心理干预对胃肠道肿瘤患者围术期焦虑及术后疼痛的应用研究
发布时间：2018-08-08 13:41
【摘要】：目的 探讨应用放松治疗和音乐治疗法的心理干预措施对于胃肠道肿瘤患者围术期焦虑及术后疼痛的影响,以了解心理干预措施对于胃肠道肿瘤人群围术期心理健康及康复中的作用,为肿瘤人群心理健康及疾病康复提供理论依据,并在临床推广。方法 选取安徽省某三甲医院胃肠外科2014年4月至2014年10月期间手术治疗的胃肠道肿瘤患者110例,采用随机数字法分为试验组58例和对照组52例。对照组采用常规护理,试验组在常规护理的基础上采用放松疗法和音乐治疗法的心理行为干预治疗,术后72小时内进行术后疼痛及焦虑评价,并进行两组患者术后住院时间的比较。结果 两组患者的一般流行病学资料及两组患者入院时SAI和TAI焦虑评分(t值分别为0.63,0.97；P值分别为0.53,0.33),对比无显著性差异。干预后试验组患者的焦虑程度低于对照组患者；重复测量的方差分析显示,干预后试验组患者围手术的SAI及TAI均低于对照组,两组之间的差异有统计学意义(F值分别为6.55,6.92；P值分别为0.01,0.01)；同一时间点的t检验显示,试验组术前一日SAI分值(t=2.75,P=0.01)、TAI分值(t=2.38,P=0.02)及术后三日SAI分值(t=2.85,P=0.01)、TAI分值(t=3.05,P=0.00)均低于对照组,两组之间的差别有统计学意义,术后随着时间的延长,对照组患者的焦虑逐渐增加,试验组患者的焦虑逐渐减低。试验组患者的疼痛程度低于对照组患者。重复测量的方差分析显示,试验组患者术后不同时点的NRS分值低于对照组,两组之间差别有统计学意义(F=6.88,P--0.01),组别与不同时间点之间无交互作用；两组术后同一时点疼痛分值t检验显示,两组术后24小时的NRS分值差别有统计学意义(t=2.46,P=0.02),术后随着时间的延长,患者的疼痛逐渐减低。试验组患者在住院天数及术后住院天数均短于对照组,两组差别有统计学意义(t值分别为2.59,2.69;P值均0.01)。结论 通过围术期放松疗法和音乐治疗法相结合的心理干预措施,能够减轻胃肠道肿瘤患者围术期的焦虑状态及焦虑特质,使胃肠道肿瘤患者术后的疼痛程度降低；在胃肠道肿瘤人群围术期开展规范、有效心理干预的不仅可以促进胃肠道肿瘤人群的心理卫生健康,还能够减少术后疼痛,还能促进患者术后康复,使患者术后住院天数缩短,增加医疗资源的利用率,提高公共卫生资源利用度,使社会受益。
[Abstract]:Objective to explore the effect of relaxation therapy and music therapy on perioperative anxiety and postoperative pain in patients with gastrointestinal cancer. To understand the effect of psychological intervention on the mental health and rehabilitation of patients with gastrointestinal cancer during perioperative period, to provide theoretical basis for mental health and disease rehabilitation of tumor population, and to promote it in clinical practice. Methods from April 2014 to October 2014, 110 patients with gastrointestinal neoplasms were selected and randomly divided into trial group (n = 58) and control group (n = 52). The control group was treated with routine nursing, the experimental group was treated with psychological and behavioral intervention of relaxation therapy and music therapy, and the postoperative pain and anxiety were evaluated within 72 hours after operation. The postoperative hospitalization time was compared between the two groups. Results the general epidemiological data of the two groups and the SAI and TAI anxiety scores of the two groups were not significantly different when they were admitted to hospital (t = 0.633 卤0.97, P = 0.53 卤0.33, respectively). After intervention, the anxiety degree of the patients in the trial group was lower than that in the control group, and the analysis of variance of repeated measurements showed that the SAI and TAI of the patients in the experimental group were lower than those in the control group after intervention, and the difference between the two groups was statistically significant (F = 6.55 卤6.92, respectively). T test at the same time point showed that the SAI scores of the two groups were significantly lower than those of the control group in the first day before operation (t = 2.75) and the SAI scores at 3 days after operation (t = 2.88 / P ~ (0.01) (t3.05 / P0. 00), and the difference between the two groups was statistically significant, and the difference between the two groups was significant with the prolongation of postoperative time. Anxiety increased in the control group and decreased in the trial group. The degree of pain in the trial group was lower than that in the control group. The analysis of variance of repeated measurement showed that the scores of NRS at different time points after operation in the trial group were lower than those in the control group, and the difference between the two groups was statistically significant (F = 6.88 ~ (P--0.01), and there was no interaction between the two groups and different time points. T test of pain score at the same time after operation showed that the difference of NRS score at 24 hours after operation between the two groups was statistically significant (t = 2.46), and the pain gradually decreased with the prolongation of time after operation. The days of hospitalization and postoperative hospitalization in the trial group were shorter than those in the control group, and the difference between the two groups was statistically significant (t = 2.59 卤2.69, P = 0.01, respectively). Conclusion the psychological intervention combined with relaxation therapy and music therapy during perioperative period can reduce the anxiety state and anxiety trait of patients with gastrointestinal cancer and reduce the degree of postoperative pain in patients with gastrointestinal cancer. During the perioperative period of gastrointestinal cancer population, effective psychological intervention can not only promote the mental health of gastrointestinal cancer population, but also reduce postoperative pain, promote postoperative rehabilitation, and shorten the postoperative hospital stay. Increase the utilization rate of medical resources, improve the utilization of public health resources, so as to benefit the society.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.73
