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Article(id=1322931550257545934, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931549481599694, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.12.015, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1756656000000, receivedDateStr=2025-09-01, revisedDate=1779897600000, revisedDateStr=2026-05-28, acceptedDate=null, acceptedDateStr=null, onlineDate=1793341060461, onlineDateStr=2026-10-30, pubDate=1782316800000, pubDateStr=2026-06-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793341060461, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793341060461, creator=13701087609, updateTime=1793341060461, updator=13701087609, issue=Issue{id=1322931549481599694, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='12', pageStart='2001', pageEnd='2192', issueExtLink='null', onlineDate='null', pubDate='1782316800000', pubDateStr='2026-06-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793341060276, creator='13701087609', updateTime=1793343118019, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940180335829530, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931549481599694, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940180335829531, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322931549481599694, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2117, endPage=2122, ext={EN=ArticleExt(id=1322931550643421903, articleId=1322931550257545934, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Application of the adaptation-system dual-model psychological nursing based on Rosenthal effect theory for elderly patients undergoing colorectal cancer surgery, columnId=1220689488284668633, journalTitle=Chinese Nursing Research, columnName=Comprehensive Study, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the application effect of the adaptive-system dual-model psychological nursing based on Rosenthal effect theory for elderly patients undergoing colorectal cancer surgery.

Methods

A total of 96 elderly patients with colorectal cancer who were admitted to the Third People's Hospital of Bengbu City,Anhui Province from July 2022 to April 2025 were selected.Among them,48 patients admitted from July 2022 to January 2024 were assigned to the control group,and 48 patients admitted from February 2024 to April 2025 were assigned to the study group.The patients in control group received routine nursing.The patients in study group implemented the adaptation-system dual-model psychological nursing based on Rosenthal effect theory on the basis of routine nursing.The perioperative related indicators and hospital stay of the two groups were compared.The psychological state,coping style,level of perceived social support,hope level and nursing satisfaction of the two groups before intervention and at discharge were also compared.

Results

The recovery time of bowel sounds,the time of first defecation,the time of getting out of bed for activities,and the length of hospital stay in the study group were all shorter than those in the control group(P<0.05).At discharge,the scores of the Psychosocial Adjustment to Illness Scale-Self Report(PAIS-SR), the Self-Rating Depression Scale(SDS), the Self-Rating Anxiety Scale(SAS),and the negative coping score decreased in both groups,and the study group had lower scores than the control group(P<0.05).At discharge,the total scores of the Life Orientation Test-Revised(LOT-R), the positive coping, Perceived Social Support Scale(PSSS), and the Herth Hope Inventory(HHI) increased in both groups,and the study group had higher scores than the control group(P<0.05).The nursing satisfaction rate of the study group was higher than that of the control group(P<0.05).

Conclusions

The adaptation-system dual-model psychological nursing based on Rosenthal effect theory in elderly patients undergoing colorectal cancer surgery could improve the psychological state and coping strategies of elderly patients undergoing colorectal cancer surgery,enhance their perception of social support and hope levels,promote postoperative recovery,shorten hospital stay,and increase nursing satisfaction.

, authors=Hexian WANG, Rui HUO, Jing CUI, authorsList=Hexian WANG, Rui HUO, Jing CUI, authorCompany=null, correspAuthors=Hexian WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322931551444533968, articleId=1322931550257545934, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=基于罗森塔尔效应理论的适应-系统双模式心理护理在老年结直肠癌手术病人中的应用, columnId=1220689488938980091, journalTitle=护理研究, columnName=综合研究, runingTitle=null, highlight=null, articleAbstract=
目的

探讨基于罗森塔尔效应理论的适应-系统双模式心理护理在老年结直肠癌手术病人中的应用效果。

方法

纳入2022年7月—2025年4月安徽省蚌埠市第三人民医院收治的96例老年结直肠癌手术病人为研究对象，其中2022年7月—2024年1月收治的48例病人为对照组，2024年2月—2025年4月收治的48例病人为研究组。对照组实施常规护理，研究组在对照组基础上实施基于罗森塔尔效应理论的适应-系统双模式心理护理。比较两组围术期相关指标及住院时间，干预前和出院时的心理状态、应对方式、领悟社会支持水平、希望水平及护理满意度。

