癌症患者家属负性情绪的调查及其综合干预研究

发布时间：2018-05-31 17:05

本文选题：癌症患者家属 + 综合心理干预　；参考：《山西医科大学》2013年硕士论文

【摘要】：目的：测查癌症晚期患者家属的负性情绪、压力、疲劳的现状,了解晚期癌症患者家属的负性情绪、照顾者压力、疲劳状况的关系。探讨综合性心理干预对癌症晚期患者家属负性情绪的作用,提高其生活质量。对象：以山西省肿瘤医院宁养院2012年3月到11月的癌症晚期患者的家属为研究对象。对符合入组条件的218人进行问卷调查。对其中有焦虑、抑郁的患者家属86人进行干预研究。方法：1.调查研究：通过面对面的访谈和问卷调查的方式对218名家属进行调查,研究工具包括家属的人口统计学资料、焦虑自评量表(SAS)、抑郁自评量表(SDS)、照顾者压力量表(CBI)、照顾者疲劳量表(FAI)。 2.干预研究：将符合条件的86人随机分为两组,每组43人。对照组,不进行系统的心理干预,对干预组进行综合心理干预：包括认知疗法、心理支持、身心灵全人健康模式等团体辅导方式。团体活动分为4次活动,每次60分钟左右。干预结束后,采用焦虑、抑郁问卷进行后测。对照组不参加本次系统的心理干预。结果：1.在患者家属中,女性的比例(65.1%)比男性的比例(34.9%)高；汉族的比例(94.0%)比少数民族的高。文化程度中,高中的比例(24.8%)最高,而小学的比例为22.5%,初中的为44.0%,大学及以上的为8.3%。在有无宗教信仰上,有宗教信仰的比例(10.6%)高于无宗教信仰的比例(89.4%)；经济收入月平均收入小于300元的比例为34.0%,收入为300-600元的比例为42.7%,收入为600元以上的比例为24.4%；家属的角色中,配偶的比例为33.0%,子女的比例为56.9%,兄弟姐妹的比例为6.0%,父母的比例为4.1%。 2.在患者家属中,有焦虑情绪的家属为97人,比例为44.5%,有抑郁情绪的家属人数为121,比例为55.5%。无焦虑的比例为55.5%,得分为38.79±5.21轻度焦虑的家属的比例为40.4%,得分为53.23±2.20；,中度焦虑的家属比例为3.20%,得分为62.71±2.36,重度焦虑的家属比例为0.90%,得分为70.50±0.71。女性和男性在有无焦虑情绪比较中,差异有统计学意义(P0.001)；在民族上,汉族和少数民族在不同焦虑情绪等级比较中,差异无统计学意义(P=0.304)；在文化程度上,小学、初中、高中和大学及以上在不同焦虑情绪等级的比较差异无统计学意义(P=0.437)；在宗教信仰上的不同焦虑情绪等级比较中,差异无统计学意义(P=0.584);在经济收入中,月平均收入小于300元、300-600元、600元以上在不同焦虑情绪等级的比较差异有统计学意义(P0.05)；家庭角色中,配偶、子女、兄弟姐妹、父母在不同焦虑情绪等级的比较差异有统计学意义(P0.05)。 3.无抑郁情绪的家属的比例为50%,得分为43.16±6.62,轻度抑郁的家属的比例为45.41%,得分为55.67±2.18；中度抑郁的家属比例为3.21%,得分为64.57±2.15;重度抑郁的家属比例为1.38%,得分为73.33±0.58。女性和男性在不同抑郁情绪等级比较中,差异有统计学意义(P0.05)；在民族上,汉族和少数民族在不同抑郁情绪等级比较中,差异有统计学意义(P0.001)；在文化程度上,小学、初中、高中和大学及以上在不同抑郁情绪等级的比较差异无统计学意义(P=0.071)；在宗教信仰上的不同抑郁情绪等级比较中,差异有统计学意义(P=0.002)；在经济收入中,月平均收入小于300元、300-600元、600元以上在不同抑郁情绪等级的比较差异有统计学意义(P=0.442)；家庭角色中,配偶、子女、兄弟姐妹、父母在不同抑郁情绪等级的比较差异有统计学意义(P0.001)。 4.患者家属的压力水平中,轻度压力的比例为4.59%,得分25.30±8.67；中度压力的比例为86.24%,得分为50.48±7.29；重度的压力比例为9.17%,得分为51.33±11.21。患者家属的疲劳程度中,轻度疲劳的比例为5.05%,疲劳的得分为59.55±11.35,中度疲劳的比例为92.2%,得分为91.98±11.95；重度的疲劳比例为2.75%,得分为144.33±5.05。经济情况好较经济情况差的家属的压力、疲劳水平低。 5.在相关分析中,焦虑与抑郁存在高度相关(r=0.625,P0.001)；焦虑、压力呈高度相关(r=0.543,P0.001)；抑郁与疲劳呈高度相关(r=0.564,P0.001)。在有其他因素的影响的偏相关中,焦虑和抑郁存在高度相关(r=0.514,P0.001)；焦虑和压力呈高度相关(r=0.522,P0.001)；焦虑和疲劳呈高度相关(r=0.513,P0.001)。 6.调查研究显示,符合入组条件的218人中,有焦虑抑郁情绪者86人,焦虑抑郁的检出率为39.45%。干预组患者家属焦虑情绪得到明显改善,前后比较有显著性差异(t=4.225,P0.001)；干预组患者家属抑郁情绪得到明显改善,前后比较有显著性差异t=4.345,P0.001)。结论：1.晚期癌症病人的家属普遍存在焦虑、抑郁情绪,压力和疲劳水平较高,不同性别、年龄、文化程度、照顾者角色的负性情绪、压力、疲劳存在差异。 2癌症晚期患者家属的负性情绪与压力、疲劳程度存在相关关系。 3综合心理干预对癌症晚期患者家属的负性情绪有一定的改善。
[Abstract]:Objective : To investigate the relationship between negative emotion , pressure and fatigue of family members of patients with advanced cancer .

