根管治疗患者的疼痛程度与生活幸福感及应对方式的相关研究

发布时间：2019-05-27 17:25

【摘要】：目的探讨根管治疗患者的疼痛程度在疾病种类、性别、身体状态、年龄、婚姻状况、文化程度、经济条件等维度上的差异情况，以及患者的幸福感、应对方式与根管治疗疼痛程度的关系。以期为寻求临床上减轻根管治疗疼痛的方法提供针对性的措施，为根管治疗的顺利实施提供保障措施并完善理论。通过研究可以对患者的应付行为进行评估，从而指导患者采取积极的应付方式，正确的幸福观以及健康的心理状态对待根管治疗。方法研究对象为北京煤炭总医院干部门诊被确诊为牙髓炎、牙髓坏死以及根尖周炎（后磨牙）的患者，随机抽取250人作为本课题的研究对象（排除牙周牙髓联合病变的病例），共发放问卷250份，回收问卷234份，剔除10份无效问卷，收集到有效问卷224份，回收有效率达95.7％。其中，男性108人，年龄最大78岁，最小22岁，平均52岁，女性116人，年龄最大77岁，最小20岁，平均54岁。采用视觉模拟量表、总体幸福感量表及应对方式问卷对研究对象进行调查，对资料进行整理，，使用SPSS13.0软件进行数据统计分析。结果1患者在接受根管治疗时，不同患者感受到的疼痛程度不同，平均为5.72分。2通过独立样本t检验、方差分析可知，根管治疗的疼痛程度（VAS）在疾病种类、性别、健康状态、年龄、婚姻状况、文化程度、收入高低等维度上存在差异，但无统计学意义。3224例研究对象的幸福感处于较高水准，平均值达到118.82分。4解决问题的应对方式的分值最高，平均分值达到0.84117分，有一部分人遇到问题时能够主动寻求他人帮忙，在别人的帮助下最终解决问题，有少数人采取合理化，自责，幻想，退避等应付策略面对问题。5幸福感指数与根管治疗疼痛程度（VAS）存在显著负相关,幸福感指数越高，根管治疗疼痛程度的分值越低。解决问题、求助及成熟型因子与疼痛指数负相关，自责、退避、幻想、不成熟型四个因子与疼痛指数正相关。合理化、混合型应对方式与疼痛指数的相关性检测无统计学意义。6应对方式与幸福感有密切的关系，解决问题、求助、成熟型、合理化、混合型五个因子与幸福感呈正相关关系；自责、幻想、退避、不成熟四个因子与幸福感呈负相关，相关系数达到显著水平。7幸福感和应对方式对根管治疗疼痛程度有着显著的预测作用，在幸福感及应对方式各因子与VAS的回归分析中，幸福感、解决问题因子、幻想因子及自责因子进入回归模型，标注化回归方程为：y=5.9782-0.98*幸福感-1.63*解决问题+1.98*幻想+2.39*自责。结论1患者所感受到根管治疗的疼痛程度处于中度水平，疼痛的不良感受对患者的身心造成一定的影响，因此应予足够的重视。2所有研究对象的幸福值得分较高，拥有正确幸福观的人对生活充满信心，遭遇挫折时能够泰然处之，合理解决问题，因此应该注重提高人们的生活幸福感。3根管治疗患者最常采取解决问题的应对方式，这种积极的人生态度使人们无论面对生活的苦难还是治疗的痛苦经历都能够沉着应对，客观分析，避免对自身产生不良的影响，应该引导人们树立积极向上的生活态度，勇于面对困难及挫折。4生活幸福感、应付方式与根管治疗的疼痛程度有密切关系，所以应该提高患者的幸福感并引导患者采取积极的应对策略解决问题，以此来降低根管治疗疼痛对患者身心造成的影响。
[Abstract]:Objective To study the relationship between the degree of pain of the patients with root canal therapy, the type of disease, the sex, the physical state, the age, the marital status, the degree of culture and the economic condition, and the well-being of the patients, the coping style and the pain degree of root canal treatment. The aim of this paper is to provide a specific measure for the method of reducing the pain of root canal treatment, and to provide the safeguard measure and perfect the theory for the smooth implementation of root canal treatment. The study can be used to evaluate the patient's coping behavior, so as to guide the patient to take a positive coping style, correct the well-being and the healthy mental state to treat the root canal. Methods A total of 250 patients who were diagnosed as pulpitis, pulp necrosis and root tip (posterior molar) were randomly selected as the subject of the study. A total of 234 questionnaires were collected, and the effective questionnaires were collected in 224 parts. The effective rate was 95.7. %. Of these,108 men, the maximum age of 78, the minimum age of 22, the average age of 52, the female 116, the maximum age of 77, the minimum age of 20, the average of 54 The study object was investigated by using the visual analog scale, the overall well-being scale and the coping style questionnaire, and the data was collected by using the SPSS13.0 software. The results showed that, in the treatment of root canal, the degree of pain of different patients was different, with an average of 5.72. According to the analysis of variance, the degree of pain (VAS) of root canal treatment was found in the type of disease, sex, health status, age, marriage, There is a difference in the degree of marriage, culture, income and so on, but there is no statistical significance. The well-being of the 3224 subjects is at a higher level, and the average value is 118.82. The score of the coping style of the problem is the highest, and the average score is 0.841. 17 points, when some people encounter problems, they can actively seek help from others, and finally solve the problem with the help of others. There are few people to adopt the coping strategies such as rationalization, self-accusation, illusion and retreat. The 5-well-being index and the root canal treatment pain degree (VAS) are significant. Negative correlation, the higher the well-being index, the degree of root canal treatment pain. The lower the value. The problem, the help and the mature factor are negatively correlated with the pain index, self-blame, back-off, fantasy, immature four-factor and pain index There is no statistical significance in the correlation between the rational, the mixed coping style and the pain index. The relationship between the coping style and the well-being is closely related, the problem is solved, the help, the maturity type, the rationalization, the mixed type of five factors are in the positive relation with the well-being, and the self-accusation, the illusion There was a negative correlation between the four factors and the well-being, and the correlation coefficient reached a significant level. The 7-well-being and the coping style had a significant effect on the degree of pain of the root canal. In the regression analysis of the factors of well-being and coping style and the VAS, the well-being and the solution to the question were solved. The problem factor, the fantasy factor and the self-blame factor enter the regression model. The labeling equation is: y = 5.9782-0.98 * well-being-1.63 * problem-solving + 1.98 * fantasy + 2.39 * Self-blame. Conclusion 1 The degree of pain in the root canal treatment is at a moderate level, and the bad feeling of pain will have a certain effect on the physical and mental health of the patient. Therefore, it should be paid enough attention. The well-being of all the subjects of the study should be higher and the person with the right and the right to be happy We should pay attention to the improvement of people's well-being.3. The most common problem in root canal treatment is to solve the problem. In the way of coping, this kind of positive people's ecological degree enables people to deal with, objective analysis and avoid the bad influence on themselves, regardless of the suffering of life or the pain of treatment, and should guide people to set up a positive attitude of life and face difficulties and setbacks. The well-being of life and coping style are closely related to the degree of pain of root canal treatment, so the well-being of the patient should be improved and the patient should be guided to take a positive coping strategy to solve the problem, so as to reduce the pain of root canal treatment to the mind and body of the patient.
【学位授予单位】：河北联合大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R781.05

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