 0.2, respectively. No statistically significant differences between the groups were observed (Student’s t-test = 0.89; р >0.05). Repeat examination showed decreased depression level (in treatment group from 7.9 ± 0.1 to 7.4 ± 0.2, in the control group from 8.1 ± 0.2 to 7.7 ± 0.1), however it remained in the range of mean values. No statistically significant differences between the groups were observed (Student’s t-test = 1.34; р >0.05).Conclusion. Psychological training using self-regulation techniques performed in the early postoperative period normalizes anxiety level and prevents its elevation in long term in patients with thyroid cancer.
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