结果

研究组肠鸣音恢复时间、首次排气时间、下床活动时间及住院时间均短于对照组（P<0.05）。出院时两组疾病心理社会适应量表（PAIS-SR）、抑郁自评量表（SDS）、焦虑自评量表（SAS）、消极应对评分降低，且研究组低于对照组（P<0.05）；两组生活定向测验修订版（LOT-R）、积极应对、领悟社会支持量表（PSSS）、Herth希望量表（HHI）总分升高，且研究组高于对照组（P<0.05）。研究组护理满意率高于对照组（P<0.05）。

结论

基于罗森塔尔效应理论的适应-系统双模式心理护理可改善老年结直肠癌手术病人心理状态及应对方式，提高病人领悟社会支持及希望水平，促进病人术后康复，缩短住院时间，提高护理满意度。

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WANG Hexian， E-mail：
王鹤仙，副主任护师，本科，E-mail：
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tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, xref=1, ext=[AuthorCompanyExt(id=1322931551918490322, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, companyId=1322931551910101713, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1Third People's Hospital of Bengbu City, Anhui 233000 China), AuthorCompanyExt(id=1322931551931073235, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, companyId=1322931551910101713, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1安徽省蚌埠市第三人民医院，安徽 233000)])], figs=[ArticleFig(id=1322931555664003825, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, language=EN, label=Table 1, caption=

Comparison of general information between two groups

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数性别（例）体质指数
(kg/m2)		年龄
(岁)		合并高血压（例）合并糖尿病（例）疾病类型（例）肿瘤分期（例）
男女结肠癌直肠癌Ⅰ期Ⅱ期Ⅲ期
对照组48301823.49±1.2275.94±2.081051731161715
研究组48321623.53±1.2676.22±2.131372028141915
统计值χ2=0.182t=-0.158t=-0.652χ2=0.515χ2=0.381χ2=0.396Z=0.244
P0.6700.8750.5160.4730.5370.5290.885
), ArticleFig(id=1322931555756278514, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, language=CN, label=表1, caption=

两组一般资料比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数性别（例）体质指数
(kg/m2)		年龄
(岁)		合并高血压（例）合并糖尿病（例）疾病类型（例）肿瘤分期（例）
男女结肠癌直肠癌Ⅰ期Ⅱ期Ⅲ期
对照组48301823.49±1.2275.94±2.081051731161715
研究组48321623.53±1.2676.22±2.131372028141915
统计值χ2=0.182t=-0.158t=-0.652χ2=0.515χ2=0.381χ2=0.396Z=0.244
P0.6700.8750.5160.4730.5370.5290.885
), ArticleFig(id=1322931555844358899, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, language=EN, label=Table 2, caption=

Comparison of perioperative related indicators and hospital stay between two groups（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数肠鸣音恢复时间首次排气时间首次下床活动时间住院时间
对照组481.25±0.421.53±0.322.01±0.638.12±1.45
研究组480.97±0.301.32±0.271.44±0.326.97±1.13
t值3.7583.4755.5894.334
P<0.0010.001<0.001<0.001
), ArticleFig(id=1322931555911467764, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, language=CN, label=表2, caption=

两组围术期相关指标及住院时间比较（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数肠鸣音恢复时间首次排气时间首次下床活动时间住院时间
对照组481.25±0.421.53±0.322.01±0.638.12±1.45
研究组480.97±0.301.32±0.271.44±0.326.97±1.13
t值3.7583.4755.5894.334
P<0.0010.001<0.001<0.001
), ArticleFig(id=1322931556041491189, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, language=EN, label=Table 3, caption=

Comparison of psychological states between two groups of patients（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
时间组别例数PAIS-SR得分LOT-R得分SDS得分SAS得分
干预前对照组4871.89±9.1210.11±1.1560.54±6.4164.29±7.42
研究组4872.34±8.5410.04±1.2360.78±6.2265.43±7.62
t值-0.2500.288-0.186-0.743
P0.8030.7740.8530.460
出院时对照组4843.78±6.12①16.41±1.03①45.41±2.55①46.32±4.11①
研究组4835.45±4.22①17.21±1.24①43.78±2.45①42.13±3.15①
t值7.763-3.4383.1935.606
P<0.0010.0010.002<0.001
), ArticleFig(id=1322931556108600054, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, language=CN, label=表3, caption=