Subjects : The family of patients with advanced cancer from March to November 2012 was investigated by questionnaires from 218 people who met the condition of enrollment . 86 patients with anxiety and depression were investigated .

Methods : 1 . Investigation and study : 218 family members were investigated by face - to - face interviews and questionnaires . The tools include family demographics , anxiety self - rating scale ( SAS ) , depression self - rating scale ( SDS ) , caregiver stress scale ( CBI ) , and caregiver fatigue scale .

2 . Intervention study : Eighty - six eligible persons were randomly divided into two groups , 43 in each group .

Results : 1 . In the family of patients , the proportion of female ( 65.1 % ) was higher than that of men ( 34.9 % ) ;
The proportion of the Han nationality ( 94.0 % ) is higher than that of the minority nationality . The proportion of high school is 22.5 % , the proportion of primary school is 44.0 % , the university and above are 8.3 % , and the proportion of religious belief ( 10.6 % ) is higher than that of non - religious belief ( 89.4 % ) .
The average monthly income of economic income is 34.0 % , the income is CNY 300 - 600 , the ratio is 42.7 % , and the proportion of income is CNY 600 or more ;
In the family ' s role , the proportion of spouses is 33.0 % , the proportion of children is 56.9 % , the ratio of siblings is 6.0 % , and the proportion of parents is 4.1 % .