[Abstract]:Objective to explore the effect of relaxation therapy and music therapy on perioperative anxiety and postoperative pain in patients with gastrointestinal cancer. To understand the effect of psychological intervention on the mental health and rehabilitation of patients with gastrointestinal cancer during perioperative period, to provide theoretical basis for mental health and disease rehabilitation of tumor population, and to promote it in clinical practice. Methods from April 2014 to October 2014, 110 patients with gastrointestinal neoplasms were selected and randomly divided into trial group (n = 58) and control group (n = 52). The control group was treated with routine nursing, the experimental group was treated with psychological and behavioral intervention of relaxation therapy and music therapy, and the postoperative pain and anxiety were evaluated within 72 hours after operation. The postoperative hospitalization time was compared between the two groups. Results the general epidemiological data of the two groups and the SAI and TAI anxiety scores of the two groups were not significantly different when they were admitted to hospital (t = 0.633 卤0.97, P = 0.53 卤0.33, respectively). After intervention, the anxiety degree of the patients in the trial group was lower than that in the control group, and the analysis of variance of repeated measurements showed that the SAI and TAI of the patients in the experimental group were lower than those in the control group after intervention, and the difference between the two groups was statistically significant (F = 6.55 卤6.92, respectively). T test at the same time point showed that the SAI scores of the two groups were significantly lower than those of the control group in the first day before operation (t = 2.75) and the SAI scores at 3 days after operation (t = 2.88 / P ~ (0.01) (t3.05 / P0. 00), and the difference between the two groups was statistically significant, and the difference between the two groups was significant with the prolongation of postoperative time. Anxiety increased in the control group and decreased in the trial group. The degree of pain in the trial group was lower than that in the control group. The analysis of variance of repeated measurement showed that the scores of NRS at different time points after operation in the trial group were lower than those in the control group, and the difference between the two groups was statistically significant (F = 6.88 ~ (P--0.01), and there was no interaction between the two groups and different time points. T test of pain score at the same time after operation showed that the difference of NRS score at 24 hours after operation between the two groups was statistically significant (t = 2.46), and the pain gradually decreased with the prolongation of time after operation. The days of hospitalization and postoperative hospitalization in the trial group were shorter than those in the control group, and the difference between the two groups was statistically significant (t = 2.59 卤2.69, P = 0.01, respectively). Conclusion the psychological intervention combined with relaxation therapy and music therapy during perioperative period can reduce the anxiety state and anxiety trait of patients with gastrointestinal cancer and reduce the degree of postoperative pain in patients with gastrointestinal cancer. During the perioperative period of gastrointestinal cancer population, effective psychological intervention can not only promote the mental health of gastrointestinal cancer population, but also reduce postoperative pain, promote postoperative rehabilitation, and shorten the postoperative hospital stay. Increase the utilization rate of medical resources, improve the utilization of public health resources, so as to benefit the society.
【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R473.73
【参考文献】
相关期刊论文 前10条
1 王力刚;孙月吉;崔爱霞;孙文恒;;度洛西汀合并菩提树放松治疗广泛性焦虑障碍的疗效及心率变异性的改变[J];中华行为医学与脑科学杂志;2014年11期
2 Miroslav Zavoral;Stepan Suchanek;Ondrej Majek;Premysl Fric;Petra Minarikova;Marek Minarik;Bohumil Seifert;Ladislav Dusek;;Colorectal cancer screening:20 years of development and recent progress[J];World Journal of Gastroenterology;2014年14期
3 李小梅;李虹义;肖文华;刘端祺;;癌症患者疼痛量表的应用[J];中国肿瘤临床;2013年24期
4 王伟娜;黄家丽;荚卫东;乔晓斐;张玲;李建生;;规范化疼痛管理在肝癌手术患者中的应用[J];实用肝脏病杂志;2013年05期
5 王亚朋;庞英;唐丽丽;;团体心理治疗对胃癌患者生活质量及情绪状况的效果[J];中国心理卫生杂志;2013年07期
6 倪雪s，
本文编号：2171957
本文链接：https://www.wllwen.com/huliyixuelunwen/2171957.html
最近更新
教材专著
