飛行員消化性潰瘍患者心理影響因素及干預(yù)研究
發(fā)布時(shí)間:2018-04-11 10:39
本文選題:心理干預(yù) + 飛行員 ; 參考:《第四軍醫(yī)大學(xué)》2011年碩士論文
【摘要】:隨著全球經(jīng)濟(jì)化、工業(yè)化、城市化和科技化的發(fā)展,心身疾病的發(fā)病率不斷增加,約占綜合醫(yī)院就診率的1/3。已有研究證實(shí),心身疾病的發(fā)生、發(fā)展、轉(zhuǎn)歸、預(yù)后和治療與心理社會(huì)因素關(guān)系密切。消化性潰瘍是常見的心身疾病,尤其是對(duì)于飛行員這一特殊職業(yè),個(gè)性特征,情緒因素,社會(huì)支持度,生活負(fù)性事件等都會(huì)影響心身疾病的治療和康復(fù)。因此,本研究在藥物治療的基礎(chǔ)上,研究影響飛行員消化性潰瘍患者的社會(huì)心理因素,探索系統(tǒng)有效的治療飛行員消化性潰瘍患者的心理綜合療法,達(dá)到心理干預(yù)的目的。 本研究采用艾森克人格問卷評(píng)估飛行員消化性潰瘍患者的人格特征,癥狀自評(píng)量表評(píng)估飛行員消化性潰瘍患者的心理健康狀況及情緒特征,生活事件量表和社會(huì)支持量表分別評(píng)定飛行員消化性潰瘍患者的應(yīng)激事件和社會(huì)支持情況。通過研究主要發(fā)現(xiàn): (1)艾森克人格問卷結(jié)果顯示,飛行員消化性潰瘍患者的穩(wěn)定性(57.63±10.24)明顯高于健康對(duì)照組(48.92±8.31),癥狀自評(píng)量表中飛行員消化性潰瘍患者的軀體化、強(qiáng)迫、人際關(guān)系、抑郁、焦慮、恐怖、偏執(zhí)、精神病性因子分顯著高于健康對(duì)照組,生活事件量表中飛行員消化性潰瘍患者的負(fù)性生活事件分值(18.46±13.81)明顯高于健康對(duì)照組(7.29±5.01),社會(huì)支持量表中飛行員消化性潰瘍患者的社會(huì)總支持分值(22.79±1.02)明顯低于健康對(duì)照組(30.04±1.79)。 (2)在藥物治療的基礎(chǔ)上,采用個(gè)體和團(tuán)體相結(jié)合的形式,應(yīng)用心理綜合療法,開展飛行員消化性潰瘍患者的心理治療。社會(huì)支持量表結(jié)果顯示,干預(yù)組的社會(huì)總支持分值(29.12±1.67)顯著高于治療前分值(22.51±1.64),同時(shí)顯著高于對(duì)照組(23.86±1.58),而對(duì)照組的社會(huì)總支持分值在治療前后無顯著差異。癥狀自評(píng)量表中干預(yù)組軀體化、強(qiáng)迫、人際關(guān)系、抑郁、焦慮、恐怖各因子分在治療后均顯著低于治療前,而對(duì)照組在治療前后各因子分均無顯著差異。經(jīng)追蹤隨訪發(fā)現(xiàn),干預(yù)組的治愈率(95.34%)顯著高于對(duì)照組(70.45%),卡方檢驗(yàn)X2=9.445,p0.05;干預(yù)組的復(fù)發(fā)率(11.63%)明顯低于對(duì)照組(40.91%),卡方檢驗(yàn)X~2=6.198,p0.05。 研究結(jié)論:(1)飛行員消化性潰瘍患者情緒不穩(wěn)定,易緊張,焦慮,生活中經(jīng)歷的負(fù)性生活事件較多,得到的社會(huì)支持較少。這些心理社會(huì)因素在消化性潰瘍的發(fā)生、發(fā)展、轉(zhuǎn)歸的過程中都是不可忽視的重要因素。 (2)針對(duì)飛行員自身的職業(yè)及心理特點(diǎn),在臨床藥物治療(三聯(lián)法)的基礎(chǔ)上,建立系統(tǒng)的心理綜合療法,包括認(rèn)知療法,行為療法,支持療法,放松療法和音樂療法,進(jìn)行飛行員消化性潰瘍患者的心理治療,提升飛行員消化性潰瘍患者的心理健康程度,縮短了治療時(shí)間,有效提高飛行員消化性潰瘍患者的治愈率,降低飛行員消化性潰瘍患者的復(fù)發(fā)率,為臨床醫(yī)生開展心理治療提供理論和實(shí)踐依據(jù)。
[Abstract]:With the development of global economy, industrialization, urbanization and science and technology, the incidence of psychosomatic diseases is increasing, accounting for about one-third of the total hospital visits.The occurrence, development, outcome, prognosis and treatment of psychosomatic diseases have been confirmed to be closely related to psychosocial factors.Peptic ulcer is a common psychosomatic disease, especially for pilots, such as special occupation, personality, emotional factors, social support, negative life events and so on, which will affect the treatment and rehabilitation of psychosomatic diseases.Therefore, on the basis of drug therapy, this study studied the social and psychological factors affecting pilots with peptic ulcer, and explored a systematic and effective psychotherapy for pilots with peptic ulcer to achieve the purpose of psychological intervention.In this study, Eysenck Personality questionnaire (Eysenck Personality questionnaire) was used to assess the personality characteristics of pilots with peptic ulcer, and the symptom Checklist (SCL-90) was used to assess the mental health and emotional