發(fā)布時間：2018-12-09 19:18

【摘要】：目的調(diào)查類風濕關節(jié)炎患者的生命質(zhì)量、焦慮抑郁、疼痛、疾病不確定感、睡眠質(zhì)量狀況,探究影響生命質(zhì)量的心理社會因素。運用認知行為和正念為理論基礎對患者進行心理干預,分析干預對影響類風濕關節(jié)炎患者生命質(zhì)量各因素的效果。方法1.調(diào)查研究:采取方便抽樣,對230例類風濕關節(jié)炎患者進行調(diào)查研究,采用類風濕關節(jié)炎患者生命質(zhì)量測定量表QLICD-RA(V2.0)、疼痛VAS評分、焦慮自評量表(SAS)、抑郁自評量表(SDS)、疾病不確定感量表(MUIS)、匹茲堡睡眠指數(shù)量表(PSQI)對患者進行調(diào)查,剔除無效問卷后,共收集210例類風濕關節(jié)炎患者。2.干預研究:選取符合入組條件的80例患者,由于研究中途脫落,最后完成干預組和對照組各35人。干預組患者在常規(guī)藥物治療的基礎上給予心理干預,對照組只進行常規(guī)藥物治療。結(jié)果1.調(diào)查研究結(jié)果:(1)類風濕關節(jié)炎患者生命質(zhì)量水平低于平均值。(2)類風濕關節(jié)炎患者生命質(zhì)量的各維度及總分在性別、年齡、文化程度、婚姻狀況等社會人口學特征及疾病的DAS28評分上有差異(p0.01)。(3)疾病不確定感各維度及總分均與生命質(zhì)量各維度及總分呈負相關,除特異模塊與復雜性不相關外(p0.01);焦慮抑郁與生命質(zhì)量的各維度及總分均呈負相關(p0.01);匹茲堡睡眠指數(shù)量表得分與生命質(zhì)量得分間呈負相關(p0.05),除社會功能、特異模塊與催眠藥物不相關外;疼痛與生理功能、社會功能、特異模塊和生命質(zhì)量總分呈負相關(p0.01)。(4)回歸分析結(jié)果顯示,影響RA患者生命質(zhì)量的主要因素依次為:SDS、睡眠障礙、SAS、疼痛VAS評分、不確定性、婚姻狀況。2.干預研究結(jié)果:(1)心理干預后,干預組和對照組患者在生命質(zhì)量上得分差異具有統(tǒng)計學意義(p0.01),干預組患者的生命質(zhì)量改善程度高于對照組;(2)心理干預后,干預組患者的焦慮、抑郁、疾病不確定感改善程度高于對照組,睡眠質(zhì)量顯著提高,疼痛感和生理指標也顯著降低(p0.01)。結(jié)論類風濕關節(jié)炎患者生命質(zhì)量總體水平低�；颊呱|(zhì)量受人口學變量及疾病相關因素的影響,而抑郁、睡眠障礙、焦慮、疼痛VAS評分、疾病不確定性、婚姻狀況在一定程度上能預測患者生命質(zhì)量的高低。心理干預可以有效地降低患者疾病不確定感和疼痛感,緩解其焦慮抑郁情緒狀態(tài),提升患者睡眠狀況和生命質(zhì)量。
[Abstract]:Objective to investigate the quality of life, anxiety, depression, pain, uncertainty and sleep quality of patients with rheumatoid arthritis. Using cognitive behavior and mindfulness as the theoretical basis, psychological intervention was conducted to analyze the effects of intervention on the factors affecting the quality of life of patients with rheumatoid arthritis. Method 1. Investigation and study: using convenience sampling, 230 patients with rheumatoid arthritis were investigated. QLICD-RA (V2.0), VAS score of pain, (SAS), of anxiety scale were used to measure the quality of life of patients with rheumatoid arthritis. Self-rating Depression scale (SDS),) (MUIS), Pittsburgh Sleep Index scale (PSQI) was used to investigate the patients. After eliminating invalid questionnaires 210 patients with rheumatoid arthritis (RA) were collected. 2. 2. Intervention study: 80 patients who fit into the group were selected, 35 patients in the intervention group and 35 patients in the control group were finished because of falling off in the middle of the study. The patients in the intervention group were given psychological intervention on the basis of routine drug therapy, while the patients in the control group were only given routine drug therapy. Result 1. The results were as follows: (1) the quality of life of patients with rheumatoid arthritis was lower than the average. (2) the dimensions and total scores of quality of life of patients with rheumatoid arthritis were gender, age, education level. There were significant differences in social demographic characteristics such as marital status and DAS28 score of disease (p0.01). (3). Each dimension and total score of disease uncertainty were negatively correlated with each dimension and total score of quality of life. The specific modules were not related to complexity (p0.01). There was a negative correlation between anxiety and depression and all dimensions and total scores of quality of life (p0.01), and there was a negative correlation between the scores of Pittsburgh Sleep Index and quality of Life (p0.05), except social function, specific modules and hypnotic drugs. There was a negative correlation between pain and physiological function, social function, specific module and total score of quality of life (p0.01). (4). The results showed that the main factors influencing the quality of life of RA patients were SDS, sleep disorder, SAS,. Pain VAS score, uncertainty, marital status. 2. The results of intervention study: (1) after psychological intervention, the scores of quality of life in the intervention group and the control group were significantly different (p0.01), and the improvement degree of the quality of life in the intervention group was higher than that in the control group; (2) after psychological intervention, the degree of anxiety, depression, disease uncertainty in the intervention group was higher than that in the control group, the sleep quality was significantly improved, and the pain and physiological indexes were also significantly decreased (p0.01). Conclusion the overall quality of life in patients with rheumatoid arthritis is low. The quality of life of patients was affected by demographic variables and disease-related factors, while depression, sleep disorder, anxiety, pain VAS score, disease uncertainty and marital status could predict the quality of life of patients to a certain extent. Psychological intervention can effectively reduce patients' feeling of uncertainty and pain, relieve their anxiety and depression, and improve their sleep status and quality of life.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R593.22

