飞行员消化性溃疡患者心理影响因素及干预研究

发布时间：2018-04-11 10:39

本文选题：心理干预 + 飞行员　；参考：《第四军医大学》2011年硕士论文

【摘要】：随着全球经济化、工业化、城市化和科技化的发展,心身疾病的发病率不断增加,约占综合医院就诊率的1/3。已有研究证实,心身疾病的发生、发展、转归、预后和治疗与心理社会因素关系密切。消化性溃疡是常见的心身疾病,尤其是对于飞行员这一特殊职业,个性特征,情绪因素,社会支持度,生活负性事件等都会影响心身疾病的治疗和康复。因此,本研究在药物治疗的基础上,研究影响飞行员消化性溃疡患者的社会心理因素,探索系统有效的治疗飞行员消化性溃疡患者的心理综合疗法,达到心理干预的目的。本研究采用艾森克人格问卷评估飞行员消化性溃疡患者的人格特征,症状自评量表评估飞行员消化性溃疡患者的心理健康状况及情绪特征,生活事件量表和社会支持量表分别评定飞行员消化性溃疡患者的应激事件和社会支持情况。通过研究主要发现: (1)艾森克人格问卷结果显示,飞行员消化性溃疡患者的稳定性(57.63±10.24)明显高于健康对照组(48.92±8.31),症状自评量表中飞行员消化性溃疡患者的躯体化、强迫、人际关系、抑郁、焦虑、恐怖、偏执、精神病性因子分显著高于健康对照组,生活事件量表中飞行员消化性溃疡患者的负性生活事件分值(18.46±13.81)明显高于健康对照组(7.29±5.01),社会支持量表中飞行员消化性溃疡患者的社会总支持分值(22.79±1.02)明显低于健康对照组(30.04±1.79)。 (2)在药物治疗的基础上,采用个体和团体相结合的形式,应用心理综合疗法,开展飞行员消化性溃疡患者的心理治疗。社会支持量表结果显示,干预组的社会总支持分值(29.12±1.67)显著高于治疗前分值(22.51±1.64),同时显著高于对照组(23.86±1.58),而对照组的社会总支持分值在治疗前后无显著差异。症状自评量表中干预组躯体化、强迫、人际关系、抑郁、焦虑、恐怖各因子分在治疗后均显著低于治疗前,而对照组在治疗前后各因子分均无显著差异。经追踪随访发现,干预组的治愈率(95.34%)显著高于对照组(70.45%),卡方检验X2=9.445,p0.05;干预组的复发率(11.63%)明显低于对照组(40.91%),卡方检验X~2=6.198,p0.05。研究结论:(1)飞行员消化性溃疡患者情绪不稳定,易紧张,焦虑,生活中经历的负性生活事件较多,得到的社会支持较少。这些心理社会因素在消化性溃疡的发生、发展、转归的过程中都是不可忽视的重要因素。 (2)针对飞行员自身的职业及心理特点,在临床药物治疗(三联法)的基础上,建立系统的心理综合疗法,包括认知疗法,行为疗法,支持疗法,放松疗法和音乐疗法,进行飞行员消化性溃疡患者的心理治疗,提升飞行员消化性溃疡患者的心理健康程度,缩短了治疗时间,有效提高飞行员消化性溃疡患者的治愈率,降低飞行员消化性溃疡患者的复发率,为临床医生开展心理治疗提供理论和实践依据。
[Abstract]:With the development of global economy, industrialization, urbanization and science and technology, the incidence of psychosomatic diseases is increasing, accounting for about one-third of the total hospital visits.The occurrence, development, outcome, prognosis and treatment of psychosomatic diseases have been confirmed to be closely related to psychosocial factors.Peptic ulcer is a common psychosomatic disease, especially for pilots, such as special occupation, personality, emotional factors, social support, negative life events and so on, which will affect the treatment and rehabilitation of psychosomatic diseases.Therefore, on the basis of drug therapy, this study studied the social and psychological factors affecting pilots with peptic ulcer, and explored a systematic and effective psychotherapy for pilots with peptic ulcer to achieve the purpose of psychological intervention.In this study, Eysenck Personality questionnaire (Eysenck Personality questionnaire) was used to assess the personality characteristics of pilots with peptic ulcer, and the symptom Checklist (SCL-90) was used to assess the mental health and emotional characteristics of pilots with peptic ulcer.Life events scale and social support scale were used to evaluate stress events and social support in pilots with peptic ulcer.The main findings of the study are as follows:The results of Eysenck Personality questionnaire showed that the stability of the pilots with peptic ulcer was 57.63 卤10.24), which was significantly higher than that of the healthy control group (48.92 卤8.31). Somatization, compulsion, interpersonal relationship, depression, anxiety and phobia in the pilots with peptic ulcer in the symptom Checklist-90 (SCL-90) were significantly higher than those in the control group.The scores of paranoid and psychotic factors were significantly higher than those of the healthy control group.The score of negative life events in pilots with peptic ulcer was 18.46 卤13.81), which was significantly higher than that in healthy control group (7.29 卤5.01). The total social support score of pilots with peptic ulcer in social support scale was 22.79 卤1.02), which was significantly lower than that in healthy control group (30.04 卤1.79g).(2) on the basis of drug therapy, the patients with peptic ulcer in pilots were treated by the combination of individual and group and comprehensive psychotherapy.The results of social support scale showed that the score of total social support in the intervention group was 29.12 卤1.67) significantly higher than that before treatment (22.51 卤1.64) and 23.86 卤1.58 in the control group, but there was no significant difference in the total social support score before and after treatment in the control group.The scores of somatization, compulsion, interpersonal relationship, depression, anxiety and phobia in the intervention group were significantly lower than those before and after treatment, but there was no significant difference between the control group and the control group before and after treatment.Conclusion: (1) the pilots with peptic ulcer had unstable mood, easy tension, anxiety, more negative life events and less social support.These psycho-social factors are important factors which can not be ignored in the process of the occurrence, development and prognosis of peptic ulcer.(2) based on the professional and psychological characteristics of the pilots themselves and on the basis of clinical drug therapy (triple therapy), a systematic psychotherapy, including cognitive therapy, behavioral therapy, support therapy, relaxation therapy and music therapy, is established.In order to improve the mental health of pilots with peptic ulcer and shorten the time of treatment, it can effectively improve the cure rate of pilots with peptic ulcer.To reduce the recurrence rate of pilots with peptic ulcer and to provide theoretical and practical basis for clinical doctors to carry out psychotherapy.
【学位授予单位】：第四军医大学
【学位级别】：硕士
【学位授予年份】：2011
【分类号】：R85

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