个体电脑游戏版豁达治疗对中晚期肺癌作用的研究
发布时间：2018-08-08 12:56
【摘要】：背景:肺癌的死亡率居高不下,是恶性肿瘤中发病率最高的肿瘤之一。因其发病较为隐匿,早期常常无明显症状,绝大多数患者一经诊断即为中晚期肺癌。被确诊为肺癌后,多数患者会出现焦虑不安、抑郁、消极等情绪,再加上治疗中产生的强烈的不良反应以及让人无法忍受的癌性疼痛,就会使绝望悲观的情绪更为严重,这种不良心理恶性循环使肺癌临床常规治疗更为困难,因此如何减轻中晚期肺癌患者消极情绪,改善心身状态,辅助临床治疗,提高他们的生存质量,成为当今研究的热点。目的:研究制作改良版个体电脑游戏版豁达治疗,探讨个体电脑游戏版豁达治疗在心理、生理以及社会等方面对中晚期肺癌患者临床疗效的影响,为促进中晚期肺癌患者身心康复提供理论方法和实证依据。方法:1、研究制作改良版个体电脑游戏版豁达治疗(Individual Computer Game-version Magnanimous Therapy,ICGMT),选取生动有趣、贴近生活、富有哲理的8个小故事,并将其编辑成Flash动画形式;随着情节的发展会穿插相关的问题,伴随“积极”“消极”的选项;每次作出不同的选择,故事将会沿不同的方向发展,最终得出不同的结果;每完成一次视频游戏后,系统会自动记分。2、将60例中晚期肺癌住院患者依照匹配分组原则,分为ICGMT组和对照组各30人。ICGMT组除常规治疗外,并在电脑上进行一对一的个体电脑游戏版豁达治疗2周,一周4次,一次约40分钟;对照组仅用肿瘤临床常规治疗,不给予豁达治疗。两组患者在治疗前后分别采用癌症心身状态问卷、T型心理量表、癌症患者心理调节量表、癌症应对问卷、进取豁达问卷、癌症病人生活功能指标量表、医院焦虑抑郁量表和潜意识绘画房-树-人测验作为患者心理、社会指标评价;所有参与者两周前后用生物反馈治疗仪记录脑电波、血压、心率和呼吸各值,采集静脉血检查免疫细胞Ig A、Ig G、Ig M、NK值作为患者生理指标评价;观察比较两组在实验前后心身状况、心理应对、调节方式、生活质量和生理指标等多方面的变化情况,以评估疗效。结果:1.研制而成改良版个体电脑游戏版豁达治疗(ICGMT)。2.患者心理、社会指标结果(1)癌症心身状态问卷评分:ICGMT组干预2周后总分、“心理”维度、“躯体”维度、“社会功能”维度、“心理行为可塑性”维度评分(30.70±3.98、8.10±1.63、7.20±1.21、8.2±1.45、7.00±1.01)均低于入院时(35.90±4.91、10.03±2.11、8.60±1.75、9.2±1.87、8.07±1.33),差异有统计学意义(p0.01);对照组2周后总分、“心理”、“躯体”、“社会功能”维度评分(40.08±1.11、11.94±4.38、10.22±2.13、14.01±3.78)均高于入院时(35.33±1.37、10.83±4.28、7.71±2.41、9.89±4.23),差异有显著性(p0.01),而在“心理行为可塑性”维度评分(9.01±3.54)与入院时(8.78±1.09)相比,差异无统计学意义(p0.05)。(2)T型心理量表评分:ICGMT组与对照组在总均分、“个性特点”、“认知习惯”、“情绪表现”和“潜意识”五个维度与入院时相比,差异均无统计学意义(p0.05)。(3)癌症患者心理调节量表评分:ICGMT组干预后总均分、“情绪/自尊”、“主观感觉”、“人际关系/社会生活”、“日常生活”和“其他”五个维度(3.40±0.33、3.65±0.54、3.53±0.41、3.53±0.34、2.89±0.45、3.37±0.59)均高于入院时(3.35±0.52、3.57±0.43、3.41±0.51、2.77±0.48、3.51±0.33、3.29±0.51),差异有显著性(p0.01);对照组2周后总均分、“情绪/自尊”、“主观感觉”、“人际关系/社会生活”、“日常生活”和“其他”五个维度(3.29±0.49、3.72±0.74、3.38±0.64、2.69±0.21、3.87±0.24、3.45±0.81)与入院时(3.31±0.64、3.73±1.49、3.39±0.52、2.71±0.42、3.89±0.32、3.47±0.49)均降低,但差异无统计学意义(p0.05)。(4)癌症应对问卷评分:ICGMT组干预后总均分、“面对”维度(2.34±0.14、2.77±0.55)高于入院时(2.29±0.23、2.48±0.52),“回避与压抑”和“屈服”维度(1.73±0.69、2.10±0.55)低于入院时(2.00±0.51、1.73±0.69),差异有显著性(p0.05);而在“幻想”和“发泄”维度(2.05±1.46、1.56±5.67)与入院时(2.04±0.61、1.55±0.41)相比,差异无统计学意义(p0.05);对照组2周后“面对”维度(2.41±0.39)低于入院时(2.56±0.41),差异有显著性(p0.05)。而总均分、“回避与压抑”、“屈服”、“幻想”、“发泄”四个维度维度(2.01±1.45、2.14±0.29、2.43±0.58、2.12±0.11、1.42±0.56)与入院时(1.99±1.08、2.13±0.63、2.46±0.44、2.01±0.22、1.43±0.58)相比,差异无统计学意义(p0.05)。(5)进取豁达问卷评分:ICGMT组干预后总分、“积极进取”维度(72.35±6.76、36.71±4.09)高于入院时(70.56±7.89、35.45±4.54),差异有显著性(p0.05);而在“豁达宽容”维度(36.27±3.55)与干预前(36.01±4.06)相比,差异无统计学意义(p0.05);对照组2周后总分、“豁达宽容”维度(70.81±6.21、35.20±1.89)与入院时(71.11±8.30、35.09±1.21)相比,差异无统计学意义(p0.05);“积极进取”维度(30.07±1.89)较2周前(34.11±2.11)降低,差异有显著性(p0.05)。(6)癌症病人生活功能指标量表评分:ICGMT组干预后总均分、“躯体良好”维度、“心理良好”维度、“社会良好”维度(4.38±1.21、4.63±1.03、4.93±0.37、5.80±1.24)高于入院时(4.13±0.67、4.34±1.31、4.86±0.88、5.67±1.15),差异有显著性(p0.05);“因癌造成的艰难”维度、“恶心”维度(3.23±1.28、4.03±1.52)低于入院时(3.72±1.54、4.78±1.82),差异有显著性(p0.01)。对照组2周后“躯体良好”维度、“心理良好”维度(3.56±1.23、4.15±1.09)低于入院时(4.11±0.98、4.77±1.22),差异有显著性(p0.05);“恶心”维度、“因癌造成的艰难”维度(4.47±2.01、3.33±1.29)高于入院时(4.46±3.21、3.21±1.04),总均分、“社会良好”维度(3.87±0.37、5.49±1.11)均低于入院时(3.88±0.52、5.55±1.09),但差异无显著性(p0.05)。(7)医院焦虑抑郁量表评分:ICGMT组干预2周后总分、焦虑评分、抑郁评分(13.23±3.12、5.99±2.13、7.87±2.24)低于入院时(16.12±3.67、6.67±2.31、9.45±2.78),差异有显著性(p0.01);对照组2周后总分、焦虑评分、抑郁评分(19.23±3.16、8.99±4.13、10.87±2.24)高于入院时(17.13±4.57、6.98±2.39、9.85±2.18),差异有显著性(p0.01)。