【參考文獻】

相關期刊論文 前10條

1 陳銘揚;梁維;呂昭萍;謝彤;譚健烽;萬崇華;;類風濕關節(jié)炎患者生命質(zhì)量/患者報告結(jié)局影響因素分析:QLICD-RA的應用[J];中華疾病控制雜志;2016年04期

2 孟璐;岳輝;;疼痛專項護理對改善類風濕關節(jié)炎患者疼痛及睡眠質(zhì)量的影響[J];護理實踐與研究;2015年12期

3 馬艷;譚震;李向培;汪國生;錢龍;厲小梅;;病情穩(wěn)定的類風濕關節(jié)炎患者臨床癥狀與氣象指標的相關研究[J];中華疾病控制雜志;2015年09期

4 楊梅;楊鈺潼;付秋蓉;晏姣;郭玲林;楊敏;;認知行為療法干預類風濕關節(jié)炎25例患者臨床觀察[J];護理學報;2015年05期

5 楊佼佼;馮耀清;陳雪霞;;類風濕關節(jié)炎患者生活質(zhì)量影響因素的調(diào)查研究[J];教育教學論壇;2014年50期

6 吳煒戎;羅政;江東霖;蔣春梅;蔡曉燕;謝啟新;聶再芳;;廣州社區(qū)風濕病患者生命質(zhì)量現(xiàn)狀及影響因素的調(diào)查研究[J];中國全科醫(yī)學;2014年21期

7 阮立云;顧岳全;;類風濕關節(jié)炎患者生命質(zhì)量的隨訪研究[J];現(xiàn)代實用醫(yī)學;2014年06期

8 楊均芳;齊慧貞;;影響類風濕性關節(jié)炎患者心理健康的因素[J];中國健康心理學雜志;2013年07期

9 齊慧貞;楊均芳;;類風濕性關節(jié)炎患者心理健康狀況與社會人口學因素的關系[J];中國健康心理學雜志;2013年06期

10 孫鵬;夏云霞;姬萍;;類風濕性關節(jié)炎患者關節(jié)疼痛與心理狀態(tài)的相關性調(diào)查[J];人民軍醫(yī);2012年11期

相關博士學位論文 前1條

1 張勝利;睡眠障礙、焦慮和抑郁與強直性脊柱炎臨床特征的相互關系及沙利度胺的干預研究[D];中國人民解放軍軍醫(yī)進修學院;2012年

相關碩士學位論文 前2條

1 孫晶;類風濕關節(jié)炎患者生活質(zhì)量及其影響因素研究[D];吉林大學;2015年

2 劉雯君;類風濕關節(jié)炎患者的生活質(zhì)量與抑郁狀態(tài)的問卷調(diào)查[D];遼寧中醫(yī)藥大學;2015年

，

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