中国肿瘤临床与康复

目的 探讨激励式护理模式对肝癌切除术后患者心理状态及生活质量的影响。方法 前瞻性选取2023年4月至2024年4月河南省人民医院收治的116例肝癌患者作为研究对象，采用随机数字表法分为常规组和联合组各58例。常规组患者采用常规干预，联合组患者采用常规干预联合激励式护理模式，比较两组患者干预前后的心理状态、心理弹性、睡眠质量、生活质量及患者满意度。结果 干预后联合组和常规组焦虑自评量表（SAS）、抑郁自评量表（SDS）评分均降低，且联合组[分别为（39.38±5.76）和（31.07±4.28）分]均低于对照组[分别为（43.18±6.83）和（34.27±5.53）分]，差异有统计学意义（均P<0.05）。干预后两组患者康纳·戴维森复原力量表（CD-RISC）乐观、自强、坚韧各维度评分均升高，且联合组[分别为（9.06±1.58）(17.76±3.15)和（30.68±4.01）分]均高于常规组[分别为（8.43±1.22）(16.24±2.14)和（27.37±3.55）分]，差异有统计学意义（均P<0.05）。干预后两组患者匹兹堡睡眠质量量表（PSQI）睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能障碍各维度评分及总分均降低（P<0.05），且联合组[分别为（0.78±0.31）(0.79±0.30)(1.12±0.47)(0.86±0.28)(1.03±0.42)(0.79±0.27)(0.86±0.32)和（6.23±1.35）分]低于常规组[（1.10±0.48）(0.98±0.23)(1.29±0.36)(1.22±0.47)(1.28±0.39)(0.89±0.19)(1.33±0.44)和（8.09±1.67）分）]，差异有统计学意义（均P<0.05）。干预后两组患者生活质量量表（QOL-LC）心理、躯体、社会、症状、自我评价各维度评分均升高（P<0.05），且联合组[分别为（34.03±5.11）(40.41±4.62)(42.26±5.94)(38.47±5.82)和（76.84±6.58）分]均高于常规组[分别为（30.16±4.15）(37.67±4.88)(36.78±5.46)(35.26±4.79)和（74.14±7.22）分]，差异有统计学意义（均P<0.05）。联合组干预满意度为72.41%(42/58)，高于常规组的53.45%(31/58)，差异有统计学意义（P<0.05）。结论 激励式护理模式可有效改善肝癌切除术后患者的焦虑、抑郁情绪，提高其心理弹性，改善睡眠质量及生活质量，提高患者满意度。

Objective To explore the effect of incentive nursing model on psychological state and quality of life of patients after liver cancer resection. Methods A total of 116 liver cancer patients admitted to Henan Provincial People's Hospital from April 2023 to April 2024 were prospectively selected as the research subjects and divided into the conventional group and the combined group, with 58 cases in each group, by the random number table method. Patients in the conventional group received conventional intervention, while those in the combined group received conventional intervention combined with the incentive nursing model. The psychological state, psychological resilience, sleep quality, quality of life, and patient satisfaction of the two groups of patients before and after the intervention were compared. Results After the intervention, the scores of the Self-Rating Anxiety Scale(SAS) and the Self-Rating Depression Scale(SDS) in both the combined group and the conventional group decreased, and the combined group(39.38±5.76 and 31.07±4.28 points) was lower than the control group(43.18±6.83 and 34.27±5.53 points)(P<0.05). After the intervention, the scores of each dimension of the Connor Davidson Resilience Scale(CD-RISC) in both groups of patients increased. Moreover, the combined group(9.06±1.58, 17.76±3.15 and 30.68±4.01 points) was higher than the conventional group(8.43±1.22, 16.24±2.14 and 27.37±3.55 points)(P<0.05). After the intervention, the scores of each dimension and the total score of the Pittsburgh Sleep Quality Scale(PSQI) in both groups of patients decreased(P<0.05). Moreover, the combined group [(0.78±0.31),(0.79±0.30),(1.12±0.47),(0.86±0.28),(1.03±0.42),(0.79±0.27),(0.86±0.32) and(6.23±1.35) points]was lower than the conventional group [(1.10±0.48),(0.98±0.23),(1.29±0.36),(1.22±0.47),(1.28±0.39),(0.89±0.19),(1.33±0.44) and(8.09±1.67) points](P<0.05). After the intervention, the scores of each dimension of the Quality of Life Scale(QOL-LC) in both groups of patients increased(P<0.05). Moreover, the combined group(34.03±5.11, 40.41±4.62, 42.26±5.94, 38.47±5.82 and 76.84±6.58 points) was higher than the conventional group(30.16±4.15, 37.67±4.88, 36.78±5.46, 35.26±4.79 and 74.14±7.2 points) 2 points)(P<0.05). The intervention satisfaction rate of the combined group was 72.41%(42/58), which was higher than that of the conventional group at 53.45%(31/58), and the difference was statistically significant(P<0.05). Conclusion The incentive nursing model can effectively improve the anxiety and depression of patients after liver cancer resection, enhance their psychological resilience, improve sleep quality and quality of life, and increase patient satisfaction.