住院癌癥患者情緒特征與相關(guān)因素及干預(yù)研究
發(fā)布時(shí)間：2018-07-20 15:34
【摘要】：20世紀(jì)以來(lái),癌癥成為威脅人類(lèi)健康的疾病之一,近年來(lái)癌癥的發(fā)病率不斷上升。全世界每年新發(fā)病例約635萬(wàn),是導(dǎo)致人類(lèi)死亡的第二大疾病。隨著醫(yī)學(xué)模式由單純生物醫(yī)學(xué)模式向生物—心理—社會(huì)醫(yī)學(xué)模式的轉(zhuǎn)變,癌癥患者的心理健康以及生活質(zhì)量日益受到人們的關(guān)注。心理社會(huì)腫瘤學(xué)認(rèn)為,癌癥的發(fā)生、發(fā)展、預(yù)后及轉(zhuǎn)歸都與心理社會(huì)因素有密切關(guān)系。因此關(guān)注研究癌癥患者的心理健康及其影響因素,實(shí)施各種有效手段提升其心理健康水平有重要意義。本研究旨在：1.探究癌癥住院患者的情緒特征及相關(guān)因素。2.探索有效且有針對(duì)性的心理干預(yù)方法,以提升癌癥患者情緒健康水平。 研究一：住院癌癥患者情緒特征及其相關(guān)因素研究 研究方法：在省內(nèi)某大型三甲醫(yī)院隨機(jī)抽取71名住院癌癥患者進(jìn)行問(wèn)卷調(diào)查,應(yīng)用非精神科住院患者心理狀態(tài)評(píng)定(MSSNS),抑郁自評(píng)問(wèn)卷(SDS)、醫(yī)學(xué)應(yīng)對(duì)方式問(wèn)卷(MCMQ),需求評(píng)估問(wèn)卷(NEQ)、患者-親屬癌癥相關(guān)交流評(píng)估工具(患者版)(CCAT-P)等分別測(cè)量患者情緒特征,應(yīng)對(duì)方式,患者需求及與親屬交流情況。運(yùn)用統(tǒng)計(jì)描述對(duì)患者情緒特征進(jìn)行描述。運(yùn)用Pearson相關(guān)分析和多因素回歸分析,考察患者情緒特征與各測(cè)量變量的相關(guān)性。 研究結(jié)果：1.47.8%的患者其SDS得分符合抑郁標(biāo)準(zhǔn)；癌癥患者M(jìn)SSNS抑郁、焦慮、孤獨(dú)得分與一般內(nèi)外科患者無(wú)顯著性差異,但其憤怒情緒顯著高于內(nèi)外科患者；患者M(jìn)SSNS因子分由高到低得分依次為：孤獨(dú)、焦慮、抑郁和憤怒。2.患者抑郁、焦慮、憤怒、孤獨(dú)等負(fù)性情緒分別與其性別、文化程度、居住地、家庭月收入、病程等一般特征有關(guān),也與其信息需求、心理支持等需求的滿(mǎn)足情況、與家屬?lài)@疾病溝通、應(yīng)對(duì)方式有關(guān)。3.患者年齡、病程,患者需求中的情感支持需求、輔助與照料需求,患者與家屬?lài)@疾病的溝通,應(yīng)對(duì)方式中的屈服、回避分別在對(duì)負(fù)性情緒的回歸分析中達(dá)顯著性水平。 研究二：探索性認(rèn)知干預(yù)提升心理健康水平的實(shí)驗(yàn)研究 研究方法：通過(guò)與部分患者面談了解患者心理問(wèn)題根源,制定出針對(duì)性的干預(yù)方案,將干預(yù)內(nèi)容印制成手冊(cè)。將患者隨機(jī)分為干預(yù)組和對(duì)照組,干預(yù)組發(fā)放干預(yù)手冊(cè)并進(jìn)行2次訪談,對(duì)照組無(wú)干預(yù)。干預(yù)前后兩組分別收集問(wèn)卷數(shù)據(jù)。 研究結(jié)果：干預(yù)前基線數(shù)據(jù)兩組不均等。干預(yù)組SDS得分、MSSNS孤獨(dú)高于對(duì)照組、回避低于對(duì)照組,差異有統(tǒng)計(jì)學(xué)意義；干預(yù)后干預(yù)組與對(duì)照組比較,SDS得分、MSSNS孤獨(dú)和回避得分無(wú)顯著性差異,其余維度差異也無(wú)統(tǒng)計(jì)學(xué)意義；干預(yù)后干預(yù)組SDS得分降低,回避得分升高,差異有統(tǒng)計(jì)學(xué)意義,而干預(yù)后對(duì)照組變化無(wú)顯著性。 結(jié)論： 1.近半數(shù)癌癥患者達(dá)到抑郁診斷標(biāo)準(zhǔn)；癌癥患者憤怒情緒較一般內(nèi)外科患者顯著；患者的主觀孤獨(dú)感受較抑郁、焦慮、憤怒等情緒強(qiáng)烈； 2.相較于照料需求、心理情感支持需求和物質(zhì)需求信息,患者的信息需求、關(guān)系需求更為顯著； 3.癌癥情緒障礙的發(fā)生受到患者性別、文化程度、居住地區(qū)、家庭月收入、病程等患者一般社會(huì)特征因素的影響。女性、文化程度低、居住地偏遠(yuǎn)、家庭月收入低、患病時(shí)間較長(zhǎng)的患者其情緒障礙發(fā)生的風(fēng)險(xiǎn)升高； 4.患者的心理健康水平與患者信息需求、患者心理情感支持需求、家庭成員之間有關(guān)疾病的溝通、應(yīng)對(duì)方式等因素相關(guān)�；颊咝畔⑿枨笪吹玫綕M(mǎn)足、患者-家屬之間溝通不良、患者采用屈服應(yīng)對(duì)方式是增加患者情緒困擾的危險(xiǎn)因素�；颊咝畔⑿枨蟮牟粷M(mǎn)足使患者更容易感受到焦慮、憤怒；不良的患-屬溝通同樣與患者的抑郁和憤怒水平有密切聯(lián)系；屈服與患者的焦慮、抑郁、憤怒和孤獨(dú)都有顯著性的聯(lián)系；積極獲取心理情感支持、采用面對(duì)和回避應(yīng)對(duì)方式有助于患者對(duì)疾病的適應(yīng)； 5.對(duì)患者進(jìn)行簡(jiǎn)短的針對(duì)性認(rèn)知干預(yù)可以緩解其部分負(fù)性情緒。
[Abstract]:Since twentieth Century, cancer has become one of the diseases that threaten human health. The incidence of cancer is rising in recent years. The new incidence of cancer is about 6 million 350 thousand in the world every year. It is the second major disease that causes human death. With the change of medical model from simple biomedical model to biological psycho social medical model, the psychological health of cancer patients Psychosocial oncology believes that the occurrence, development, prognosis and prognosis of cancer are closely related to psychosocial factors. Therefore, it is of great significance to pay attention to the psychological health of cancer patients and their influencing factors and to implement various effective means to improve their mental health. 1.: 1. explore the emotional characteristics and related factors of cancer inpatients, explore effective and targeted psychological intervention to improve the emotional health of cancer patients.
Study 1: emotional characteristics and related factors of hospitalized cancer patients
