脊髓型颈椎病患者术前心理善及心理干预研究

发布时间：2018-02-20 08:20

本文关键词： 人格心理健康脊髓型颈椎病心理干预　出处：《郑州大学》2009年硕士论文　论文类型：学位论文

【摘要】：目的探讨脊髓型颈椎病患者的术前心理健康状况及其相关心理社会因素:通过了解该类患者围术期间介入心理干预治疗,与单纯手术治疗的差异,为脊髓型颈椎病手术治疗的同时采取相应心理干预措施提供科学依据。方法选择100例住院准备手术治疗的脊髓型颈椎病患者,在收入院后两天内应用一般情况调查表、症状自评量表(SCL-90)、艾森克人格问卷(EPQ)、社会支持评定量表(SSRS)、日本骨科学会(JOA)脊髓功能评定表进行患者的一般情况、心理健康状况、人格个性特征、社会支持情况及脊髓功能的测查。再以入院先后次序按数字表法将患者随机分为心理干预组(在进行常规住院手术治疗的同时,施加心理干预)、对照组(常规住院手术治疗)。所有患者在术后再进行症状自评量表及脊髓功能评定表的测查。其中100例患者入院时的症状自评量表、艾森克人格问卷及社会支持量表结果分别以相应的中国常模作为对照进行分析,并通过分析探讨人格个性特征及社会支持情况与心理健康的关系;通过了解心理干预组与对照组手术前后的SCL-90及JOA结果的不同,以了解手术及心理干预对患者的影响。结果①脊髓型颈椎病患者症状自评量表的总分、总均分、躯体化、强迫状态、抑郁、焦虑、恐怖、精神病性因子分均高于中国常模,有显著性差异(P＜0.01);人际关系敏感因子分低于中国常模,有显著性差异(P＜0.01)。②脊髓型颈椎病患者EPQ各因子分与中国常模相比较,患者的EPQ中神经质分和精神质分显著高于中国常模,差异有显著性意义(P＜0.05)。③脊髓型颈椎病患者EPQ中神经质因子分与SCL-90各因子分均呈正相关,精神质因子分与躯体化、抑郁、焦虑、精神病性因子分呈正相关,掩饰因子分与总分、焦虑、敌对、恐怖因子分呈负相关,内外向因子分与恐怖因子分呈负相关。④脊髓型颈椎病患者术前社会支持水平高于正常人群(P＜0.01)。⑤脊髓型颈椎病患者术前在社会支持方面水平高者其心理状况优于社会支持水平低者(P＜0.01)。⑥心理干预组和对照组两组脊髓型颈椎病患者手术前,SCL-90各因子分无统计学差异:术后对照组在躯体化、抑郁、焦虑因子分上与术前比较有组内差异(P＜0.05);术后心理干预组在躯体化、抑郁、焦虑、恐怖因子分上与术前比较有组内差异(P＜0.05);术后心理干预组在躯体化、抑郁、焦虑、恐怖因子分上与对照组比较有组间差异(P＜0.05)。⑦心理干预组与对照组间的术后改善率比较差异有显著性意义(P＜0.05)。结论①脊髓型颈椎病患者术前存在抑郁、焦虑、恐怖等多种心理症状。②脊髓型颈椎病患者心理症状出现与其人格特征(特别是神经质及精神质)相关。③良好的社会支持有利于脊髓型颈椎病患者的心身健康。④心理干预措施有利于改善脊髓型颈椎病手术患者的心理症状及躯体功能恢复。
[Abstract]:Objective to investigate the preoperative mental health status of patients with cervical Spondylotic myelopathy (CSM) and its related psycho-social factors. To provide scientific basis for the surgical treatment of cervical Spondylotic myelopathy and the corresponding psychological intervention measures. Methods A total of 100 patients with cervical Spondylotic myelopathy who were hospitalized for surgical treatment were investigated with general information questionnaire within two days after admission. SCL-90, Eysenck Personality questionnaire (Eysenck Personality questionnaire), Social support scale (SSRS), Japanese Orthopedic Society (JOA), Spinal Cord function Assessment (SCL-90) were used to assess the general situation, mental health status and personality characteristics of the patients. Social support and spinal cord function were measured. Then the patients were randomly divided into psychological intervention group according to the order of admission. Psychological intervention was given to the control group (routine operation in hospital). All patients were examined with symptom checklist and spinal cord function scale again after operation. 100 of them were admitted to hospital with SCL-90. The results of Eysenck Personality questionnaire and Social support scale were compared with Chinese norm, and the relationship between personality characteristics, social support and mental health was discussed. The results of SCL-90 and JOA before and after operation in the psychological intervention group and the control group were studied to understand the influence of the operation and psychological intervention on the patients. Results 1 the total score, mean score, somatization, obsessive-compulsive state, depression, anxiety, phobic anxiety, psychotic factor scores of the SCL-90 patients with cervical Spondylotic myelopathy were higher than those of the Chinese norm. There was significant difference (P < 0.01), the score of sensitive factor of interpersonal relationship was lower than that of Chinese norm, and the scores of EPQ in patients with cervical Spondylotic myelopathy were significantly higher than those in Chinese norm. The scores of neuroticism and psychoticism in EPQ were significantly higher than those in Chinese norm. The difference was significant (P < 0.05). There was a positive correlation between neuroticism factor score and SCL-90 factor score in EPQ, positive correlation between psychoticism factor score and somatization, depression, anxiety, psychotic factor score and total score, between neuroticism factor score and SCL-90 factor score in patients with cervical Spondylotic myelopathy (P < 0.05). Anxiety, hostility, terror factor scores were negatively correlated, Negative correlation between extroversion factor score and phobic factor score. 4. The preoperative social support level in patients with cervical Spondylotic myelopathy is higher than that in the normal population (P < 0.01). 5. The psychological status of the patients with cervical Spondylotic myelopathy before operation is superior to that of the society. The scores of SCL-90 in patients with cervical Spondylotic myelopathy before operation were not significantly different between the two groups (P < 0.01) and control group (P < 0.01). The scores of depression and anxiety factors were significantly higher than those before operation (P < 0.05); the scores of somatization, depression, anxiety and phobic anxiety were significantly higher in the post-operative psychological intervention group than before (P < 0.05); the scores of somatization, depression, anxiety in the postoperative psychological intervention group were significantly different from those before operation (P < 0.05). There was significant difference in the scores of phobic factors between the two groups (P < 0.05). There was significant difference in the postoperative improvement rate between the psychological intervention group and the control group (P < 0.05). Conclusion 1patients with cervical Spondylotic myelopathy have depression and anxiety before operation. Psychological symptoms of Cervical Spondylotic Spondylotic Spondylotic Myelopathy. The intervention is helpful to improve the psychological symptoms and the recovery of somatic function in patients with cervical Spondylotic myelopathy (cervical Spondylotic myelopathy).
【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2009
【分类号】：R395.5

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