(8)房-树-人测验:ICGMT组干预2周后,房-树-人绘画内容较之前充实,各部分布局完整无缺失,比例适中,线头连续、画面清晰、笔触果决,无反复修改痕迹,画面寓意更积极更阳光,消极投射点大幅度降低;而对照组2周后,整体画面清晰度无明显改善,房树人各个部分仍不完整,画面仍显单调,整副影像严重偏向图纸一方,大小比例仍失衡,落笔无力、犹豫不决,线条弯弯曲曲,存在许多反复修改的痕迹,画面寓意消极悲观,积极投射点显著降低。3.患者生理指标结果(1)ICGMT组经心理干预后,收缩压值、舒张压值、心率值和呼吸值(129.55±7.23、80.31±8.09、84.55±4.38、17.47±1.35)与入院时(134.78±7.57、85.77±9.23、87.11±8.22、19.56±2.11)相比,均降低,差异有统计学意义(p0.05)。对照组与入院时相比,差异无统计学意义。(2)脑电波和皮电、皮温值比较:ICGMT组干预2周后,α波值(35.94±0.98)高于入院时(34.85±1.69),θ波值(3.69±1.61)低于入院时(4.68±1.78),差异均有统计学意义(p0.01);对照组2周后,θ波(28.71±4.56)高于入院时(24.51±8.21),α波值(9.39±3.52)低于入院(11.65±4.94),差异均有显著性(p0.01)。ICGMT组和对照组在皮电值、皮温值、β波值和SMR波值与入院时相比,差异均无统计学意义(p0.05)。(3)免疫细胞Ig A、Ig G、Ig M、NK值比较:ICGMT组干预2周后,Ig A、Ig G、Ig M、NK细胞值(2.55±3.23、14.87+4.27、1.48±0.13、0.35±0.47)均高于入院时(2.29±2.10、10.43+3.14、1.01±0.88、0.21±0.23),差异有显著性(p0.05);对照组2周后,Ig A、Ig G、Ig M、NK细胞值(1.55±1.19、9.57±5.19、1.35±0.61、0.21±0.21)均低于入院时(2.18±1.10、10.92±3.91、1.61±0.88、0.35±0.13),差异有显著性(p0.05)。4.临床定性评价大部分中晚期肺癌患者认为电脑游戏版豁达治疗生动有趣、贴近生活,再现了患者平时内心的纠结;富有哲理,通过向患者传递易于理解的道理,纠正他们歪曲的认知和消极的想法;操作简单,适合不同年龄层次。使患者无论在心身状况、心理应对、调节方式、生活质量和生理指标等方面均有所改善,受到患者一致好评。结论:个体电脑游戏版豁达治疗是一种规范、生动、实用、有效的心理干预方式,帮助患者逐步养成积极乐观的人生态度,达到豁达的人生境界。此治疗对于提高中晚期肺癌患者心身状况、心理应对、调节方式、社会功能和生活质量均有积极作用;对于患者生理指标尤其是免疫功能,也有相对较大的改善。作为一种有效地心理干预方式,帮助肺癌住院患者提高生存质量,为以后的癌症临床工作提供了有力的实证依据。
[Abstract]:Background: the mortality of lung cancer is high. It is one of the most malignant tumors in the malignant tumor. Because of its insidious incidence and no obvious symptoms in the early stage, most patients are diagnosed as middle and late lung cancer. After being diagnosed as lung cancer, most patients have anxiety, depression, negative emotions, combined with treatment. The strong adverse reaction and unbearable cancer pain will make the despair and pessimistic mood more serious. This bad psychological vicious circle makes the lung cancer clinical routine treatment more difficult, so how to reduce the negative emotion, improve the mental state, assist the clinical treatment and improve the quality of life of the patients with middle and late lung cancer. Objective: To study and make an improved version of the individual computer game version of the open-minded therapy, to explore the effect of the individual computer game on the clinical efficacy of the patients with middle and advanced lung cancer in the psychological, physiological and social aspects, and to provide a theoretical and empirical basis for the promotion of Shen Xinkang in the middle and late stage lung cancer patients. Method: 1, Make the improved version of Individual Computer Game-version Magnanimous Therapy (ICGMT), select 8 small stories that are lively and interesting, close to life, and be rich in philosophy, and edit them into Flash animated forms; with the development of the plot, they will be interspersed with the question of "positive" and "negative"; each time To make different choices, the story will develop in different directions and finally get different results. After each video game, the system will automatically score.2. 