癌症病人创伤后成长及其影响因素的研究
发布时间：2018-08-13 16:19
【摘要】：目的为了讨论癌症患者创伤后成长及其影响因素的研究,癌症是非常严重的创伤事件,严重影响着人类的身体健康和生命,必然会对其身体和心理造成很大的影响,大多数学者研究癌症创伤后造成其负面影响,但随着西方积极心理学的兴起,国外心理学学者Tedeschi等人首次创造性提出“创伤后成长(Posttraumatic Growth,PTG)这个新概念,癌症病人创伤后成长主要是指在人际关系、新的可能性、个人力量、精神变化和欣赏生活等5个方面的成长,是指个体遭受癌症这一重大创伤事件后,其认知结构发生重组。癌症创伤后成长会比病前以新的视角去看待生活。随着医学技术的发展,癌症病人十年生存率显著增加,现在癌症已成为慢性可治疗疾病而非终极病,国内外心理学者和医学工作者也越来越关注癌症患者的创伤后成长。临床研究发现,并非所有癌症病人在初期得知病情后都只表现出负面心理状态,部分患者在与癌症抗争的过程中也体验到心理方面的正性变化并获得创伤后成长。国外多项研究已证实,创伤后成长的出现可以降低癌症患者的负性心理状况、提升治疗效果、改善心理状态,进而提高癌症患者的生存质量。我国对癌症病人创伤后成长的相关研究尚处于引入阶段,虽然有少量癌症病人心理问题流行病学研究报告,但研究对癌症病人特性研究及创伤后成长研究不多。本研究的目的亦是针对癌症患者这一特殊人群,研究其创伤后成长的状况及影响因素,全面了解患者的心理状况,为临床上如何恢复和提升患者的身心机能、指导其有效应对、开展心理健康教育、促进康复进程提供科学依据,使患者在住院治疗期间获得更好的心理治疗,促进身心康复,最终提高患者的生活质量。方法1、研究对象本课题拟在泰安市3所三级甲等医院和各县市区综合医院肿瘤科和各专科肿瘤医院住院治疗、被确诊为癌症半年以上且愿意参与本次调查研究的患者选取500名患者进行调查。2、研究工具研究一在征得医院批准,并得到临床大夫配合,首先患者建立良好关系、获得其信任下完成。所有问卷调查均在患者住院期间填写,测试地点为病房,由经过培训的调查员对患者进行指导,并统一指导语和填表方式。由于测试题量较大,患者在住院期间分5次完成问卷.选取创伤后成长评定量表(Posttraumatic Growth Inventory,PTGI)、心理弹性问卷(Connor-Davidson resilience scale)、防御方式问卷(Defensive style Questionnaire,DSQ)、人生意义问卷(Meaning in Life Questionnaire,MLQ)死亡态度描绘量表(修订版)(Death Attitude Profile-Revised,DAP-R)等问卷进行测量。研究二在研究一的基础上进行半结构化深入访谈(Semi-Structured In-DepthInterview)。3.统计方法研究一数据采用SPSS17.0软件进行统计学处理,统计方法有t检验、相关分析、方差分析、多元回归等分析方法。研究二采用根据自编的研究提纲,进行诠释现象学分析(Interpretative Phenomenological Analysis,IPA)进行个案访谈的整理。结果研究一的结果为癌症病人创伤后成长与心理弹性、生命意义、死亡态度、防御机制和心理健康相关,通过回归方程结果显示,心理弹性、生命意义、死亡态度和防御机制4个变量进入模型。多元相关系数0.471,共解释变异量20.5%,回归方程为:Y=-17.411+0.182X1+0.250X2+0.213X3+0.026X4(F=13.183,p0.05),回归方程有效。研究二通过对6例个案分析和比较数据,得出以下四个主题:即(1)积极自我;(2)积极调整与适应;(3)自我意识增强;(4)珍爱生命;(5)交友模式重组(6)人生哲学与态度的改变等6个主题和13个的亚主题。
[Abstract]:Objective To discuss the post-traumatic growth of cancer patients and its influencing factors. Cancer is a very serious traumatic event, which seriously affects human health and life, and will inevitably have a great impact on their physical and psychological. Most scholars have studied the negative effects of cancer after trauma, but with the development of positive psychology in the West. The rise of foreign psychologists Tedeschi and others for the first time creatively put forward the concept of "Posttraumatic Growth (PTG). The post-traumatic growth of cancer patients mainly refers to the growth of interpersonal relationships, new possibilities, personal strength, mental change and appreciation of life. It refers to the individual suffering from cancer as a major trauma. With the development of medical technology, the ten-year survival rate of cancer patients has increased significantly. Now cancer has become a chronic and treatable disease rather than an ultimate disease. Psychologists and medical workers at home and abroad are paying more and more attention to cancer patients. Clinical studies have found that not all cancer patients show only negative psychological state when they first learn the condition of the disease. Some patients also experience positive psychological changes and acquire post-traumatic growth in the process of fighting cancer. The study on post-traumatic growth of cancer patients in China is still in the stage of introduction. Although there are a few epidemiological studies on psychological problems of cancer patients, the study on the characteristics of cancer patients and post-traumatic growth is still in progress. The purpose of this study is to study the post-traumatic growth of cancer patients and its influencing factors, to fully understand the psychological status of patients, and to provide a scientific basis for how to restore and improve their physical and mental functions, guide their effective coping, carry out mental health education, and promote the rehabilitation process. During hospitalization, the patients received better psychotherapy, promoted physical and mental recovery, and ultimately improved the quality of life of patients. Methods 1. The subjects were planned to be hospitalized in the Department of oncology of three third-class first-class hospitals in Tai'an City, general hospitals in counties and cities, and specialized tumor hospitals. They were diagnosed with cancer for more than half a year and were willing to participate in the survey. Five hundred patients were selected for the study. Because of the large number of questions, the patients completed the questionnaire five times during hospitalization. Posttraumatic Growth Inventory (PTGI), Connor-Davidson Resilience Scale, Defensive Style Questionnaire (DSQ), and Me were selected. Study 2 was based on Study 1 and conducted semi-structured in-depth interviews (Semi-Structured In-Depth Interview). 3. Statistical methods The data were analyzed by SPSS17.0 software. Statistical methods include t-test, correlation analysis, variance analysis, multiple regression and so on. In study 2, case interviews were conducted with Interpretative Phenomenological Analysis (IPA) based on a self-compiled research outline. Significance, attitude to death, defense mechanism and mental health were correlated. The results of regression equation showed that psychological resilience, meaning of life, attitude to death and defense mechanism were involved in the model. Study 2: Through case study and comparative data analysis of 6 cases, the following four themes were obtained: (1) positive self; (2) positive adjustment and adaptation; (3) enhanced self-awareness; (4) cherishing life; (5) re-organization of friendship pattern; (6) change of philosophy and attitude of life, and 13 sub-themes.