两组病人心理状态比较（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
时间组别例数PAIS-SR得分LOT-R得分SDS得分SAS得分
干预前对照组4871.89±9.1210.11±1.1560.54±6.4164.29±7.42
研究组4872.34±8.5410.04±1.2360.78±6.2265.43±7.62
t值-0.2500.288-0.186-0.743
P0.8030.7740.8530.460
出院时对照组4843.78±6.12①16.41±1.03①45.41±2.55①46.32±4.11①
研究组4835.45±4.22①17.21±1.24①43.78±2.45①42.13±3.15①
t值7.763-3.4383.1935.606
P<0.0010.0010.002<0.001
), ArticleFig(id=1322931556188291831, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, language=EN, label=Table 4, caption=

Comparison of SCSQ and PSSS scores between two groups(x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数积极应对消极应对PSSS得分
干预前出院时干预前出院时干预前出院时
对照组4812.91±1.6218.95±1.94①20.21±1.189.14±1.05①35.72±2.5055.78±2.69①
研究组4812.78±1.5723.12±2.44①20.13±1.258.49±1.03①35.61±2.4464.41±3.72①
t值0.399-9.2680.3223.0620.218-13.024
P0.691<0.0010.7480.0030.828<0.001
), ArticleFig(id=1322931556276372216, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, language=CN, label=表4, caption=

两组SCSQ及PSSS得分比较（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数积极应对消极应对PSSS得分
干预前出院时干预前出院时干预前出院时
对照组4812.91±1.6218.95±1.94①20.21±1.189.14±1.05①35.72±2.5055.78±2.69①
研究组4812.78±1.5723.12±2.44①20.13±1.258.49±1.03①35.61±2.4464.41±3.72①
t值0.399-9.2680.3223.0620.218-13.024
P0.691<0.0010.7480.0030.828<0.001
), ArticleFig(id=1322931556481893113, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, language=EN, label=Table 5, caption=

Comparison of HHI scores between two groups（x±s)

, figureFileSmall=null, figureFileBig=null, tableContent=
时间组别例数与他人互动积极行动对现实和未来积极的心态HHI总分
干预前对照组488.15±0.297.83±0.617.94±0.5823.92±1.48
研究组488.11±0.347.78±0.557.91±0.6223.80±1.51
t值0.6200.4220.2450.393
P0.5370.6740.8070.695
出院时对照组4811.93±0.95①10.85±1.02①10.77±0.84①33.55±2.81①
研究组4812.51±1.02①12.54±1.12①12.32±1.05①37.37±3.19①
t值-2.883-7.729-7.986-6.226
P0.005<0.001<0.001<0.001
), ArticleFig(id=1322931556561584890, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, language=CN, label=表5, caption=

两组HHI得分比较（x±s）

, figureFileSmall=null, figureFileBig=null, tableContent=
时间组别例数与他人互动积极行动对现实和未来积极的心态HHI总分
干预前对照组488.15±0.297.83±0.617.94±0.5823.92±1.48
研究组488.11±0.347.78±0.557.91±0.6223.80±1.51
t值0.6200.4220.2450.393
P0.5370.6740.8070.695
出院时对照组4811.93±0.95①10.85±1.02①10.77±0.84①33.55±2.81①
研究组4812.51±1.02①12.54±1.12①12.32±1.05①37.37±3.19①
t值-2.883-7.729-7.986-6.226
P0.005<0.001<0.001<0.001
), ArticleFig(id=1322931556637082363, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, language=EN, label=Table 6, caption=

Comparison of nursing satisfaction between two groups

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数非常满意满意基本满意不满意总满意
对照组4814(29.17)18(37.50)7(14.58)9(18.75)39(81.25)
研究组4823(47.92)17(35.42)6(12.50)2(4.17)46(95.83)
), ArticleFig(id=1322931556712579836, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, language=CN, label=表6, caption=

