心理治疗在慢性乙型肝炎康复过程中作用的研究

发布时间：2018-09-10 15:24

【摘要】：目的对慢性乙型肝炎(CHB)患者的心理及行为问题进行系统评估,探讨影响慢性乙肝患者生活质量的因素;对慢性乙肝患者进行心理治疗,比较药物治疗配合心理治疗是否比单纯药物治疗有更好的疗效,为慢性乙肝患者的临床心理治疗提供实验和理论依据。研究对象和方法 1.以济南市传染病院住院的CHB患者152例为对象,同时以该医院的医学生和护士为对照,用SCL-90、SAS、SDS、MCMQ、CLDQ研究慢性乙肝患者的心理及行为问题。 2.从患者中抽取90名自愿者,按照病情和人口学资料相匹配原则分为心理康复组(50例)和患者对照组(40例)。入院后病情稳定后两组患者进行第一次评估,包括心理问题评估(SCL-90、SAS、SDS、MCMQ)、生活质量(CLDQ)和肝功能生化指标(ALT、AST、TBIL、DBIL、ALB)。 3.给心理康复组患者发放健康教育小册子,并用自编的慢性乙肝患者半定式晤谈表确定患者的核心心理问题。在药物治疗的同时针对患者的核心心理问题进行每周1-2次、住院期间共2-12次的心理治疗。患者对照组只进行药物治疗。 4.治疗结束进行第二次评估。比较两次评估结果的异同。研究结果 1.CHB患者的心理问题: 患者的SCL-90除了人际敏感和偏执因子,其他因子分及总分与中国常模差异有显著性,在躯体化、焦虑、抑郁、敌对及睡眠饮食方面与医护对照组比较有显著差异。患者SAS、SDS得分高于常模,差异有显著性。MCMQ测量结果:
[Abstract]:Objective to evaluate the psychological and behavioral problems of patients with chronic hepatitis B (CHB) and to explore the factors affecting the quality of life of patients with chronic hepatitis B. In order to provide experimental and theoretical basis for clinical psychotherapy of patients with chronic hepatitis B, the comparison between drug therapy and psychotherapy is more effective than that of drug therapy alone. Object and method 1. 152 cases of CHB patients hospitalized in Jinan Infectious Diseases Hospital were taken as subjects, while the medical students and nurses in the hospital were taken as control. To study the psychological and behavioral problems of chronic hepatitis B patients with SCL-90,SAS,SDS,MCMQ,CLDQ. 2. 90 volunteers were selected from the patients and divided into psychological rehabilitation group (50 cases) and patient control group (40 cases) according to the principle of matching condition and demographic data. The patients in the two groups were evaluated for the first time after admission, including psychological assessment (SCL-90,SAS,SDS,MCMQ), quality of life (CLDQ) and liver function biochemical index (ALT,AST,TBIL,DBIL,ALB). 3. Health education pamphlets were distributed to the patients in the psychological rehabilitation group, and the core psychological problems of the patients were determined by the self-compiled semi-fixed interview table for the patients with chronic hepatitis B. At the same time, the patients were treated with 2-12 psychotherapy times a week and 2-2 times a week for the patients' core psychological problems. The patients in the control group were treated with drugs only. 4. A second assessment was performed at the end of the treatment. Compare the similarities and differences between the results of the two evaluations. Results the psychological problems of patients with 1.CHB: in addition to interpersonal sensitivity and paranoid factors, patients with SCL-90, The scores of other factors and total scores were significantly different from those of Chinese norm, and there were significant differences in somatization, anxiety, depression, hostility and sleeping diet. The SAS,SDS score of the patients was higher than that of the norm, and the difference was significant.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2005
【分类号】：R395.5

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