characteristics of pilots with peptic ulcer.Life events scale and social support scale were used to evaluate stress events and social support in pilots with peptic ulcer.The main findings of the study are as follows:The results of Eysenck Personality questionnaire showed that the stability of the pilots with peptic ulcer was 57.63 鹵10.24), which was significantly higher than that of the healthy control group (48.92 鹵8.31). Somatization, compulsion, interpersonal relationship, depression, anxiety and phobia in the pilots with peptic ulcer in the symptom Checklist-90 (SCL-90) were significantly higher than those in the control group.The scores of paranoid and psychotic factors were significantly higher than those of the healthy control group.The score of negative life events in pilots with peptic ulcer was 18.46 鹵13.81), which was significantly higher than that in healthy control group (7.29 鹵5.01). The total social support score of pilots with peptic ulcer in social support scale was 22.79 鹵1.02), which was significantly lower than that in healthy control group (30.04 鹵1.79g).(2) on the basis of drug therapy, the patients with peptic ulcer in pilots were treated by the combination of individual and group and comprehensive psychotherapy.The results of social support scale showed that the score of total social support in the intervention group was 29.12 鹵1.67) significantly higher than that before treatment (22.51 鹵1.64) and 23.86 鹵1.58 in the control group, but there was no significant difference in the total social support score before and after treatment in the control group.The scores of somatization, compulsion, interpersonal relationship, depression, anxiety and phobia in the intervention group were significantly lower than those before and after treatment, but there was no significant difference between the control group and the control group before and after treatment.Conclusion: (1) the pilots with peptic ulcer had unstable mood, easy tension, anxiety, more negative life events and less social support.These psycho-social factors are important factors which can not be ignored in the process of the occurrence, development and prognosis of peptic ulcer.(2) based on the professional and psychological characteristics of the pilots themselves and on the basis of clinical drug therapy (triple therapy), a systematic psychotherapy, including cognitive therapy, behavioral therapy, support therapy, relaxation therapy and music therapy, is established.In order to improve the mental health of pilots with peptic ulcer and shorten the time of treatment, it can effectively improve the cure rate of pilots with peptic ulcer.To reduce the recurrence rate of pilots with peptic ulcer and to provide theoretical and practical basis for clinical doctors to carry out psychotherapy.
【學(xué)位授予單位】:第四軍醫(yī)大學(xué)
【學(xué)位級(jí)別】:碩士
【學(xué)位授予年份】:2011
【分類號(hào)】:R85
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