两组护理满意度比较

, figureFileSmall=null, figureFileBig=null, tableContent=
组别例数非常满意满意基本满意不满意总满意
对照组4814(29.17)18(37.50)7(14.58)9(18.75)39(81.25)
研究组4823(47.92)17(35.42)6(12.50)2(4.17)46(95.83)
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基于罗森塔尔效应理论的适应-系统双模式心理护理在老年结直肠癌手术病人中的应用
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王鹤仙 , 霍蕊 , 崔静
护理研究 | 综合研究 2026,40(12): 2117-2122
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护理研究 |综合研究 2026 , 40 (12) : 2117 -2122
基于罗森塔尔效应理论的适应-系统双模式心理护理在老年结直肠癌手术病人中的应用
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233000 China), AuthorCompanyExt(id=1322931551931073235, tenantId=1146029695717560320, journalId=1220038315760373764, articleId=1322931550257545934, companyId=1322931551910101713, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1安徽省蚌埠市第三人民医院，安徽 233000)])])]
王鹤仙 , 霍蕊, 崔静
作者信息
  • 1安徽省蚌埠市第三人民医院，安徽 233000
通讯作者:
WANG Hexian， E-mail：
王鹤仙，副主任护师，本科，E-mail：
Application of the adaptation-system dual-model psychological nursing based on Rosenthal effect theory for elderly patients undergoing colorectal cancer surgery
Hexian WANG , Rui HUO, Jing CUI
Affiliations
  • 1Third People's Hospital of Bengbu City, Anhui 233000 China
出版时间: 2026-06-25 doi: 10.12102/j.issn.1009-6493.2026.12.015
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摘要
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目的

探讨基于罗森塔尔效应理论的适应-系统双模式心理护理在老年结直肠癌手术病人中的应用效果。

方法

纳入2022年7月—2025年4月安徽省蚌埠市第三人民医院收治的96例老年结直肠癌手术病人为研究对象，其中2022年7月—2024年1月收治的48例病人为对照组，2024年2月—2025年4月收治的48例病人为研究组。对照组实施常规护理，研究组在对照组基础上实施基于罗森塔尔效应理论的适应-系统双模式心理护理。比较两组围术期相关指标及住院时间，干预前和出院时的心理状态、应对方式、领悟社会支持水平、希望水平及护理满意度。

结果

研究组肠鸣音恢复时间、首次排气时间、下床活动时间及住院时间均短于对照组（P<0.05）。出院时两组疾病心理社会适应量表（PAIS-SR）、抑郁自评量表（SDS）、焦虑自评量表（SAS）、消极应对评分降低，且研究组低于对照组（P<0.05）；两组生活定向测验修订版（LOT-R）、积极应对、领悟社会支持量表（PSSS）、Herth希望量表（HHI）总分升高，且研究组高于对照组（P<0.05）。研究组护理满意率高于对照组（P<0.05）。

结论

基于罗森塔尔效应理论的适应-系统双模式心理护理可改善老年结直肠癌手术病人心理状态及应对方式，提高病人领悟社会支持及希望水平，促进病人术后康复，缩短住院时间，提高护理满意度。

结直肠癌  /  老年人  /  罗森塔尔效应  /  适应-系统双模式  /  应对方式  /  希望水平  /  心理护理
Objective

To explore the application effect of the adaptive-system dual-model psychological nursing based on Rosenthal effect theory for elderly patients undergoing colorectal cancer surgery.

Methods

A total of 96 elderly patients with colorectal cancer who were admitted to the Third People's Hospital of Bengbu City,Anhui Province from July 2022 to April 2025 were selected.Among them,48 patients admitted from July 2022 to January 2024 were assigned to the control group,and 48 patients admitted from February 2024 to April 2025 were assigned to the study group.The patients in control group received routine nursing.The patients in study group implemented the adaptation-system dual-model psychological nursing based on Rosenthal effect theory on the basis of routine nursing.The perioperative related indicators and hospital stay of the two groups were compared.The psychological state,coping style,level of perceived social support,hope level and nursing satisfaction of the two groups before intervention and at discharge were also compared.

