正念减压疗法对非霍奇金淋巴瘤患者创伤后成长的效果研究

发布时间：2019-06-21 18:57

【摘要】：目的探讨正念减压疗法对促进正在化疗的非霍奇金淋巴瘤患者的创伤后成长水平,减轻患者的疲劳,改善睡眠质量的效果。方法选取2015年11月至2016年4月在郑州大学第一附属医院肿瘤科住院化疗的非霍奇金淋巴瘤患者96例,便利分配到两个肿瘤病区中各48例,采用抛硬币法将两个病区分为对照组、试验组。对照组接受医院常规的护理,组在常规护理基础上,进行每周1次、共8次的正念减压训练。采用中文版创伤后成长量表(Posttraumatic Growth Inventory,PTGI)、Piper疲乏修订量表(The Revised Piper Fatigue Scale,PFS-R)、匹兹堡睡眠质量指数(Pittsburgh Sleep Quality Index,PSQI)量表,于干预前(T1)、干预后(T2)以及干预后3个月(T3)对患者进行测评,评估干预效果。采用Excel2016录入数据,SPSS18.0进行统计分析,计量资料采用均数±标准差,计数资料采用频数、百分比(n%),两组基线资料比较采用t-test或者χ2检验,重复测量方差分析比较两组的差异,检验干预的效应采用Cohen’s D。结果1)本研究按照纳入、排除标准对郑州大学第一附属医院肿瘤科首次化疗的非霍奇金淋巴瘤患者96例进行干预,最后完成所有结果评价的有效样本91例,完成率为94.8%。2)干预前两组研究变量差异无统计学意义,8周干预后:(1)两组患者的PTGI总分均有升高,并且PTGI总分时间效应、时间与组别的交互效应均有统计学意义(P0.001)。然而,新的可能性(F=3.57,P=0.05)、精神变化(F=2.43,P=0.11)没有组别效应以及组别和时间的交互效应。(2)重复测量方差分析显示,试验组和对照组感觉方面、行为方面、情绪方面以及总疲劳得分干预主效应有统计学意义(P0.05);两组感觉方面、情绪方面、总疲劳得分时间主效应有统计学意义(P0.05),即感觉方面、情绪方面以及总疲劳随时间的变化而变化;感觉方面、情绪方面、行为方面以及总疲劳得分的干预因素与时间因素存在交互作用(P0.05)。(3)睡眠质量、入睡时间、睡眠时间、睡眠效率以及睡眠总分的组间效应差异有统计学意义(P0.05),睡眠质量、入睡时间、睡眠时间以及睡眠总分时间效应差异有统计学意义(P0.05),睡眠质量、睡眠时间、睡眠障碍、睡眠总分交互效应差异有统计学意义。3)干预结束时,干预组除行为方面、日间功能障碍Cohen’s D0.5,其余均大于0.5,表明8周正念减压疗法(Mindfullness-Based Stress Reduction,MBSR)干预措施在结束时,能达到各个变量中等及中等及以上效应。4)干预结束后3个月,对个人力量、欣赏生活、行为方面、日间功能障碍Cohen’s D0.5,干预持续效应为中等,对与他人的关系、感觉方面、情绪方面、总疲劳、睡眠质量、睡眠时间、睡眠效率以及入睡时间的干预效应很大,Cohen’s D均大于1.2,对PTGI总分干预效应巨大,Cohen’s D为2.0。结论8周正念减压疗法干预措施以及效果评价表明,作为非药物治疗的方法能够有效促进非霍奇金淋巴瘤患者的创伤后成长,减轻化疗期的疲乏,改善睡眠质量,并且在较长时间内(3个月)持续效应很大,患者积极接受正念减压疗法干预,能够从中获益良多。
[Abstract]:Objective To study the effect of stress-reduction therapy on the post-traumatic growth of patients with non-Hodgkin's lymphoma undergoing chemotherapy, to reduce the fatigue of patients and to improve the quality of sleep. Methods 96 patients with non-Hodgkin's lymphoma were selected from November 2015 to April 2016 at the First Affiliated Hospital of Zhengzhou University. The control group received the routine care of the hospital, and on the basis of routine nursing, the control group conducted once a week for 8 times, and the training was carried out in a total of 8 times. Patients were assessed using the Chinese version of Post-traumatic Growth Inventory (PTGI), the Piper Fatigue Revision Scale (PFS-R), the Pittsburgh Sleep Quality Index (PSQI) scale, the pre-intervention (T1), post-intervention (T2), and 3 months after intervention (T3), Evaluate the effect of the intervention. The data of Excel2016 and SPSS18.0 were used for statistical analysis. The standard deviation of the mean number was used for the measurement data, and the frequency and the percentage (n%) were used for counting the data. The difference between the two groups was compared with the two groups of baseline data by the t-test or the second test, and the variance of the two groups was compared with the analysis of variance. The effect of the test intervention was Cohen's D. Results 1) The study included 96 cases of non-Hodgkin's lymphoma who received the first chemotherapy in the first affiliated hospital of Zhengzhou University in accordance with the inclusion and exclusion criteria, and the effective sample of all the results was completed in 91 cases. The completion rate was 94.8%.2) There was no statistical significance in the difference between the two groups before the intervention, and after 8 weeks of intervention: (1) the total score of PTGI in the two groups was increased, and the time effect of the total score of the PTGI was statistically significant (P 0.001). However, the new possibilities (F = 3.57, P = 0.05), mental changes (F = 2.43, P = 0.11) had no group effects and group and time interaction effects. (2) The results of variance analysis showed that there was a significant difference between the two groups of sensory, emotional and total fatigue scores (P0.05). I. e., sensory, emotional, and total fatigue change with time; sensory, emotional, behavioral, and total fatigue scores have an interaction with time factors (p0.05). (3) The effects of sleep quality, sleep time, sleep time, sleep efficiency and sleep total score were of statistical significance (P0.05), sleep quality, sleep time, sleep time and time effect of sleep total score (P0.05), and sleep quality. The effect of sleep time, sleep disturbance and sleep total score is of statistical significance. At the end of the intervention, the intervention group, in addition to the behavior, the daytime dysfunction Cohen's D.5, the balance of which is greater than 0.5, indicates that the intervention of the 8-week positive-reading stress reduction (MBSR) intervention is at the end of the intervention. can reach the effects of middle and middle and above effects of various variables.4)3 months after the intervention, for personal power, to enjoy the life and the behavior, the daytime dysfunction Cohen's D.5, the intervention sustained effect is middle, the relationship with the other, the feeling aspect, the emotional aspect, the total fatigue, The effects of sleep quality, sleep time, sleep efficiency and time of sleep are significant. Cohen's D is more than 1.2, and the intervention effect on the total score of PTGI is huge. Cohen's D is 2.0. Conclusion 8-week treatment of non-Hodgkin's lymphoma can effectively promote the post-traumatic growth of non-Hodgkin's lymphoma, reduce the fatigue of the chemotherapy period and improve the sleep quality. And for a long period of time (3 months), the effect of the continuous effect is very large, and the patient is actively receiving the intervention of the positive and negative pressure therapy, so that the patient can benefit from it.
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.73

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