60 cases of advanced lung cancer patients are divided into group ICGMT and control group, each of which is divided into group ICGMT and control group.ICGMT except routine treatment, and one to one on the computer. The individual computer game edition was treated for 2 weeks, 4 times a week, and one time for about 40 minutes. The control group only used the tumor clinical routine treatment and no open-minded treatment. The two groups were treated with the cancer psychosomatic state questionnaire, the T mental scale, the cancer patient psychological adjustment scale, the cancer coping questionnaire, the enterprising and open-minded questionnaire, the cancer patient's life. The function index scale, the Hospital Anxiety Depression Scale and the subconscious painting room - tree - man test were used as the patients' psychological and social indicators. All the participants recorded brain wave, blood pressure, heart rate and respiratory value by biofeedback therapy instrument before and after two weeks, and collected venous blood to examine immuno cell Ig A, Ig G, Ig M, NK value as the evaluation of physiological indexes of patients. The two groups were compared before and after the experiment, such as psychosomatic condition, psychological response, adjustment mode, quality of life and physiological indexes, and so on to evaluate the effect. Results: 1. developed a modified version of the individual computer game version of open-minded therapy (ICGMT).2. patients' psychological, social indicators (1) cancer psychosomatic state questionnaire score: group ICGMT intervention 2 weeks later. The total score, "psychological" dimension, "body" dimension, "social function" dimension, "psychological behavior plasticity" score (30.70 + 3.98,8.10 + 1.63,7.20 + 1.21,8.2 + 1.45,7.00 + 1.01) were lower than admission (35.90 + 4.91,10.03 + 2.11,8.60 + 1.75,9.2 + 1.87,8.07 + 1.33), and the difference was statistically significant (P0.01), and the total score of the control group after 2 weeks, " The score of "psychological", "body" and "social function" (40.08 + 1.11,11.94 + 4.38,10.22 + 2.13,14.01 + 3.78) were higher than that of admission (35.33 + 1.37,10.83 + 4.28,7.71 + 2.41,9.89 + 4.23), and the difference was significant (P0.01), but there was no statistical difference between the "psychological behavior plasticity" dimension score (9.01 + 3.54) and admission (8.78 + 1.09). Learning significance (P0.05). (2) T mental scale score: ICGMT group and control group in the total average, "personality", "cognitive habit", "emotional expression" and "subconscious", compared to the admission, the difference was not statistically significant (P0.05). (3) the psychological adjustment scale score of the cancer patients: the total average score of the ICGMT group, "emotion / self-esteem" "Subjective feeling", "interpersonal relationship / social life", "daily life" and "other" five dimensions (3.40 + 0.33,3.65 + 0.54,3.53 + 0.41,3.53 + 0.34,2.89 + 0.45,3.37 + 0.59) were higher than admission (3.35 + 0.52,3.57 + 0.43,3.41 + 0.51,2.77 + 0.48,3.51 + 0.33,3.29 + 0.51), the difference was significant (P0.01); the control group was 2 weeks after the total. The five dimensions of "emotion / self-esteem", "subjective feeling", "interpersonal relationship / social life", "daily life" and "other" (3.29 + 0.49,3.72 + 0.74,3.38 + 0.64,2.69 + 0.21,3.87 + 0.24,3.45 + 0.81) were all decreased with admission (3.31 + 0.64,3.73 + 1.49,3.39 + 0.52,2.71 + 0.42,3.89 + 0.32,3.47 + 0.49), but the difference was not statistically significant Learning significance (P0.05). (4) cancer Coping Questionnaire score: the total average score of the ICGMT group, the "face" dimension (2.34 + 0.14,2.77 + 0.55) was higher than that of admission (2.29 + 0.23,2.48 + 0.52), "avoidance and