Results

The recovery time of bowel sounds,the time of first defecation,the time of getting out of bed for activities,and the length of hospital stay in the study group were all shorter than those in the control group(P<0.05).At discharge,the scores of the Psychosocial Adjustment to Illness Scale-Self Report(PAIS-SR), the Self-Rating Depression Scale(SDS), the Self-Rating Anxiety Scale(SAS),and the negative coping score decreased in both groups,and the study group had lower scores than the control group(P<0.05).At discharge,the total scores of the Life Orientation Test-Revised(LOT-R), the positive coping, Perceived Social Support Scale(PSSS), and the Herth Hope Inventory(HHI) increased in both groups,and the study group had higher scores than the control group(P<0.05).The nursing satisfaction rate of the study group was higher than that of the control group(P<0.05).

Conclusions

The adaptation-system dual-model psychological nursing based on Rosenthal effect theory in elderly patients undergoing colorectal cancer surgery could improve the psychological state and coping strategies of elderly patients undergoing colorectal cancer surgery,enhance their perception of social support and hope levels,promote postoperative recovery,shorten hospital stay,and increase nursing satisfaction.

colorectal cancer  /  the elderly  /  Rosenthal effect  /  adaptation-system dual-model  /  coping style  /  hope level  /  psychological nursing
王鹤仙, 霍蕊, 崔静. 基于罗森塔尔效应理论的适应-系统双模式心理护理在老年结直肠癌手术病人中的应用. 护理研究, 2026 , 40 (12) : 2117 -2122 . DOI: 10.12102/j.issn.1009-6493.2026.12.015
Hexian WANG, Rui HUO, Jing CUI. Application of the adaptation-system dual-model psychological nursing based on Rosenthal effect theory for elderly patients undergoing colorectal cancer surgery[J]. Chinese Nursing Research, 2026 , 40 (12) : 2117 -2122 . DOI: 10.12102/j.issn.1009-6493.2026.12.015
正文
