住院癌症患者情绪特征与相关因素及干预研究
发布时间：2018-07-20 15:34
【摘要】：20世纪以来,癌症成为威胁人类健康的疾病之一,近年来癌症的发病率不断上升。全世界每年新发病例约635万,是导致人类死亡的第二大疾病。随着医学模式由单纯生物医学模式向生物—心理—社会医学模式的转变,癌症患者的心理健康以及生活质量日益受到人们的关注。心理社会肿瘤学认为,癌症的发生、发展、预后及转归都与心理社会因素有密切关系。因此关注研究癌症患者的心理健康及其影响因素,实施各种有效手段提升其心理健康水平有重要意义。本研究旨在：1.探究癌症住院患者的情绪特征及相关因素。2.探索有效且有针对性的心理干预方法,以提升癌症患者情绪健康水平。 研究一：住院癌症患者情绪特征及其相关因素研究 研究方法：在省内某大型三甲医院随机抽取71名住院癌症患者进行问卷调查,应用非精神科住院患者心理状态评定(MSSNS),抑郁自评问卷(SDS)、医学应对方式问卷(MCMQ),需求评估问卷(NEQ)、患者-亲属癌症相关交流评估工具(患者版)(CCAT-P)等分别测量患者情绪特征,应对方式,患者需求及与亲属交流情况。运用统计描述对患者情绪特征进行描述。运用Pearson相关分析和多因素回归分析,考察患者情绪特征与各测量变量的相关性。 研究结果：1.47.8%的患者其SDS得分符合抑郁标准；癌症患者MSSNS抑郁、焦虑、孤独得分与一般内外科患者无显著性差异,但其愤怒情绪显著高于内外科患者；患者MSSNS因子分由高到低得分依次为：孤独、焦虑、抑郁和愤怒。2.患者抑郁、焦虑、愤怒、孤独等负性情绪分别与其性别、文化程度、居住地、家庭月收入、病程等一般特征有关,也与其信息需求、心理支持等需求的满足情况、与家属围绕疾病沟通、应对方式有关。3.患者年龄、病程,患者需求中的情感支持需求、辅助与照料需求,患者与家属围绕疾病的沟通,应对方式中的屈服、回避分别在对负性情绪的回归分析中达显著性水平。 研究二：探索性认知干预提升心理健康水平的实验研究 研究方法：通过与部分患者面谈了解患者心理问题根源,制定出针对性的干预方案,将干预内容印制成手册。将患者随机分为干预组和对照组,干预组发放干预手册并进行2次访谈,对照组无干预。干预前后两组分别收集问卷数据。 研究结果：干预前基线数据两组不均等。干预组SDS得分、MSSNS孤独高于对照组、回避低于对照组,差异有统计学意义；干预后干预组与对照组比较,SDS得分、MSSNS孤独和回避得分无显著性差异,其余维度差异也无统计学意义；干预后干预组SDS得分降低,回避得分升高,差异有统计学意义,而干预后对照组变化无显著性。 结论： 1.近半数癌症患者达到抑郁诊断标准；癌症患者愤怒情绪较一般内外科患者显著；患者的主观孤独感受较抑郁、焦虑、愤怒等情绪强烈； 2.相较于照料需求、心理情感支持需求和物质需求信息,患者的信息需求、关系需求更为显著； 3.癌症情绪障碍的发生受到患者性别、文化程度、居住地区、家庭月收入、病程等患者一般社会特征因素的影响。女性、文化程度低、居住地偏远、家庭月收入低、患病时间较长的患者其情绪障碍发生的风险升高； 4.患者的心理健康水平与患者信息需求、患者心理情感支持需求、家庭成员之间有关疾病的沟通、应对方式等因素相关。患者信息需求未得到满足、患者-家属之间沟通不良、患者采用屈服应对方式是增加患者情绪困扰的危险因素。患者信息需求的不满足使患者更容易感受到焦虑、愤怒；不良的患-属沟通同样与患者的抑郁和愤怒水平有密切联系；屈服与患者的焦虑、抑郁、愤怒和孤独都有显著性的联系；积极获取心理情感支持、采用面对和回避应对方式有助于患者对疾病的适应； 5.对患者进行简短的针对性认知干预可以缓解其部分负性情绪。
[Abstract]:Since twentieth Century, cancer has become one of the diseases that threaten human health. The incidence of cancer is rising in recent years. The new incidence of cancer is about 6 million 350 thousand in the world every year. It is the second major disease that causes human death. With the change of medical model from simple biomedical model to biological psycho social medical model, the psychological health of cancer patients Psychosocial oncology believes that the occurrence, development, prognosis and prognosis of cancer are closely related to psychosocial factors. Therefore, it is of great significance to pay attention to the psychological health of cancer patients and their influencing factors and to implement various effective means to improve their mental health. 1.: 1. explore the emotional characteristics and related factors of cancer inpatients, explore effective and targeted psychological intervention to improve the emotional health of cancer patients.
