Abstract:

Objective　To retrospectively analyze the effect of stage-based rehabilitation combined with therapeutic communication on postoperative psychological function in patients with gallbladder cancer. Methods　Eighty-six patients with gallbladder cancer treated at Henan Cancer Hospital from December 2021 to December 2023 were selected for the randomized controlled trial, and were divided into an observation group and a control group by the random number table method, with 43 cases in each group. In the control group, there were 24 males and 19 females; they were  (56.71±8.45) years old; they did stage-based rehabilitation. In the observation group, there were 27 males and 16 females; they were  (57.23±8.36) years old; they did stage-based rehabilitation and therapeutic communication. The perioperative conditions (exhaustion, off-bed activities, and hospitalization), psychological status [scores of Self-assessment Scale for Anxiety (SAS) and Self-assessment Scale for Depression (SDS)], scores of Psychological Resilience Inventory Connor-Davidson Resilience Scale (CD-RISC), complications, and scores of Short Form-36 of the Health Survey (SF-36) were compared between the two groups. Independent sample t test and χ² test were used for the statistical analysis. Results　The time to exhaustion, time to first off-bed activity, and hospitalization time in the observation group were shorter than those in the control group [(24.16±1.84) h vs. (36.29±2.13) h, (3.25±0.92) h vs. (6.02±1.09) h, and (7.56±1.27) d vs. (11.13±1.85) d], with statistical differences (t=28.260, 12.735, and 10.432; all P<0.05). The score of SAS and SDS in the observation group were lower than those in the control group (49.63±3.15 vs. 55.37±4.09 and 52.14±4.26 vs. 58.31±5.03], with statistical differences (t=7.291 and 6.138; both P<0.05). The score of resilience, self-improvement, and optimism in the observation group were higher than those in the control group (24.53±2.08 vs. 16.85±1.42, 22.68±1.56 vs. 17.27±1.34, and 11.24±0.76 vs. 7.73±0.54], with statistical differences (t=19.997, 17.251, and 24.688; all P<0.05). The incidence rate of complications in the observation group was lower than that in the control group [6.98% (3/43) vs. 23.26% (10/43); χ²=4.441, P=0.035]. The score of physiological function, somatic pain, and general health in the observation group were higher than those in the control group (69.52±5.63 vs. 60.27±5.18, 72.34±6.19 vs. 62.35±5.86, and 71.64±6.12 vs. 62.73±5.79], with statistical differences (t=7.929, 7.685, and 6.935, all P<0.05). Conclusion　Stage-based rehabilitation combined with therapeutic communication for patients with gallbladder cancer can improve their psychological state, accelerate their postoperative rehabilitation, reduce complications, and improve their quality of life.

Key words: Gallbladder cancer, Stage-based rehabilitation, Therapeutic communication

摘要：

目的　分析阶段性康复联合治疗性沟通对胆囊癌术后心理功能的影响。方法　选取2021年12月至2023年12月河南省肿瘤医院收治的胆囊癌术后患者86例，按随机数字表法分为观察组（43例）和对照组（43例）。对照组男24例，女19例；年龄（56.71±8.45）岁，采用阶段性康复。观察组男27例，女16例；年龄（57.23±8.36）岁，在对照组基础上联合治疗性沟通。对比两组围手术期情况（排气、下床活动、住院）、心理状态［焦虑自评量表（SAS）评分、抑郁自评量表（SDS）评分］、心理弹性量表（CD-RISC）、并发症、健康调查简表-36（SF-36）评分。采用独立样本t检验和χ2检验进行统计分析。结果　观察组排气时间、初次下床活动时间、住院时间均较对照组短［（24.16±1.84）h比（36.29±2.13）h、（3.25±0.92）h比（6.02±1.09）h］、（7.56±1.27）d比（11.13±1.85）d］，差异均有统计学意义（t=28.260，12.735，10.432；均P<0.05）；观察组SAS评分、SDS评分均较对照组低［（49.63±3.15）分比（55.37±4.09）分，（52.14±4.26）分比（58.31±5.03）分］，差异均有统计学意义（t=7.291，6.138，均 P<0.05）；观察组CD-RISC量表的韧性、自强、乐观评分均较对照组高［（24.53±2.08）分比（16.85±1.42）分、（22.68±1.56）分比（17.27±1.34）分、（11.24±0.76）分比（7.73±0.54）分］，差异均有统计学意义（t=19.997，17.251，24.688；均P<0.05）；观察组并发症发生率较对照组低［6.98%（3/43）比23.26%（10/43），差异有统计学意义（χ2=4.441，P=0.035）；观察组SF-36量表的生理职能、躯体疼痛、总体健康评分均较对照组高［（69.52±5.63）分比（60.27±5.18）分、（72.34±6.19）分比（62.35±5.86）分、（71.64±6.12）分比（62.73±5.79）分］，差异均有统计学意义（t=7.929，7.685，6.935；均P<0.05）。结论　阶段性康复联合治疗性沟通应用于胆囊癌术后患者中，可改善心理状态，加快术后康复，降低并发症发生率，提高生活质量。

关键词: 胆囊癌,  ,  , 阶段性康复,  ,  , 治疗性沟通