认知行为疗法对胶质瘤化疗患者负性情绪和主观幸福感的影响研究

发布时间：2018-11-08 19:35

【摘要】：目的:了解胶质瘤化疗患者以焦虑、抑郁为主的负性情绪现状和主观幸福感水平,探讨认知行为疗法对胶质瘤化疗患者焦虑和抑郁的干预效果;分析认知行为疗法对胶质瘤化疗患者主观幸福感的干预效果;找出更适合患者的认知行为疗法方案。方法:根据纳入标准和排除标准,选取174例在2015年12月~2016年12月期间,入住吉林大学第一医院神经肿瘤外科且首次接受化疗的胶质瘤患者,采用随机数字表法,将其分为对照组、腹式呼吸训练组、音乐疗法组、联合组四组。其中,对照组实施常规护理干预,腹式呼吸训练组实施认知干预和腹式呼吸训练,音乐疗法组采取认知干预和音乐疗法,联合组实施认知干预和腹式呼吸训练及音乐疗法。在干预前第1次化疗后和第4次化疗后分别采用焦虑自评量表(SAS)、抑郁自评量表(SDS)及总体幸福感量表(GWBS)对四组患者焦虑得分、抑郁得分及主观幸福感得分进行测评。结果:1.胶质瘤化疗患者普遍存在焦虑(53.82±2.18)、抑郁(59.56±3.74),主观幸福感得分(68.57±9.97)低于中国常模(71.00±18.00)。2.干预后三组患者焦虑得分均降低,以联合组降低尤为明显,其次为音乐疗法组,腹式呼吸训练组,各组间差异均具有统计学意义(P0.05)。3.干预后三组患者抑郁得分降低,抑郁情绪得到明显改善,以联合组最为明显,依次为腹式呼吸训练组、音乐疗法组,各组间差异显著,有统计学意义(P0.05)。4.干预后三组患者的主观幸福感水平升高,以联合组主观幸福感得分最高,其次为音乐疗法组、腹式呼吸训练组,该三组与对照组相比,存在差异,且差异具备统计学意义(P0.05),联合组与腹式呼吸训练组、音乐疗法组相比均有统计学差异(P0.05),但腹式呼吸训练组与音乐疗法组得分尚不具备统计学意义(P0.05)。结论:1.胶质瘤化疗患者普遍存在焦虑、抑郁,主观幸福感水平较低,亟待实施干预措施加以改善。2.认知行为疗法能明显改善患者焦虑情绪,且联合腹式呼吸训练和音乐疗法的行为干预方案效果最好,音乐疗法次之,两者均优于腹式呼吸训练。3.认知行为疗法可减轻患者抑郁程度,且联合腹式呼吸训练和音乐疗法的行为干预方案效果最好,腹式呼吸训练次之,两者均优于音乐疗法。4.认知行为疗法可提高患者主观幸福感水平,联合干预方法效果较为突出。
[Abstract]:Objective: to explore the effect of cognitive behavior therapy on anxiety and depression in glioma chemotherapy patients. Objective: to analyze the effect of cognitive behavioral therapy on subjective well-being of glioma patients after chemotherapy, and to find out a more suitable cognitive behavior therapy scheme for glioma patients. Methods: according to the inclusion criteria and exclusion criteria, 174 patients with glioma admitted to neurooncology surgery in the first Hospital of Jilin University from December 2015 to December 2016 and received chemotherapy for the first time were selected. They were divided into four groups: control group, abdominal breathing training group, music therapy group and combined group. The control group received routine nursing intervention, the abdominal breathing training group received cognitive intervention and abdominal breathing training, the music therapy group received cognitive intervention and music therapy, and the combined group received cognitive intervention and abdominal breathing training and music therapy. After the first chemotherapy before intervention and after the fourth chemotherapy, the anxiety scores of the four groups were assessed with (SAS), depression self-rating scale (SDS) and general well-being scale (GWBS) respectively. The scores of depression and subjective well-being were measured. The result is 1: 1. Anxiety (53.82 卤2.18), depression (59.56 卤3.74) and subjective well-being (68.57 卤9.97) in glioma chemotherapy patients were significantly lower than those in Chinese norm (71.00 卤18.00). After intervention, the anxiety scores of the three groups were all decreased, especially in the combined group, followed by music therapy group, abdominal breathing training group, the differences among groups were statistically significant (P0.05). After intervention, the depression scores of the three groups decreased, and the depression mood improved significantly, especially in the combined group, followed by abdominal respiratory training group and music therapy group, the difference was significant among the three groups (P0.05). 4. After intervention, the subjective well-being level of the three groups increased, with the combined group having the highest score, followed by music therapy group, abdominal breathing training group, the three groups were different from the control group. And the difference was statistically significant (P0.05), the combination group and abdominal breathing training group, music therapy group compared with statistical difference (P0.05), But abdominal breathing training group and music therapy group score is not statistically significant (P0.05). Conclusion: 1. There are anxiety, depression and low subjective well-being in patients with glioma chemotherapy. Cognitive behavior therapy can obviously improve the anxiety of patients, and the combination of abdominal breathing training and music therapy has the best effect, music therapy takes the second place, both of them are better than abdominal breathing training. Cognitive behavioral therapy can reduce depression, and the combination of abdominal breathing training and music therapy has the best effect, abdominal breathing training is the second, both of them are better than music therapy. 4. Cognitive behavioral therapy can improve the level of subjective well-being of patients, and the combined intervention method is more effective.
【学位授予单位】：吉林大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.73

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