中国肿瘤临床与康复

目的 探讨放松训练联合根本原因分析对肺癌术后患者疾病认知以及并发症发生率的影响。方法前瞻性选取2021年3月至2023年3月在开封市中心医院接受手术治疗的130例肺癌患者作为研究对象，按照随机数字表法分为对照组(65例)和研究组(65例)。对照组中，男41例，女24例；年龄42～78岁[(66.28±4.16)岁]。研究组中，男42例，女23例；年龄40～75岁[(65.73±4.11)岁]。两组患者均接受常规护理，研究组患者在常规护理的基础上开展放松训练联合根本原因分析护理。护理前后采用自行设计的肺癌知识问卷评估疾病认知，采用中文版心理弹性量表(CD-RISC)、世界卫生组织生存质量测定量表简表(WHOQOL-BREF)分别评估心理状况和生活质量，记录并发症发生情况。两组患者护理前后疾病认知、心理弹性和生活质量评分的比较采用t检验，并发症发生情况的比较采用χ²检验。结果 护理后，研究组患者肺癌认知评分为(13.85±3.71)分，明显高于对照组[(11.24±3.56)分，P<0.001]；研究组患者CD-RISC坚韧、自立、乐观维度评分及总分分别为(43.62±5.39)分、(26.83±3.62)分、(11.82±2.18)分和(82.27±10.25)分，均明显高于对照组[分别为(35.87±3.91)分、(20.64±2.47)分、(9.39±1.84)分和(65.90±8.32)分，均P<0.001]；研究组患者WHOQOL-BREF的生理、心理、环境和社会维度评分分别为(85.33±8.29)分、(89.59±8.65)分、(94.37±9.35)分和(91.48±8.36)分，均明显高于对照组[分别为(73.56±6.57)分、(76.85±6.95)分、(82.79±8.58)分和(80.96±8.12)分，均P<0.001]。研究组患者并发症的发生率为4.6%(3/65)，明显低于对照组[16.9%(11/65)；χ²=5.13,P=0.024]。结论 放松训练联合根本原因分析的护理方式可改善肺癌术后患者对疾病的认知，促进其心理状态和生活质量的提升，降低并发症的发生率，促进患者康复。

Objective The objective of this study is to investigate relaxation training combined with root cause analysis(RCA) on disease cognition and the incidence of complications in patients after lung cancer surgery. Methods The selected subjects in this study were 130 lung cancer patients who underwent surgical treatment in our hospital between March 2021 and March 2023. The selected patients were randomly divided into a control group(n=65) and a study group(n=65) using a random number table. The control group included 41 males and 24 females, aged 42-78 years(66.28±4.16), while the study group included 42 males and 23 females, aged 40-75 years(65.73±4.11). Both groups received routine nursing care; in addition, the intervention group received nursing based on relaxation training combined with RCA. Disease cognition was assessed using a selfdeveloped lung cancer knowledge questionnaire. Psychological resilience and quality of life were measured using the Chinese version of the Connor-Davidson Resilience Scale(CDRISC) and the World Health Organization Quality of Life Brief Scale(WHOQOL-BREF), respectively. The incidence of complications was recorded. Independent-samples t-tests were used to compare scores between groups before and after the intervention, and the chi-square test was used for comparisons of complication rates. Results After the intervention, the disease cognition score in the intervention group was significantly higher than that in the control group [(13.85±3.71) vs(11.24±3.56), P<0.001]. The intervention group also had significantly higher scores in the CD-RISC dimensions of tenacity, self-reliance, optimism, and total score [(43.62±5.39),(26.83±3.62),(11.82±2.18), and(82.27±10.25), respectively] compared with the control group [(35.87±3.91),(20.64±2.47),(9.39±1.84), and(65.90±8.32); all P < 0.001]. After the intervention, scores in the physiological, psychological, environmental, and social domains of WHOQOL-BREF in the intervention group were also significantly higher [(85.33±8.29),(89.59±8.65),(94.37±9.35),(91.48±8.36)] than those in the control group [(73.56±6.57),(76.85±6.95),(82.79±8.58),(80.96±8.12); all P < 0.001]. The incidence of complications was significantly lower in the intervention group(4.6%, 3/65) than in the control group(16.9%, 11/65; χ2 =5.13, P=0.024). Conclusions Nursing care involving relaxation training combined with root cause analysis can significantly enhance disease cognition, improve psychological well-being and quality of life, reduce the incidence of postoperative complications, and facilitate recovery in patients undergoing lung cancer surgery.