Methods: 71 hospitalized cancer patients were randomly selected from a large three a hospital in the province to conduct a questionnaire survey, using the mental state assessment (MSSNS) of non psychiatric inpatients, the self rating Depression Questionnaire (SDS), the Medical Coping Style Questionnaire (MCMQ), the demand assessment questionnaire (NEQ), the patient relative cancer related exchange assessment tool (patient Edition), and so on (CCAT-P). The emotional characteristics of patients, coping styles, patients' needs and communication with relatives were measured respectively. Statistical description was used to describe the emotional characteristics of the patients. The correlation between the emotional characteristics and the measured variables was investigated by Pearson correlation analysis and multiple regression analysis.
The results of the study: the score of SDS in 1.47.8% patients was in conformity with the standard of depression; the scores of MSSNS depression, anxiety and loneliness in cancer patients were not significantly different from those in general internal and external subjects, but their anger was significantly higher than those in the internal and external subjects; the scores of MSSNS factor from high to low were in turn: depression, anxiety and anxiety in patients with.2., anxiety, depression and anger. Negative emotions, such as anger and loneliness, are related to their gender, educational level, residence, family monthly income, and course of illness, as well as their information needs, psychological support and other needs, communication with their families around the disease, coping styles related to the age of.3. patients, the course of illness, emotional support needs in the needs of the patients, and support and care. In conclusion, the communication between patients and their families around the disease, the surrender in coping styles and the avoidance in the regression analysis of negative emotions reached a significant level.
Study two: exploratory cognitive intervention to improve mental health
Research methods: through the interview with some patients to understand the root of the patient's psychological problems, a targeted intervention program was formulated and the content of the intervention was printed into a manual. The patients were randomly divided into intervention group and control group. Intervention group issued intervention manual and conducted 2 interviews, and the control group had no intervention. The two groups were collected before and after intervention.
Results: before intervention, the baseline data of two groups were not equal. The score of SDS in the intervention group was higher than that of the control group, and the MSSNS loneliness was higher than the control group. The difference was statistically significant. There was no significant difference between the intervention group and the control group, the score of SDS, the score of MSSNS loneliness and avoidance, and the difference of the residual dimension. SDS score decreased and avoidance score increased. The difference was statistically significant, but there was no significant change in the control group after intervention.
Conclusion:
1. nearly half of the cancer patients reached the criteria for the diagnosis of depression; the anger of the cancer patients was more significant than that in the general internal and external subjects; the subjective loneliness of the patients was more depressed, anxious and angry.
2. compared with care needs, psychological emotional support needs and material needs information, patients' information needs and relationship needs are more significant.
3. the occurrence of emotional disorders of cancer is affected by the general social characteristics of the patients, such as sex, educational level, living area, family month income, and course of illness.