depression" and "yield" dimension (1.73 + 0.69,2.10 + 0.55) were lower than that of admission (2 + 0.51,1.73 + 0.69), and the difference was significant (P0.05). There was no significant difference in the dimension (2.05 + 1.46,1.56 + 5.67) and the admission (2.04 + 0.61,1.55 + 0.41), and the control group was lower than the admission (2.41 + 0.39) after 2 weeks (2.56 + 0.41), and the difference was significant (P0.05). The total equalization, "avoidance and depression", "yield", "fantasy", and "vent" four were significant. The dimension (2.01 + 1.45,2.14 + 0.29,2.43 + 0.58,2.12 + 0.11,1.42 + 0.56) had no significant difference compared with the admission (1.99 + 1.08,2.13 + 0.63,2.46 + 0.22,1.43 + 0.58). (5) the enterprising and open-minded questionnaire score: the total score of the ICGMT group and the positive enterprising dimension (72.35 + 4.09) was higher than that of the admission (70.5). 6 + 7.89,35.45 + 4.54), the difference was significant (P0.05), but there was no significant difference between the "open-minded tolerance" dimension (36.27 + 3.55) and the intervention (36.01 + 4.06) before the intervention (P0.05), and the total score of the control group after 2 weeks (70.81 + 6.21,35.20 + 1.89) and the admission (71.11 + 8.30,35.09 + 1.21) had no statistical significance (p0.0 5); the dimension of "aggressive" (30.07 + 1.89) was lower than that of 2 weeks (34.11 + 2.11), and the difference was significant (P0.05). (6) the scale score of the life function index of cancer patients: the total average score of the ICGMT group, the "good body" dimension, the "good psychological" dimension, and the "social good" dimension (4.38 + 1.21,4.63 + 0.37,5.80 + 1.24) were higher than that of the entry. In hospital (4.13 + 0.67,4.34 + 1.31,4.86 + 0.88,5.67 + 1.15), the difference was significant (P0.05); "nausea" dimension (3.23 + 1.28,4.03 + 1.52) was lower than that of admission (3.72 + 1.54,4.78 + 1.82). The difference was significant (P0.01). In the control group, "good body" dimension and "good psychological" dimension (3.56 + 1.23,4.15) after 2 weeks. The difference was significantly lower than that of admission (4.11 + 0.98,4.77 + 1.22), and the difference was significant (P0.05); the dimension of "nausea" and "the difficulty of cancer" (4.47 + 2.01,3.33 + 1.29) were higher than that of admission (4.46 + 3.21,3.21 + 1.04), the total average, and the "good social" dimension (3.87 + 0.37,5.49 + 1.11) were lower than that of admission (3.88 + 0.52,5.55 + 4.11), but the difference was not (P0.05). (7) the hospital anxiety and Depression Scale score: the total score, the anxiety score and the depression score (13.23 + 3.12,5.99 + 2.13,7.87 + 2.24) in the group ICGMT were lower than that of the admission (16.12 + 3.67,6.67 2.31,9.45 + 2.78), and the difference was significant (P0.01); the total score, anxiety score, and depression score (19.23 + 3.16,8.99 + 4.13,10.87 + 2.24) in the control group were 2 weeks later. ) higher than the admission (17.13 + 4.57,6.98 + 2.39,9.85 + 2.18), the difference was significant (P0.01). (8) room tree man test: 2 weeks after the intervention of group ICGMT, the content of room tree man painting was more full, the layout of each part was complete and no missing, the proportion was moderate, the line head was continuous, the picture was clear, the pen touched the