抑郁、焦虑患者睡眠质量的影响因素及个案干预研究

发布时间：2018-02-12 01:50

本文关键词： 抑郁、焦虑患者睡眠质量调查干预研究　出处：《山西医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：睡眠障碍是抑郁、焦虑患者临床发生率较高的躯体症状之一,主要有入睡时间延长、睡眠轻浅及早醒三个症状。睡眠障碍与抑郁、焦虑情绪互相影响,互相作用,对抑郁、焦虑症的预后及复发有着重要的影响。目的:调查了解抑郁、焦虑患者的睡眠质量、睡眠信念与态度及应对方式的现况,并探讨影响患者睡眠质量的影响因素之间的关系。通过对一例抑郁障碍伴失眠患者进行心理干预,研究认知行为疗法对患者抑郁情绪及睡眠障碍的缓解情况。对象:以某医科大学附属医院精神卫生科2016年9月到12月的135名抑郁、焦虑患者为研究对象。对其中符合入组条件的135名患者进行问卷调查,对其中一名抑郁伴失眠患者进行心理干预。方法:1.调查研究:采用方便抽样的方法,对135抑郁、焦虑住院患者进行调查。使用匹兹堡睡眠质量指数量表、睡眠个人信念及态度量表、汉密尔顿抑郁量表、汉米尔顿焦虑量表量表及特质应对方式量表进行调查。2.干预研究:采用个体心理治疗结合团体心理治疗的方法,对一名抑郁症伴睡眠障碍的患者进行心理干预。其中个体心理治疗分为四次,中间穿插两次团体心理治疗,两次团体治疗的主题分别为认识我们的睡眠和如何拯救我们的睡眠。在个体心理治疗过程中,一方面通过失眠的认知行为疗法对患者的不良睡眠认知及错误的睡眠行为进行矫正;另一方面,通过精神分析的方法,对患者的失眠根源进行发掘,处理患者心中的创伤,使患者正确面对生命中的重大丧失。结果:1.调查研究结果:(1)约有61.5%的被调查者存在睡眠紊乱的情况,其中在入睡时间和睡眠效率上问题较为突出,且79%的患者在入院前一个月有规律服用催眠类药物的情况。患者对失眠原因的认识及对睡眠的期望有较多错误的认知。(2)睡眠质量差对男性日间功能的影响要显著高于女性(t=2.16,p=0.033);未婚患者入睡时间(t=-2.15,p=0.040)及睡眠效率(t=-4.53,p=0.000)要明显好于已婚患者,且对控制和预测睡眠能力(t=2.27,p=0.029)的评价要好于已婚患者;不同文化程度的患者在对失眠原因的理解上有显著差异(F=3.40,p=0.004)。(3)在睡眠认知上,患者的睡眠质量与患者对失眠后果的估计及对控制和预测睡眠能力的评价呈负相关,与患者对睡眠的期望呈正相关;在情绪上,患者的睡眠质量与患者的躯体性焦虑及抑郁、焦虑的严重程度呈正相关。(4)患者对睡眠的期望、对控制和预测睡眠能力的评价及躯体性焦虑对患者的睡眠质量有显著的预测作用,而患者焦虑的严重程度对患者睡眠信念与态度和睡眠质量之间有显著的调节作用。2.干预研究结果:通过记录患者在干预前及干预后的变化,说明心理干预对抑郁伴失眠患者的抑郁情绪的改善及失眠的缓解有一定的效果。结论:1.抑郁、焦虑患者有不同程度的睡眠问题,且较多人选择服用催眠类药物来缓解睡眠问题,且对于睡眠问题的认知较差。不同性别、婚姻状况及文化程度的患者间存在差异。2.抑郁、焦虑患者的睡眠质量与其自身对睡眠的认知及抑郁、焦虑情绪的严重程度有密切的关系。3.焦虑情绪通过睡眠信念与态度对睡眠质量的影响起调节作用。4.心理干预对患者的抑郁情绪及失眠的症状有一定的改善作用。
[Abstract]:Sleep disorder is one of the physical symptoms of depression, a higher rate of clinical anxiety patients, mainly in sleep time, sleep Qingqian wake up three early symptoms. Sleep disorders and depression, anxiety, mutual influence, interaction, on depression, has an important influence on the prognosis and recurrence of anxiety disorders. Objective: To investigate the depression the anxiety, sleep quality, sleep status beliefs and attitudes and coping style, and to explore the relationship between the factors affecting the quality of sleep in patients with psychological intervention. Through a case of depression in patients with insomnia, relief of cognitive behavioral therapy on mood and sleep disorders in patients with depression. Object: to the Department of mental health the Affiliated Hospital of a Medical University in September 2016 to 135 in December the depression, anxiety patients as the research object. In which 135 patients were eligible for questionnaire survey, one of A depression with insomnia patients with psychological intervention. Methods: 1. investigation: using convenience sampling method, 135 depression, anxiety inpatients were investigated. Using the Pittsburgh sleep quality index scale, personal beliefs and sleep attitude scale, Hamilton depression scale, the Milton anxiety scale and trait coping style scale amount table.2.: research methods of individual psychological intervention therapy combined with psychotherapy, psychological intervention of a depression with sleep disorder. The individual psychological treatment is divided into four times, two times in between the inserted group psychotherapy, two group therapy subjects were sleep and we know how to save we sleep. In individual psychotherapy, one of the patient's poor sleep cognition and wrong sleep behavior through cognitive behavioral therapy for insomnia correction; another Hand, through spiritual analysis, to explore the root of insomnia patients, treatment of patients with heart trauma, make the patient to face a major loss of life. Results: 1. research results: (1) sleep disorders are about 61.5% of the respondents of the situation, the problems in sleep latency and sleep efficiency is more prominent, and 79% of the patients had regular use of hypnotic drugs in a month before admission. There are many wrong understanding of the causes of insomnia patients with cognitive and expectations for sleep. (2) poor sleep quality and daytime function influence on male is significantly higher than that of female (t=2.16, p=0.033); unmarried patients sleep time (t=-2.15, p=0.040) and sleep efficiency (t=-4.53, p=0.000) was significantly better in married patients, and to control and predict the ability to sleep (t=2.27, p=0.029) evaluation is better than the married patients; the different cultural degree in patients with insomnia There are significant differences in the understanding of the reasons (F=3.40, p=0.004). (3) in sleep cognition, negative correlation to estimate the consequences of insomnia and sleep quality of patients and to evaluate the prediction and control of the ability to sleep, positively correlated with patient expectations to sleep; in the mood, sleep quality and patients' the somatic anxiety and depression, anxiety was positively correlated with the severity of. (4) patients expected to sleep, to evaluate the ability of control and predict sleep and somatic anxiety had significant predictive effect on the sleep quality of patients, and the severity of patients with anxiety have significant moderating effect on the results of the intervention of.2. between the patients' sleep quality and sleep: the beliefs and attitudes were recorded before and after intervention changes, improvement and insomnia and depression psychological intervention on depression associated with insomnia relief conclusion have a certain effect: 1. patients with depression, anxiety and sleep problems in different degree, and more people choose to use hypnotic drugs to alleviate sleep problems, and poor sleep for cognitive problems. There are differences in different gender, marital status and education level of.2. depression among patients, anxiety and sleep quality in patients with their sleep cognition and depression, severe the degree of anxiety related.3. anxiety closely affected by sleep beliefs and attitudes on sleep quality play an important role in the regulation of.4. psychological intervention on depression and insomnia symptoms have certain effect.

【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R749

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