Abstract:

Objective　To investigate the intervention effect of group cognitive behavioral nursing in children undergoing chemotherapy for leukemia. Methods　A total of 86 children undergoing chemotherapy for leukemia in Zhumadian Central Hospital from August 2022 to August 2024 were selected for a prospective study. They were divided into a control group (43 cases) and an observation group (43 cases) by the random number table method. In the control group, there were 23 boys and 20 girls; the age ranged from 7 to 14 years old [with an average of (10.56±1.13) years old]; the disease duration was from 1 to 3 years [with an average of (2.19±0.33) years]. In the observation group, there were 22 boys and 21 girls; the age ranged from 7 to 14 years old [with an average of (10.59±1.14) years old]; the disease duration was from 1 to 3 years [with an average of (2.16±0.35) years]. The control group received routine nursing, while the observation group received group cognitive behavioral nursing. Both groups received continuous nursing for 6 weeks. The mental state, coping style, quality of life, and family satisfaction were compared between the two groups. Statistical analysis was conducted using the t test and χ² test. Results　After nursing, the scores of separation anxiety, generalized anxiety, social phobia, school phobia, and somatization/panic of the Screen for Child Anxiety Related Emotional Disorders (SCARED) in the observation group were (5.54±1.01) points, (7.37±1.04) points, (4.39±1.05) points, (2.18±0.34) points, and (11.87±1.26) points, which were all lower than those in the control group [(8.76±1.07) points, (10.19±1.12) points, (6.08±1.10) points, (4.27±0.50) points, and (15.35±1.64) points] (t=14.350, 12.099, 7.288, 22.666, and 11.034, all P<0.001). After nursing, the score of facing situations of the Medical Coping Modes Questionnaire (MCMQ) in the observation group was (17.96±1.94) points, which was higher than that in the control group [(14.79±1.78) points]; the scores of avoidance and submission in the observation group were (10.01±1.05) points and (8.71±1.04) points, which were lower than those in the control group [(12.39±1.08) points and (11.53±1.07) points] (t=7.895 10.361, and 12.393, all P<0.001). After nursing, the scores of emotional function, social function, role function, and physical function of the Pediatric Quality of Life Inventory Version 4.0 (PedsQL4.0) in the observation group were (79.19±4.16) points, (82.29±4.70) points, (84.49±5.31) points, and (85.15±4.53) points, which were all higher than those in the control group [(72.28±4.04) points, (75.53±4.61) points, (76.06±5.23) points, and (77.19±4.26) points] (t=7.814, 6.733, 7.417, and 8.394, all P<0.001). The satisfaction rate of family members towards the nursing services in the observation group was 95.35% (41/43), which was higher than that in the control group [81.40% (35/43)] (χ²=4.074, P=0.044). Conclusion　Group cognitive behavioral nursing can alleviate the negative psychological state in children undergoing chemotherapy for leukemia, improve their coping style, improve their quality of life, and enhance the satisfaction of family members with nursing services.

Key words:

Leukemia, Chemotherapy, Group cognitive behavioral nursing, Mental state, Coping style, Quality of life, Children

摘要：

目的　探讨白血病化疗患儿采取团体认知行为护理的干预效果。方法　选取驻马店市中心医院2022年8月至2024年8月期间收治的86例白血病患儿进行前瞻性研究，采用随机数字表法将其分为对照组（43例）和观察组（43例）。对照组男23例，女20例；年龄7～14（10.56±1.13）岁；病程1～3（2.19±0.33）年。观察组男22例，女21例；年龄7～14（10.59±1.14）岁；病程1～3（2.16±0.35）年。对照组采取常规护理，观察组采取团体认知行为护理，两组均持续护理6周。比较两组心理状态、应对方式、生活质量以及家属满意度。采用t检验、χ²检验进行统计学分析。结果　护理后，观察组儿童焦虑性情绪障碍筛查量表（SCARED）中分离性焦虑、广泛性焦虑、社交恐怖、学校恐怖、躯体化/惊恐评分分别为（5.54±1.01）分、（7.37±1.04）分、（4.39±1.05）分、（2.18±0.34）分、（11.87±1.26）分，均低于对照组的（8.76±1.07）分、（10.19±1.12）分、（6.08±1.10）分、（4.27±0.50）分、（15.35±1.64）分（t=14.350、12.099、7.288、22.666、11.034，均P<0.001）；观察组医学应对方式问卷（MCMQ）中面对评分为（17.96±1.94）分，高于对照组的（14.79±1.78）分，回避、屈服评分为（10.01±1.05）分、（8.71±1.04）分，均低于对照组的（12.39±1.08）分、（11.53±1.07）分（t=7.895、10.361、12.393，均P<0.001）；观察组儿童生存质量测定量表（PedsQL4.0）中感情功能、社会功能、角色功能、生理功能评分分别为（79.19±4.16）分、（82.29±4.70）分、（84.49±5.31）分、（85.15±4.53）分，均高于对照组的（72.28±4.04）分、（75.53±4.61）分、（76.06±5.23）分、（77.19±4.26）分（t=7.814、6.733、7.417、8.394，均P<0.001）。观察组患儿家属对护理服务的满意度为95.35%（41/43），高于对照组的81.40%（35/43）（χ²=4.074，P=0.044）。结论　团体认知行为护理可缓解白血病化疗患儿消极心理状态，有助于改善其应对方式，提升生活质量，提高患儿家属对护理服务的满意度。

关键词:

白血病, 化疗, 团体认知行为护理, 心理状态, 应对方式, 生活质量, 儿童