腰椎间盘突出手术前后病人的心理特点和心理治疗研究

发布时间：2018-02-24 02:04

本文关键词： 贝克焦虑量表(BAI) 汉密顿抑郁量表(HAMD) 心理干预　出处：《山西医科大学》2007年硕士论文　论文类型：学位论文

【摘要】： 目的:研究适合腰椎间盘突出手术患者心理特征的心理学量标、心理干预方案。方法:选择腰椎间盘突出手术患者120人,试验组80人,对照组40人,试验组分为两组,医生干预组和护士干预组。试验组给予心理干预,对照组不做心理干预。在心理干预前对对照组和试验组的每个病人进行贝克焦虑量表(BAI)、汉密顿抑郁量表(HAMD)问卷调查。在进行心理干预后进行第二次问卷调查,调查时间选择在病人手术后一周内。贝克焦虑量表(BAI)由患者自己完成,汉密顿抑郁量表(HAMD)由调查员根据患者的叙述完成。心理干预措施为:倾听、解释、指导、鼓励、渐进松驰疗法、音乐疗法。结果:在进行腰椎间盘手术的患者中,心理干预实施前试验组和对照组的BAI问卷得分、HAMD问卷得分均高于诊断标准分(p＜0.01),心理干预实施前,试验组和对照组的焦虑发生率在97.5%～100%,抑郁发生率在97.5%～100%,心理干预实施后医生干预组、护士干预组的BAI问卷得分、HAMD问卷得分要低于焦虑诊断标准分(p＜0.01),而对照组的BAI问卷得分、HAMD问卷得分要高于焦虑诊断标准分(p＜0.01),心理干预实施后,医生干预组、护士干预组和对照组的焦虑发生率分别为2.5%、30%和95%,抑郁发生率分别为5%、25%和92.5%。经统计学检验,医生干预组和护士干预组焦虑发生率抑郁发生率低于对照组,医生干预组远低于护士干预组、对照组。心理干预实施后,医生干预组、护士干预组的BAI问卷、HAMD问卷得分和焦虑、抑郁发生率均低于均低于心理干预前,而未采取心理干预的对照组在手术前后无明显变化。患者出院时的满意程度与心理干预后BAI问卷、HAMD问卷得分呈现负相关与干预类型、治疗效果呈现正相关。从相关系数的大小可以看出干预类型、治疗效果要高于焦虑、抑郁问卷得分。贝克焦虑量表(BAI)得分与汉密顿抑郁量表(HAMD)得分呈现正相关。结论:腰椎间盘突出手术患者存在严重的焦虑、抑郁症状,实施心理干预能明显缓解患者的焦虑、抑郁症状。影响患者满意程度的因素大小依次为干预类型、治疗效果、心理干预后的抑郁程度、焦虑程度。医生对患者的干预要好于护士。贝克焦虑量表(BAI)与汉密顿抑郁量表(HAMD)对腰椎间盘突出手术患者进行焦虑、抑郁症状调查较为全面合理。
[Abstract]:Objective: to study the psychological scale and psychological intervention program for patients with lumbar disc herniation. Methods: 120 patients with lumbar disc herniation, 80 patients in the experimental group and 40 patients in the control group were selected. The experimental group was divided into two groups: the doctor intervention group and the nurse intervention group. Before the psychological intervention, each patient in the control group and the experimental group was investigated with the Baker anxiety scale (BAIN), the Hamilton Depression scale (Hamd) and the second questionnaire after psychological intervention. The investigation time was chosen within one week after the operation. The Beck anxiety scale (BAI) was completed by the patient himself, and the Hamilton Depression scale (Hamd) was completed by the investigator according to the patient's narration. The psychological intervention measures were: listening, explaining, guiding, encouraging. Progressive relaxation therapy, music therapy. Results: in the patients undergoing lumbar disc surgery, the scores of BAI questionnaire and Hamd questionnaire in the experimental group and the control group before psychological intervention were higher than those in the diagnostic standard (P < 0.01). The incidence of anxiety in the trial group and the control group was 97.50.The incidence of depression was 97.50.After the psychological intervention, the doctor's intervention group, The scores of BAI questionnaire and Hamd questionnaire in the nurses intervention group were lower than those in the anxiety diagnosis standard (P < 0.01), while the scores of the BAI questionnaire in the control group were higher than those in the anxiety diagnosis standard (P < 0.01). The incidence of anxiety and depression in the nurse intervention group and the control group were 2.5% and 95% respectively. The incidence of depression was 52.5% and 92.5% respectively. The incidence of anxiety and depression in the doctor intervention group and the nurse intervention group was lower than that in the control group. After psychological intervention, the scores of BAI questionnaire, anxiety and depression in the doctor intervention group and nurse intervention group were lower than those before psychological intervention. There was no significant change before and after operation in the control group without psychological intervention. There was a negative correlation between the degree of satisfaction at discharge and the score of BAI questionnaire / Hamd questionnaire after psychological intervention and the type of intervention. From the correlation coefficient, we can see that the intervention type is higher than that of anxiety, the score of depression questionnaire is higher, and the score of BAI is positively correlated with the score of Hamilton Depression scale (Hamd). Conclusion: the patients with lumbar disc herniation have serious anxiety and depression symptoms. Psychological intervention can obviously relieve the anxiety and depression symptoms of the patients. The factors influencing the patients' satisfaction are the type of intervention and the therapeutic effect. The degree of depression and anxiety after psychological intervention was better than that of nurses. Baker anxiety scale (BAI) and Hamilton Depression scale (Hamd) performed anxiety on patients with lumbar disc herniation.
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2007
【分类号】：R473.6;R395

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