fruit, no repeated modification marks, the picture allegedly more active more sunshine, disappear. After 2 weeks of the control group, the overall picture clarity did not improve obviously, the whole picture was still incomplete, the picture was still monotonous, the whole image was seriously biased toward the drawing side, the size ratio was still unbalance, the pen was weak, the line was irresolute, the lines were bending, the picture implied negative sadness. The positive projection points significantly reduced the results of.3. patients' physiological index (1) group ICGMT after psychological intervention, systolic pressure, diastolic pressure, heart rate and respiratory value (129.55 + 7.23,80.31 + 8.09,84.55 + 4.38,17.47 + 1.35) were lower than those at admission (134.78 + 7.57,85.77 + 9.23,87.11 + 8.22,19.56 + 2.11), and the difference was statistically significant (P0.05). There was no significant difference between the group and the admission group. (2) the comparison of brain wave and skin electricity and skin temperature: after 2 weeks of ICGMT intervention, the value of alpha wave (35.94 + 0.98) was higher than that of admission (34.85 + 1.69), and the value of theta wave (3.69 + 1.61) was lower than that of admission (4.68 + 1.78) (4.68 + 1.78), and the difference was all (P0.01). After the control group, theta wave (28.71 + 4.56) was higher than the admission (24.51) after 2 weeks (24.51). 8.21), the value of alpha wave (9.39 + 3.52) was lower than admission (11.65 + 4.94). The difference was significant (P0.01) in group.ICGMT and control group, there was no significant difference in skin electrical value, skin temperature, beta wave value and SMR wave value (P0.05). (3) immune cells Ig A, Ig G, Ig M, NK comparison: 2 weeks after ICGMT group intervention (2.55 + 3.) 23,14.87+4.27,1.48 + 0.13,0.35 + 0.47) was higher than that of admission (2.29 + 2.10,10.43+3.14,1.01 + 0.88,0.21 + 0.23), and the difference was significant (P0.05). After 2 weeks in the control group, Ig A, Ig G, Ig M, and NK cell values were lower than those of the admission (2.18 + and 2.18 + 0.21), and the difference was significant 0.05).4. clinical qualitative evaluation of most patients with middle and late stage lung cancer think that the computer game version of open-minded treatment is lively and interesting, close to life, reproduces the patient's innermost inner entanglement; rich philosophic, through the transfer of easy understanding to the patient, correct their distorted cognition and extreme ideas; simple operation, suitable for different age levels. Make patients suffer from different ages. No matter in heart and body condition, psychological coping, adjustment way, quality of life and physiological index, the patient is well received. Conclusion: the individual computer game version of open-minded treatment is a standard, vivid, practical and effective psychological intervention, helping the patients develop a positive and optimistic attitude towards life and achieve an open-minded life. This treatment has a positive effect on improving the psychosomatic condition, psychological response, adjustment mode, social function and quality of life for patients with middle and advanced lung cancer, and also has relatively large improvement on the patient's physiological index, especially the immune function. As an effective psychological intervention formula, it helps the patients with lung cancer improve the quality of life. The post cancer clinical work provides a strong empirical basis.