Study 1: emotional characteristics and related factors of hospitalized cancer patients
Methods: 71 hospitalized cancer patients were randomly selected from a large three a hospital in the province to conduct a questionnaire survey, using the mental state assessment (MSSNS) of non psychiatric inpatients, the self rating Depression Questionnaire (SDS), the Medical Coping Style Questionnaire (MCMQ), the demand assessment questionnaire (NEQ), the patient relative cancer related exchange assessment tool (patient Edition), and so on (CCAT-P). The emotional characteristics of patients, coping styles, patients' needs and communication with relatives were measured respectively. Statistical description was used to describe the emotional characteristics of the patients. The correlation between the emotional characteristics and the measured variables was investigated by Pearson correlation analysis and multiple regression analysis.
The results of the study: the score of SDS in 1.47.8% patients was in conformity with the standard of depression; the scores of MSSNS depression, anxiety and loneliness in cancer patients were not significantly different from those in general internal and external subjects, but their anger was significantly higher than those in the internal and external subjects; the scores of MSSNS factor from high to low were in turn: depression, anxiety and anxiety in patients with.2., anxiety, depression and anger. Negative emotions, such as anger and loneliness, are related to their gender, educational level, residence, family monthly income, and course of illness, as well as their information needs, psychological support and other needs, communication with their families around the disease, coping styles related to the age of.3. patients, the course of illness, emotional support needs in the needs of the patients, and support and care. In conclusion, the communication between patients and their families around the disease, the surrender in coping styles and the avoidance in the regression analysis of negative emotions reached a significant level.
Study two: exploratory cognitive intervention to improve mental health
Research methods: through the interview with some patients to understand the root of the patient's psychological problems, a targeted intervention program was formulated and the content of the intervention was printed into a manual. The patients were randomly divided into intervention group and control group. Intervention group issued intervention manual and conducted 2 interviews, and the control group had no intervention. The two groups were collected before and after intervention.
Results: before intervention, the baseline data of two groups were not equal. The score of SDS in the intervention group was higher than that of the control group, and the MSSNS loneliness was higher than the control group. The difference was statistically significant. There was no significant difference between the intervention group and the control group, the score of SDS, the score of MSSNS loneliness and avoidance, and the difference of the residual dimension. SDS score decreased and avoidance score increased. The difference was statistically significant, but there was no significant change in the control group after intervention.
Conclusion:
1. nearly half of the cancer patients reached the criteria for the diagnosis of depression; the anger of the cancer patients was more significant than that in the general internal and external subjects; the subjective loneliness of the patients was more depressed, anxious and angry.
2. compared with care needs, psychological emotional support needs and material needs information, patients' information needs and relationship needs are more significant.
3. the occurrence of emotional disorders of cancer is affected by the general social characteristics of the patients, such as sex, educational level, living area, family month income, and course of illness.
4. the mental health level of the patients is related to the patient's information demand, the patient's psychological and emotional support needs, the communication between the family members, the coping style and so on. The patient's information demand is not met, the patient and the family are not communicating with each other, and the patient's yield should be the risk factor of increasing the patient's emotional distress. The unsatisfaction of the interest demand makes the patient more susceptible to anxiety and anger; poor communication is closely linked to the patient's depression and anger levels; yield is significantly associated with anxiety, depression, anger and loneliness; positive emotional support, and the use of face and avoidance responses are helpful to the patient. The adaptation of the disease;
5. a short targeted cognitive intervention can alleviate some of the negative emotions.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R395.1
本文编号：2133985
[Abstract]:Since twentieth Century, cancer has become one of the diseases that threaten human health. The incidence of cancer is rising in recent years. The new incidence of cancer is about 6 million 350 thousand in the world every year. It is the second major disease that causes human death. With the change of medical model from simple biomedical model to biological psycho social medical model, the psychological health of cancer patients Psychosocial oncology believes that the occurrence, development, prognosis and prognosis of cancer are closely related to psychosocial factors. Therefore, it is of great significance to pay attention to the psychological health of cancer patients and their influencing factors and to implement various effective means to improve their mental health. 1.: 1. explore the emotional characteristics and related factors of cancer inpatients, explore effective and targeted psychological intervention to improve the emotional health of cancer patients.