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结直肠癌是老年人群中常见的恶性肿瘤之一，手术治疗是其主要的治疗手段[1]。然而，手术作为一种强烈的应激源，往往导致病人出现焦虑、抑郁等负性情绪，并影响其应对方式和希望水平，进而降低术后康复效果[2]。老年病人由于生理机能衰退、社会支持不足及心理调适能力减弱，在面对疾病和手术时更容易产生消极应对行为，甚至丧失治疗信心[3]。因此，探索有效的心理护理干预模式，改善老年结直肠癌手术病人的心理状态，成为临床护理研究的重要课题之一。罗森塔尔效应是指他人的期望能够显著影响个体的行为表现和心理状态[4]。在医疗环境中，医护人员的积极期望和正向暗示可能增强病人的治疗信心，促使其采取更积极的应对策略[5]。基于此，本研究尝试将罗森塔尔效应与心理护理相结合，构建“适应-系统双模式心理护理”干预方案。该模式一方面通过适应性训练帮助病人调整心理状态，另一方面利用系统性支持强化病人的希望水平，从而形成多维度的心理干预体系。目前，国内外关于心理护理在肿瘤病人中的应用研究较多[6-7]，但针对老年结直肠癌手术病人群体，尤其是结合罗森塔尔效应与适应-系统双模式心理护理模式的研究较少。此外，常规护理多侧重于单一的情绪调节，而容易忽视病人应对方式和希望水平的整体提升。因此，本研究旨在探讨罗森塔尔效应理论下的适应-系统双模式心理护理对老年结直肠癌手术病人应对方式及希望水平的影响，为临床实践提供科学、系统的心理干预依据。
1　对象与方法
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1.1　对象
回顾性纳入2022年7月—2025年4月安徽省蚌埠市第三人民医院收治的96例老年结直肠癌手术病人。纳入标准：结直肠癌诊断参照文献[8]中的相关标准；首次确诊为结直肠癌，且均接受手术治疗者；年龄≥65岁；肿瘤分期Ⅰ~Ⅲ期[9]。排除标准：合并免疫缺陷疾病、自身免疫性疾病、心脑血管疾病及血液系统疾病者；视听障碍，无法配合相关调查者；伴有老年痴呆或其他精神异常，无法积极配合干预者等。其中2022年7月—2024年1月收治的48例病人为对照组，2024年2月—2025年4月收治的48例病人为研究组。两组性别、体质指数、年龄、合并高血压、合并糖尿病、疾病类型及肿瘤分期比较，差异均无统计学意义（P>0.05）。见表1。本研究已取得安徽省蚌埠市第三人民医院伦理委员会批准（编号：伦科批字〔2025〕第K100号）。
1.2　护理方法
1.2.1　对照组
对照组病人实施常规护理。1）术前护理：向病人及其家属讲解手术流程、注意事项及可能的并发症；护士进行常规心理疏导，解答病人疑问，减轻其焦虑情绪；指导病人禁食、肠道准备及皮肤清洁等。2）术中护理：按标准流程配合手术团队，监测生命体征，确保手术安全。3）术后护理：按医嘱给予病人镇痛药物，评估其疼痛程度；鼓励病人术后24 h内床上活动，逐步过渡至下床行走；根据病人恢复情况调整饮食，从流质饮食逐渐过渡到半流质饮食、正常饮食；监测病人切口愈合、感染及肠梗阻等情况，并及时处理。4）出院指导：向病人提供术后康复建议，如饮食、运动、复诊时间等。
1.2.2　研究组
在对照组的基础上实施罗森塔尔效应理论下的适应-系统双模式心理护理。建立罗森塔尔效应理论下的适应-系统双模式心理护理小组，护理方案经小组讨论、专家咨询确定，小组成员包括主管医生1人、护士长1人、主管护师1人、护士2人、心理医生1人，小组成员均接受系统的罗森塔尔效应理论下的适应-系统双模式心理护理知识培训，并经考核合格后参与研究。实施罗森塔尔效应理论下的适应-系统双模式心理护理方案，具体步骤如下。1）术前阶段干预（入院至手术前）：罗森塔尔效应干预（医护积极期望训练）。护士接受专项培训，学习如何通过语言、行为向病人传递积极期望（如“您的恢复能力很好，术后会顺利康复”）。与病人沟通过程中采用正向暗示沟通方式，避免使用消极词汇（如“风险”“痛苦”等），改用积极表述（如“我们会帮您顺利度过手术期”）。每日查房时给予病人鼓励（如“您的检查指标很好，手术准备很充分”）。适应性心理训练：给予病人认知行为干预，帮助病人纠正消极思维，建立积极认知（如“手术是有效的治疗手段”）。给予病人放松训练，指导其深呼吸，并采用渐进性肌肉放松法缓解术前焦虑。家庭-医疗团队联合支持：邀请家属参加病人的心理辅导过程，让家属学习如何给予病人情感支持。多学科团队协作，外科医生、护士、心理科医生共同制订个性化护理计划，如外科医生展示手术动画（突出安全保障环节），护士指导腹式呼吸训练，心理医生筛查情绪状态等。2）术中阶段干预：手术团队积极配合，主刀医生和麻醉师在术中保持积极语言（如“手术很顺利”），避免负面暗示。3）术后阶段干预（术后至出院）：希望水平强化干预。为病人制订活动计划，术后第1天床边坐起5 min，站立2 min（分次进行），床边踏步10~20步；术后第2天在病房内短距离行走（2次或3次），累计500~1 000步，行直腿抬高训练（每侧5次，2组）；术后第3天走廊步行（3次或4次），累计1 000~2 000步，行床边坐位抬膝训练（5次，2组），引导病人设定短期康复目标；通过向病人分享成功案例以增强其康复信心（如“类似病人术后恢复良好”）。加强系统性社会支持，安排康复期病友交流经验，给予病人社会支持；心理科医生定期对病人心理进行评估，动态监测其心理状态，可开展早期支持性心理干预，如每日10~15 min床边沟通，耐心倾听病人主诉，给予病人关心和鼓励。做好延续性护理准备，出院前为病人制订个性化随访计划，包括定期电话回访、线上咨询等。持续干预至出院。
