目的 基于接纳承诺疗法（acceptance and commitment therapy，ACT) 构建癌症患者死亡焦虑虚拟现实（virtual reality，VR）技术的干预方案并初步应用，为改善癌症患者死亡焦虑提供参考。方法 通过文献回顾、相关指南与专家共识，利用VR技术，基于ACT及研究小组前期调查结果等制订方案初稿，通过2轮德尔菲专家咨询形成最终干预方案。2023年11月，采用随机数字表法选取湖南省某三级甲等肿瘤专科医院门诊或住院的初诊癌症患者12例为研究对象，以信封法将其分为对照组与干预组，每组6例。干预组在常规心理护理基础上，线下一对一进行基于ACT的癌症患者死亡焦虑VR干预，1次/周，35~45 min/次，共8周。住院期间的对照组患者，在其病房中进行常规心理护理，若已出院则通过电话进行，均1次/周，35~45 min/次，共8周。干预前后采用中文版Templer死亡焦虑量表、接纳与行动问卷第2版、中文版生命意义感量表等对两组患者进行评估。结果 最终干预方案包括8个项目及39项干预措施。经过8周干预，观察组患者死亡焦虑与经验性回避得分均低于对照组，而生命意义感得分均高于对照组，差异均有统计学意义（均P＜0.05）。结论 基于ACT的癌症患者死亡焦虑VR干预方案科学可靠，可改善癌症患者的死亡焦虑。

Objective To develop an intervention program using virtual reality(VR) technology based on acceptance and commitment therapy(ACT) for death anxiety(DA) in cancer patients and explore its preliminary application,to provide reference for improvement.Methods Through literature review,relevant guidelines and expert consensus,the first draft of the intervention program was formed by VR technology,based on the ACT and the preliminary survey results of the research team,and the final version was formed through two rounds of Delphi expert consultation. In November 2023,12 outpatients or inpatients with newly diagnosed cancer in a tertiary A cancer hospital in Hunan Province were selected by the random number table method.They were divided into the control group and the intervention group by the envelope method,each with 6 cases.On the basis of routine psychological care,the intervention group carried out one-on-one ACT-based VR intervention for cancer patients’ DA offline,once a week for 8 weeks,35-45 min/time.The control group patients received routine psychological care once a week in their ward during hospitalization,or once a week by telephone if discharged,for 8 weeks,35-45 minutes per time.Before and after the intervention,Templer Death Anxiety Scale(Chinese version),Acceptance and Action Questionnaire(second version) and Meaning in Life Scale(Chinese version) were used for evaluation.Results The final intervention plan consisted of 8 projects and 39 interventions.After 8 weeks of intervention,the scores of DA and experiential avoidance in observation group were lower than those in control group,while the scores of sense of meaning of life in observation group were higher than those in control group, with statistical significance(all P＜0.05).Conclusions VR intervention program for cancer patients with DA based on ACT is scientific and reliable,and can improve the DA of cancer patients.

R473.73

国家自然科学青年基金项目(82103026)