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乳腺癌病人術后抑郁狀態調查及護理對策

熱度0票  瀏覽10次 時間:2019年3月26日 11:27
  摘要: 乳腺癌患者術后形態與身體狀況會發生改變,患者不能接受現狀、現實與期待不符合時,患者就會產生抑郁的不良情緒,影響術后恢復和疾病的痊愈。乳腺癌患者抑郁主要原因有患者對手術治療后果的憂慮、患者文化程度以及年齡等[1]。乳腺癌病人術后抑郁狀態的護理對策為:對乳腺癌患者進行心理康復治療、加強健康教育、患者加強鍛煉以及醫護人員增強與家屬的溝通,共同支持鼓勵患者等。
  關鍵詞: 乳腺癌病人;術后抑郁狀態調查;護理對策
        乳腺癌是女性最常見的惡性腫瘤之一。在我國占全身各種惡性腫瘤的 7%—10%,呈逐年上升趨勢。部分大城市報告乳腺癌占女性惡性腫瘤之首位。乳腺癌的主要治療方法是手術治療,即全乳房切除術、乳腺癌根治術與乳腺癌擴大根治術等等。一般乳腺癌患者會喪失乳房器官,患者會因此而產生自卑、煩躁不安、抑郁、焦慮等不良情緒[4],其中抑郁是最常見的心理障礙,給患者疾病的治愈與術后的恢復帶來極大的困難。因此,調查乳腺癌病人術后抑郁狀態,研究護理對策是必不可少的。
  1 乳腺癌病人術后抑郁狀態調查
  據統計可知,至少有 25.36%的乳腺癌患者術后處于抑郁狀態,甚至高達 70.24%[2]。乳腺癌患者抑郁主要與手術治療憂慮、患者文化程度以及年齡等有關。
  1.1 乳腺癌病人術后抑郁狀態與手術治療有關
  乳腺癌是惡性腫瘤之一,患者在手術前后會對手術是否成功、自身是否可以康復心懷憂慮,并且對于經濟不好的家庭,沉重的經濟負擔會給患者帶來壓力以及焦慮心理。術后患者一般身體不完整和機體功能下降,會擔心丈夫和孩子是否嫌棄自己,害怕自己身體不能恢復健康而不能承擔養家糊口、撫養子女的責任,甚至生活不能自理需依賴父母和子女。
  1.2 乳腺癌病人術后抑郁狀態與文化程度有關
  文化程度越高的女性,對乳腺癌的了解越多,越清楚乳腺癌的治愈率及對自身造成的傷害,對手術是否可以成功擔憂越嚴重。同時,文化程度高的女性對于自身形象越關注,害怕自身形象的損壞對以后的職業前途產生不良影響,因此她們對手術及術后恢復期待很高,要求嚴格,當現實與期待不符合時,患者容易出現抑郁。因此,醫護人員需警惕、多多照顧文化程度相對較高的患者。
  1.3 乳腺癌病人術后抑郁狀態與年齡有關
  乳腺癌患者的年齡一般在 40 到 60 歲之間,對于這個年齡段的中年婦女,其一般在工作和家庭中扮演的重要的角色,十分關注自己的形象和威信,會擔心自己因疾病而喪失自尊[4],因此容易發生心理應激反應和憂慮、煩躁、抑郁等不良情緒。而對于年輕乳腺癌患者而言,手術后會失去乳房而影響形態,患者會對未來產生擔憂,害怕疾病對生育、擇偶、結婚等產生消極影響。
  1.4 乳腺癌病人術后抑郁狀態與經濟收入、居住地有關調查顯示,經濟情況較差的患者抑郁程度高,可能與經濟較差的患者無法支配其所需的手術費用和生活費用有關系。居住于農村的患者更傾向于關心費用的問題,居住于城市的患者更傾向于關心治療效果的問題。居住于城市與農村對乳腺癌病人術后抑郁狀態與統計學差異。
  2 乳腺癌病人術后抑郁狀態的護理對策
  2.1 乳腺癌患者心理的康復護理
  醫護人員對待患者時,態度要和藹可親、要有耐心,言語上詢問時要隱晦不可以傷及乳腺癌患者的自尊和面子,肢體上要多多與患者接觸,避免給患者帶來高高在上的感覺。
  患者的親人親戚對待患者時,要注意多多安慰患者,經常回家探望患者,在時間經濟以及患者身體情況允許的情況下,家屬可以帶患者出去旅游逛街,領略祖國大好河山,放松心情。醫護人員和家屬可以多多與患者溝通,給患者講解心理波動與治療乳腺癌之間的關系,了解到控制情緒對治療乳腺癌疾病的重要性,同時幫助患者重建信心,提高自己控制情緒的能力,遇事時盡量保持平靜的心情[3]。在患者情緒不高漲的時候,醫護人員和家屬要迂回詢問原因,及時紓解患者心中郁結,將壓力宣泄出來,降低心理壓力。
  2.2 乳腺癌患者的健康教育
  醫護人員于手術后對患者進行健康教育是至關重要的。
  醫護人員應該給患者宣傳術后形態改變認識和預防術后并發癥的教育。鼓勵患者正確認識自身,并且主動和丈夫以及兒女談及自己術后的改變,爭取相互理解解除誤會。醫護人員還可以介紹患者乳房再造術和義乳的植入的方法,幫助患者進行乳房再造術和義乳的植入,增加患者自信心。還可以教導患者衣服搭配、裝飾品佩戴以及化妝等方法改變患者外形[1],使得患者不再自卑。
  2.3 鍛煉習慣
  乳腺癌的還要注意平常生活中的鍛煉習慣。患者可以選擇早晨或者是晚上,根據自己身體健康狀況,選擇進行一些符合自己身體承受力的有氧運動,比如慢跑、散步、打太極、騎自行車等,運動的同時,可以促進患者全身血液循環,增強患者體質,提高對疾病的免疫能力,同時消除抑郁情緒。
  2.4 加強家屬對患者的理解
  家屬對患者的態度與關心程度,直接關系著患者的心理狀態。親切的關心、理解的心理以及溫和的態度,可以消除患者對自身的懷疑,抵消患者失去親人的害怕心理。因此,醫護人員可以通過告知患者病情、 治療情況和心理情況,爭取家屬的理解。患者患有疾病,心情會有所煩躁,家屬面對患者需求時不應表現出不耐煩的表情,更不應該表現出傷心,防止患者抑郁加重。醫護人員應鼓勵丈夫與妻子共同解決治療中的問題[3],攜手共度難關。
  3 結束語
  因此,不同年齡、不同文化程度、對手術的不同認識,會導致乳腺癌患者不同程度的抑郁。因此,患者術后急需醫護人員護理避免抑郁。通過護理,乳腺癌患者可以建立客服疾病的信心,增加對未來生活的希望,提高生活質量,從而促進疾病的治療和痊愈。
  參考文獻
  [1]張索娟,耿寅卯,王曉春等.乳腺癌病人術后抑郁狀態調查及護理對策[J].河北職工醫學院學報, 2002, 20(2): 33-35.
        [2]仇曉霞,郭艷,邵潔,鐘衛菲,龔麗駿,阮燕. 綜合護理干預對乳腺癌 根治術后患者婚姻質量的影 響 [J]. 2010,25(10):35-37。
  [3]曹慧嬌,覃惠英,黃薇,張麗娟. 乳腺癌患者術后生活質量與焦慮、抑郁情緒的相關性分析 [J]. 2009,8(7):1-3.
  [4]文華,蘇小茵,高玲玲. 化療期乳腺癌病人抑郁與自我效能的相關性研究 [J]. 2007,42(4):322-324.



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