1.3　观察指标
1.3.1　围术期相关指标及住院时间
详细记录两组病人肠鸣音恢复、首次排气、下床活动及住院时间。
1.3.2　心理状态
干预前和出院时采用疾病心理社会适应量表（Psychosocial Adjustment to Illness Scale-Self Report，PAIS-SR）[10]、生活定向测验修订版（Life Orientation Test-Revised，LOT-R）[11]以及抑郁自评量表（SDS）[12]、焦虑自评量表（SAS）[12]评估两组病人的心理状态。其中PAIS-SR总分为0~132分，得分越高提示病人心理社会适应水平越低；LOT-R总分为0~24分，得分越高提示病人乐观倾向越强；SDS、SAS标准分总分均为0~100分，SDS≥53分说明有抑郁症状，SAS≥50分说明有焦虑症状，二者得分越高提示病人抑郁、焦虑程度越高。
1.3.3　应对方式
干预前和出院时采用王端卫[13]编制的简明应对方式问卷（Simplified Coping Style Questionnaire，SCSQ），评估两组病人的应对方式。SCSQ问卷含积极应对（12个条目）、消极应对（8个条目）2个维度，各条目均予以0~3分Likert 4级评分法，其中积极应对总分0~36分，消极应对总分0~24分，得分越高提示病人越倾向采取相应应对方式。
1.3.4　领悟社会支持
干预前和出院时采用姜乾金[14]编制的领悟社会支持量表（Perceived Social Support Scale，PSSS）评估两组病人的领悟社会支持水平。PSSS总分12~84分，得分越高提示病人领悟社会支持水平越高。
1.3.5　希望水平
干预前和出院时采用Herth希望量表（Herth Hope Inventory，HHI）[15]评估两组病人的希望水平。包括与他人互动（4个条目）、积极行动（4个条目）、对现实和未来积极的心态（4个条目）3个维度，共12个条目，各条目采用Likert 4级（1~4分）评分法，各维度总分均为4~16分，HHI总分为12~48分，得分越高提示病人希望水平越高。
1.3.6　护理满意度
研究者查阅资料自行设计护理满意度调查问卷，问卷内容含健康教育内容、沟通水平、护理责任、护理专业性、护理效果等，总分为0~100分，其中>95分为非常满意，81~95分为满意，65~80分为基本满意，<65分为不满意。总护理满意率=（非常满意例数+满意例数+基本满意例数）/总例数×100%。该量表一致性信度Cronbach's α系数为0.90，效度系数为0.89。
1.4　统计学方法
采用SPSS 26.0软件处理数据。定性资料用频数、百分比（%）表示，采用χ2检验，等级资料则行秩和检验；符合正态分布的定量资料以均数±标准差（x±s）表示，组内比较行配对t检验，组间比较行独立样本t检验。以P<0.05为差异有统计学意义。
2　结果
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2.1　两组围术期相关指标及住院时间比较（见表2）
2.2　两组心理状态比较（见表3）
2.3　两组应对方式及领悟社会支持水平比较（见表4）
2.4　两组希望水平比较（见表5）
2.5　两组护理满意度比较（见表6）
3　讨论
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随着医学模式向生物-心理-社会模式的转变，心理护理在肿瘤病人围术期管理中的重要性日益凸显[16]。老年结直肠癌手术病人因疾病本身及手术创伤的双重压力，常表现出较高的心理应激反应，如悲观情绪及消极应对行为等，而这些因素会影响其术后康复进程[17]。尽管现有研究已证实心理干预在改善肿瘤病人情绪状态方面的积极作用[18-20]，但针对老年病人这一特殊群体，尤其是如何通过系统化护理模式优化其应对策略并增强希望水平，仍缺乏深入探索。罗森塔尔效应的引入为心理护理提供了新的视角，其核心在于通过医护人员的正向期望与支持性干预，激发病人的内在潜能，从而促使其形成更积极的疾病应对方式[21]。本研究基于罗森塔尔效应构建的适应-系统双模式心理护理，不仅关注个体心理调适能力的培养，还整合了家庭、医疗团队及社会支持系统的作用，可为临床优化老年结直肠癌手术病人护理方案提供一定的指导。