【学位授予单位】：广东药科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R734.2
本文编号：2171845
[Abstract]:Background: the mortality of lung cancer is high. It is one of the most malignant tumors in the malignant tumor. Because of its insidious incidence and no obvious symptoms in the early stage, most patients are diagnosed as middle and late lung cancer. After being diagnosed as lung cancer, most patients have anxiety, depression, negative emotions, combined with treatment. The strong adverse reaction and unbearable cancer pain will make the despair and pessimistic mood more serious. This bad psychological vicious circle makes the lung cancer clinical routine treatment more difficult, so how to reduce the negative emotion, improve the mental state, assist the clinical treatment and improve the quality of life of the patients with middle and late lung cancer. Objective: To study and make an improved version of the individual computer game version of the open-minded therapy, to explore the effect of the individual computer game on the clinical efficacy of the patients with middle and advanced lung cancer in the psychological, physiological and social aspects, and to provide a theoretical and empirical basis for the promotion of Shen Xinkang in the middle and late stage lung cancer patients. Method: 1, Make the improved version of Individual Computer Game-version Magnanimous Therapy (ICGMT), select 8 small stories that are lively and interesting, close to life, and be rich in philosophy, and edit them into Flash animated forms; with the development of the plot, they will be interspersed with the question of "positive" and "negative"; each time To make different choices, the story will develop in different directions and finally get different results. After each video game, the system will automatically score.2. 60 cases of advanced lung cancer patients are divided into group ICGMT and control group, each of which is divided into group ICGMT and control group.ICGMT except routine treatment, and one to one on the computer. The individual computer game edition was treated for 2 weeks, 4 times a week, and one time for about 40 minutes. The control group only used the tumor clinical routine treatment and no open-minded treatment. The two groups were treated with the cancer psychosomatic state questionnaire, the T mental scale, the cancer patient psychological adjustment scale, the cancer coping questionnaire, the enterprising and open-minded questionnaire, the cancer patient's life. The function index scale, the Hospital Anxiety Depression Scale and the subconscious painting room - tree - man test were used as the patients' psychological and social indicators. All the participants recorded brain wave, blood pressure, heart rate and respiratory value by biofeedback therapy instrument before and after two weeks, and collected venous blood to examine immuno cell Ig A, Ig G, Ig M, NK value as the evaluation of physiological indexes of patients. The two groups were compared before and after the experiment, such as psychosomatic condition, psychological response, adjustment mode, quality of life and physiological indexes, and so on to