2 . In the family of the patients , there were 97 families with anxiety feeling , the proportion was 44.5 % , the number of family members with depressive emotion was 121 , the proportion was 55.5 % . The proportion of non - anxiety was 55.5 % , and the proportion of family members divided into 38.79 卤 5.21 mild anxiety was 40.4 % , and the score was 53.23 卤 2.20 ;
The proportion of family members with moderate anxiety was 3.20 % , and the proportion of family members was 62.71 卤 2.36 . The proportion of family members with severe anxiety was 0.90 % , and the score was 70.50 卤 0.71 . There was significant difference between women and men in the absence of anxiety . ( P 0.001 ) ;
There was no significant difference between the Han nationality and the ethnic minorities in different levels of anxiety and emotion ( P = 0.304 ) .
There was no significant difference in the levels of anxiety among primary , junior , high and high schools and above ( P = 0.437 ) .
There was no significant difference between different levels of anxiety and emotion in religious belief ( P = 0.584 ) ; in the economic income , monthly average income was less than 300 yuan , 300 - 600 yuan , more than 600 yuan had statistical significance at different levels of anxiety emotion ( P0.05 ) ;
In the family role , the differences between spouses , children , siblings and parents in different levels of anxiety were statistically significant ( P0.05 ) .

3 . The proportion of family members without depressive emotion was 50 % , which was 43.16 卤 6.62 , and the proportion of family members with mild depression was 45.41 % , which was divided into 55.67 卤 2.18 ;
The proportion of patients with moderate depression was 3.21 % , which was 64.57 卤 2.15 ; the proportion of family members with severe depression was 1.38 % , which was 73.33 卤 0.58 . There was significant difference between female and men in different depressive emotion levels ( P0.05 ) .
There was significant difference between the Han nationality and the national minorities in different depressive emotion levels ( P0.001 ) .
There was no significant difference in the levels of depression among primary , middle and high schools and above at the level of culture ( P = 0.071 ) .
There was a significant difference among different depressive emotion levels in religious belief ( P = 0.002 ) .
In the economic income , the monthly average income was less than 300 yuan , 300 - 600 yuan , more than 600 yuan had statistical significance in different depressive emotion levels ( P = 0.442 ) ;
In the family role , the differences between spouses , children , siblings and parents in different levels of depression were statistically significant ( P0.001 ) .

4 . The proportion of mild stress was 4.59 % and the score was 25.30 卤 8.67 .
The proportion of moderate pressure was 86.24 % , which was divided into 50.48 卤 7.29 ;
The proportion of severe fatigue was 9.17 % , which was 51.33 卤 11.21 . The proportion of mild fatigue was 5.05 % , the fatigue score was 59.55 卤 11.35 , the proportion of moderate fatigue was 92.2 % , and the score was 91.98 卤 11.95 ;
The ratio of fatigue to severe fatigue was 2.75 % , and it was divided into 144.33 卤 5.05 . The economic condition is better than that of families with worse economic conditions , and the fatigue level is low .

5 . There was a high correlation between anxiety and depression in the correlation analysis ( r = 0 . 625 , P 0 . 001 ) .
There was a high correlation between anxiety and stress ( r = 0.543 , P0.001 ) .
Depression and fatigue were highly correlated ( r = 0.564 , P0.001 ) . There was a high correlation between anxiety and depression in migraine with other factors ( r = 0.514 , P0.001 ) ;
There was a high correlation between anxiety and stress ( r = 0.522 , P0.001 ) .
There was a high correlation between anxiety and fatigue ( r = 0.513 , P0.001 ) .

6 . The study showed that 86 people who had anxiety and depression were among 218 people who met the condition of enrollment . The prevalence rate of anxiety and depression was 39.45 % . The anxiety of family members in the intervention group was significantly improved , and there was a significant difference between them ( t = 4.225 , P0.001 ) .
The depressed mood of family members was significantly improved in the intervention group ( t = 4.345 , P0.001 ) .

Conclusion : 1 . The family members of advanced cancer patients generally have higher anxiety , depression , stress and fatigue level , different sex , age , culture degree , negative emotion , pressure and fatigue of the role of caregivers .

The negative emotion of family members in late stage of cancer is related to stress and fatigue degree .

3 Comprehensive psychological intervention has some improvement to the negative emotion of family members of patients with advanced cancer .
【学位授予单位】：山西医科大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：B842.6;R89

【参考文献】