本研究结果显示，研究组病人肠鸣音恢复时间、首次排气时间、首次下床活动时间及住院时间较对照组更短（P<0.05），说明罗森塔尔效应理论下的适应-系统双模式心理护理可促进老年结直肠癌手术病人术后康复，缩短住院时间。罗森塔尔效应通过医护人员的积极期望传递，能够降低病人的术前焦虑，减少手术应激对下丘脑-垂体-肾上腺轴的过度激活，从而有助于促进术后胃肠激素分泌，加速肠蠕动恢复；同时，正向心理暗示可能通过脑-肠轴互动，增强迷走神经活性，缩短术后肠麻痹时间，进而有助于促进病人术后康复，缩短病人住院时间。既往研究发现，术前接受标准化心理干预（含放松训练与积极期望引导）的病人，术后肠鸣音恢复时间较对照组缩短[22]。可见，罗森塔尔效应理论下的适应-系统双模式心理护理可促进老年结直肠癌手术病人术后康复。
本研究结果还显示，研究组出院时PAIS-SR、SDS、SAS、消极应对评分较对照组更低（P<0.05），LOT-R、积极应对、PSSS、与他人互动、积极行动、对现实和未来积极的心态评分及HHI总分较对照组更高（P<0.05），提示罗森塔尔效应理论下的适应-系统双模式心理护理可改善老年结直肠癌手术病人心理状态及应对方式，提高病人领悟社会支持及希望水平。罗森塔尔效应理论下的适应-系统双模式心理护理过程中通过给予病人适应性心理训练，帮助病人纠正消极思维，建立积极认知，并给予病人放松训练，有助于缓解其负性心理，促进其以乐观的心态面对疾病，进而可改善其心理状态及应对方式。干预过程中给予病人家庭及医疗支持，一方面家属可提供情感支持，另一方面医护团队使用标准化积极语言增强权威信任，同时组织康复期病友分享经历，给予病人社会支持，进而能够提高病人的领悟社会支持水平。另外，罗森塔尔效应干预通过语言、行为向病人传递积极期望，一定程度上能够被老年病人内化为自我认知，进而增强其希望感；且语言暗示可促进病人认知重塑，可直接增强其希望水平。干预过程中引导病人设定短期康复目标，可增强其动力信念，并通过向病人分享成功案例，可增强其康复信心，进而有助于提高病人的希望水平。有报道显示，参与病友互助的病人可促进其积极应对方式[23]。也有研究显示，当权威医生使用积极语言时有助于提高病人的希望水平[24]。可见，罗森塔尔效应理论下的适应-系统双模式心理护理可改善老年结直肠癌手术病人的应对方式，提高病人希望水平。此外，本研究结果还显示，研究组护理满意率较对照组高，表明罗森塔尔效应理论下的适应-系统双模式心理护理可提高老年结直肠癌手术病人护理满意度。罗森塔尔效应理论下的适应-系统双模式心理护理可优化医疗沟通质量，为病人提供个性化的情感支持，病人负性心理得到疏解，希望水平得到提升，进而提高护理满意度。既往研究发现，老年癌症病人的希望水平提高，其护理满意度也提升[25]。可见，罗森塔尔效应理论下的适应-系统双模式心理护理可提高老年结直肠癌手术病人的护理满意度。
4　小结
收起
罗森塔尔效应理论下的适应-系统双模式心理护理可改善老年结直肠癌手术病人心理状态及应对方式，提高病人领悟社会支持及希望水平，进而有助于促进病人术后康复，缩短住院时间，提高护理满意度。但本研究仅纳入96例病人，样本代表性具有一定局限性，今后需在大样本的基础上开展更深入的研究，以进一步验证本研究结果。

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2026年第40卷第12期
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doi: 10.12102/j.issn.1009-6493.2026.12.015
  • 接收时间：2025-09-01
  • 首发时间：2026-10-30
  • 出版时间：2026-06-25
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  • 收稿日期：2025-09-01
  • 修回日期：2026-05-28
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    1安徽省蚌埠市第三人民医院，安徽 233000

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鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
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