【学位授予单位】：曲阜师范大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：B845.67
本文编号：2181524
[Abstract]:Objective To discuss the post-traumatic growth of cancer patients and its influencing factors. Cancer is a very serious traumatic event, which seriously affects human health and life, and will inevitably have a great impact on their physical and psychological. Most scholars have studied the negative effects of cancer after trauma, but with the development of positive psychology in the West. The rise of foreign psychologists Tedeschi and others for the first time creatively put forward the concept of "Posttraumatic Growth (PTG). The post-traumatic growth of cancer patients mainly refers to the growth of interpersonal relationships, new possibilities, personal strength, mental change and appreciation of life. It refers to the individual suffering from cancer as a major trauma. With the development of medical technology, the ten-year survival rate of cancer patients has increased significantly. Now cancer has become a chronic and treatable disease rather than an ultimate disease. Psychologists and medical workers at home and abroad are paying more and more attention to cancer patients. Clinical studies have found that not all cancer patients show only negative psychological state when they first learn the condition of the disease. Some patients also experience positive psychological changes and acquire post-traumatic growth in the process of fighting cancer. The study on post-traumatic growth of cancer patients in China is still in the stage of introduction. Although there are a few epidemiological studies on psychological problems of cancer patients, the study on the characteristics of cancer patients and post-traumatic growth is still in progress. The purpose of this study is to study the post-traumatic growth of cancer patients and its influencing factors, to fully understand the psychological status of patients, and to provide a scientific basis for how to restore and improve their physical and mental functions, guide their effective coping, carry out mental health education, and promote the rehabilitation process. During hospitalization, the patients received better psychotherapy, promoted physical and mental recovery, and ultimately improved the quality of life of patients. Methods 1. The subjects were planned to be hospitalized in the Department of oncology of three third-class first-class hospitals in Tai'an City, general hospitals in counties and cities, and specialized tumor hospitals. They were diagnosed with cancer for more than half a year and were willing to participate in the survey. Five hundred patients were selected for the study. Because of the large number of questions, the patients completed the questionnaire five times during hospitalization. Posttraumatic Growth Inventory (PTGI), Connor-Davidson Resilience Scale, Defensive Style Questionnaire (DSQ), and Me were selected. Study 2 was based on Study 1 and conducted semi-structured in-depth interviews (Semi-Structured In-Depth Interview). 3. Statistical methods The data were analyzed by SPSS17.0 software. Statistical methods include t-test, correlation analysis, variance analysis, multiple regression and so on. In study 2, case interviews were conducted with Interpretative Phenomenological Analysis (IPA) based on a self-compiled research outline. Significance, attitude to death, defense mechanism and mental health were correlated. The results of regression equation showed that psychological resilience, meaning of life, attitude to death and defense mechanism were involved in the model. Study 2: Through case study and comparative data analysis of 6 cases, the following four themes were obtained: (1) positive self; (2) positive adjustment and adaptation; (3) enhanced self-awareness; (4) cherishing life; (5) re-organization of friendship pattern; (6) change of philosophy and attitude of life, and 13 sub-themes.
【学位授予单位】：曲阜师范大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：B845.67
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