4. the mental health level of the patients is related to the patient's information demand, the patient's psychological and emotional support needs, the communication between the family members, the coping style and so on. The patient's information demand is not met, the patient and the family are not communicating with each other, and the patient's yield should be the risk factor of increasing the patient's emotional distress. The unsatisfaction of the interest demand makes the patient more susceptible to anxiety and anger; poor communication is closely linked to the patient's depression and anger levels; yield is significantly associated with anxiety, depression, anger and loneliness; positive emotional support, and the use of face and avoidance responses are helpful to the patient. The adaptation of the disease;
5. a short targeted cognitive intervention can alleviate some of the negative emotions.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類(lèi)號(hào)】：R395.1
本文編號(hào)：2133985
[Abstract]:Since twentieth Century, cancer has become one of the diseases that threaten human health. The incidence of cancer is rising in recent years. The new incidence of cancer is about 6 million 350 thousand in the world every year. It is the second major disease that causes human death. With the change of medical model from simple biomedical model to biological psycho social medical model, the psychological health of cancer patients Psychosocial oncology believes that the occurrence, development, prognosis and prognosis of cancer are closely related to psychosocial factors. Therefore, it is of great significance to pay attention to the psychological health of cancer patients and their influencing factors and to implement various effective means to improve their mental health. 1.: 1. explore the emotional characteristics and related factors of cancer inpatients, explore effective and targeted psychological intervention to improve the emotional health of cancer patients.
Study 1: emotional characteristics and related factors of hospitalized cancer patients
Methods: 71 hospitalized cancer patients were randomly selected from a large three a hospital in the province to conduct a questionnaire survey, using the mental state assessment (MSSNS) of non psychiatric inpatients, the self rating Depression Questionnaire (SDS), the Medical Coping Style Questionnaire (MCMQ), the demand assessment questionnaire (NEQ), the patient relative cancer related exchange assessment tool (patient Edition), and so on (CCAT-P). The emotional characteristics of patients, coping styles, patients' needs and communication with relatives were measured respectively. Statistical description was used to describe the emotional characteristics of the patients. The correlation between the emotional characteristics and the measured variables was investigated by Pearson correlation analysis and multiple regression analysis.
The results of the study: the score of SDS in 1.47.8% patients was in conformity with the standard of depression; the scores of MSSNS depression, anxiety and loneliness in cancer patients were not significantly different from those in general internal and external subjects, but their anger was significantly higher than those in the internal and external subjects; the scores of MSSNS factor from high to low were in turn: depression, anxiety and anxiety in patients with.2., anxiety, depression and anger. Negative emotions, such as anger and loneliness, are related to their gender, educational level, residence, family monthly income, and course of illness, as well as their information needs, psychological support and other needs, communication with their families around the disease, coping styles related to the age of.3. patients, the course of illness, emotional support needs in the needs of the patients, and support and care. In conclusion, the communication between patients and their families around the disease, the surrender in coping styles and the avoidance in the regression analysis of negative emotions reached a significant level.
Study two: exploratory cognitive intervention to improve mental health
Research methods: through the interview with some patients to understand the root of the patient's psychological problems, a targeted intervention program was formulated and the content of the intervention was printed into a manual. The patients were randomly divided into intervention group and control group. Intervention group issued intervention manual and conducted 2 interviews, and the control group had no intervention. The two groups were collected before and after intervention.
Results: before intervention, the baseline data of two groups were not equal. The score of SDS in the intervention group was higher than that of the control group, and the MSSNS loneliness was higher than the control group. The difference was statistically significant. There was no significant difference between the intervention group and the control group, the score of SDS, the score of MSSNS loneliness and avoidance, and the difference of the residual dimension. SDS score decreased and avoidance score increased. The difference was statistically significant, but there was no significant change in the control group after intervention.
Conclusion:
1. nearly half of the cancer patients reached the criteria for the diagnosis of depression; the anger of the cancer patients was more significant than that in the general internal and external subjects; the subjective loneliness of the patients was more depressed, anxious and angry.
2. compared with care needs, psychological emotional support needs and material needs information, patients' information needs and relationship needs are more significant.
3. the occurrence of emotional disorders of cancer is affected by the general social characteristics of the patients, such as sex, educational level, living area, family month income, and course of illness.
4. the mental health level of the patients is related to the patient's information demand, the patient's psychological and emotional support needs, the communication between the family members, the coping style and so on. The patient's information demand is not met, the patient and the family are not communicating with each other, and the patient's yield should be the risk factor of increasing the patient's emotional distress. The unsatisfaction of the interest demand makes the patient more susceptible to anxiety and anger; poor communication is closely linked to the patient's depression and anger levels; yield is significantly associated with anxiety, depression, anger and loneliness; positive emotional support, and the use of face and avoidance responses are helpful to the patient. The adaptation of the disease;
5. a short targeted cognitive intervention can alleviate some of the negative emotions.
【學(xué)位授予單位】：山東大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2011
【分類(lèi)號(hào)】：R395.1
【引證文獻(xiàn)】
相關(guān)碩士學(xué)位論文 前1條
1 梁桂云;SIRT6、PON1、HSP70基因多態(tài)性與廣西巴馬長(zhǎng)壽的相關(guān)性研究[D];廣西醫(yī)科大學(xué);2012年
，本文編號(hào)：2133985
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