Study 1: emotional characteristics and related factors of hospitalized cancer patients
Methods: 71 hospitalized cancer patients were randomly selected from a large three a hospital in the province to conduct a questionnaire survey, using the mental state assessment (MSSNS) of non psychiatric inpatients, the self rating Depression Questionnaire (SDS), the Medical Coping Style Questionnaire (MCMQ), the demand assessment questionnaire (NEQ), the patient relative cancer related exchange assessment tool (patient Edition), and so on (CCAT-P). The emotional characteristics of patients, coping styles, patients' needs and communication with relatives were measured respectively. Statistical description was used to describe the emotional characteristics of the patients. The correlation between the emotional characteristics and the measured variables was investigated by Pearson correlation analysis and multiple regression analysis.
The results of the study: the score of SDS in 1.47.8% patients was in conformity with the standard of depression; the scores of MSSNS depression, anxiety and loneliness in cancer patients were not significantly different from those in general internal and external subjects, but their anger was significantly higher than those in the internal and external subjects; the scores of MSSNS factor from high to low were in turn: depression, anxiety and anxiety in patients with.2., anxiety, depression and anger. Negative emotions, such as anger and loneliness, are related to their gender, educational level, residence, family monthly income, and course of illness, as well as their information needs, psychological support and other needs, communication with their families around the disease, coping styles related to the age of.3. patients, the course of illness, emotional support needs in the needs of the patients, and support and care. In conclusion, the communication between patients and their families around the disease, the surrender in coping styles and the avoidance in the regression analysis of negative emotions reached a significant level.
Study two: exploratory cognitive intervention to improve mental health
Research methods: through the interview with some patients to understand the root of the patient's psychological problems, a targeted intervention program was formulated and the content of the intervention was printed into a manual. The patients were randomly divided into intervention group and control group. Intervention group issued intervention manual and conducted 2 interviews, and the control group had no intervention. The two groups were collected before and after intervention.
Results: before intervention, the baseline data of two groups were not equal. The score of SDS in the intervention group was higher than that of the control group, and the MSSNS loneliness was higher than the control group. The difference was statistically significant. There was no significant difference between the intervention group and the control group, the score of SDS, the score of MSSNS loneliness and avoidance, and the difference of the residual dimension. SDS score decreased and avoidance score increased. The difference was statistically significant, but there was no significant change in the control group after intervention.
Conclusion:
1. nearly half of the cancer patients reached the criteria for the diagnosis of depression; the anger of the cancer patients was more significant than that in the general internal and external subjects; the subjective loneliness of the patients was more depressed, anxious and angry.
2. compared with care needs, psychological emotional support needs and material needs information, patients' information needs and relationship needs are more significant.
3. the occurrence of emotional disorders of cancer is affected by the general social characteristics of the patients, such as sex, educational level, living area, family month income, and course of illness.
4. the mental health level of the patients is related to the patient's information demand, the patient's psychological and emotional support needs, the communication between the family members, the coping style and so on. The patient's information demand is not met, the patient and the family are not communicating with each other, and the patient's yield should be the risk factor of increasing the patient's emotional distress. The unsatisfaction of the interest demand makes the patient more susceptible to anxiety and anger; poor communication is closely linked to the patient's depression and anger levels; yield is significantly associated with anxiety, depression, anger and loneliness; positive emotional support, and the use of face and avoidance responses are helpful to the patient. The adaptation of the disease;
5. a short targeted cognitive intervention can alleviate some of the negative emotions.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R395.1
【引证文献】
相关硕士学位论文 前1条
1 梁桂云;SIRT6、PON1、HSP70基因多态性与广西巴马长寿的相关性研究[D];广西医科大学;2012年
，本文编号：2133985
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