evaluate the effect. Results: 1. developed a modified version of the individual computer game version of open-minded therapy (ICGMT).2. patients' psychological, social indicators (1) cancer psychosomatic state questionnaire score: group ICGMT intervention 2 weeks later. The total score, "psychological" dimension, "body" dimension, "social function" dimension, "psychological behavior plasticity" score (30.70 + 3.98,8.10 + 1.63,7.20 + 1.21,8.2 + 1.45,7.00 + 1.01) were lower than admission (35.90 + 4.91,10.03 + 2.11,8.60 + 1.75,9.2 + 1.87,8.07 + 1.33), and the difference was statistically significant (P0.01), and the total score of the control group after 2 weeks, " The score of "psychological", "body" and "social function" (40.08 + 1.11,11.94 + 4.38,10.22 + 2.13,14.01 + 3.78) were higher than that of admission (35.33 + 1.37,10.83 + 4.28,7.71 + 2.41,9.89 + 4.23), and the difference was significant (P0.01), but there was no statistical difference between the "psychological behavior plasticity" dimension score (9.01 + 3.54) and admission (8.78 + 1.09). Learning significance (P0.05). (2) T mental scale score: ICGMT group and control group in the total average, "personality", "cognitive habit", "emotional expression" and "subconscious", compared to the admission, the difference was not statistically significant (P0.05). (3) the psychological adjustment scale score of the cancer patients: the total average score of the ICGMT group, "emotion / self-esteem" "Subjective feeling", "interpersonal relationship / social life", "daily life" and "other" five dimensions (3.40 + 0.33,3.65 + 0.54,3.53 + 0.41,3.53 + 0.34,2.89 + 0.45,3.37 + 0.59) were higher than admission (3.35 + 0.52,3.57 + 0.43,3.41 + 0.51,2.77 + 0.48,3.51 + 0.33,3.29 + 0.51), the difference was significant (P0.01); the control group was 2 weeks after the total. The five dimensions of "emotion / self-esteem", "subjective feeling", "interpersonal relationship / social life", "daily life" and "other" (3.29 + 0.49,3.72 + 0.74,3.38 + 0.64,2.69 + 0.21,3.87 + 0.24,3.45 + 0.81) were all decreased with admission (3.31 + 0.64,3.73 + 1.49,3.39 + 0.52,2.71 + 0.42,3.89 + 0.32,3.47 + 0.49), but the difference was not statistically significant Learning significance (P0.05). (4) cancer Coping Questionnaire score: the total average score of the ICGMT group, the "face" dimension (2.34 + 0.14,2.77 + 0.55) was higher than that of admission (2.29 + 0.23,2.48 + 0.52), "avoidance and depression" and "yield" dimension (1.73 + 0.69,2.10 + 0.55) were lower than that of admission (2 + 0.51,1.73 + 0.69), and the difference was significant (P0.05). There was no significant difference in the dimension (2.05 + 1.46,1.56 + 5.67) and the admission (2.04 + 0.61,1.55 + 0.41), and the control group was lower than the admission (2.41 + 0.39) after 2 weeks (2.56 + 0.41), and the difference was significant (P0.05). The total equalization, "avoidance and depression", "yield", "fantasy", and "vent" four were significant. The dimension (2.01 + 1.45,2.14 + 0.29,2.43 + 0.58,2.12 + 0.11,1.42 + 0.56) had no significant difference compared with the admission (1.99 + 1.08,2.13 + 0.63,2.46 + 0.22,1.43 + 0.58). (5) the enterprising and open-minded questionnaire score: the total score of the ICGMT group and the positive enterprising dimension (72.35 + 4.09) was higher than that of the admission (70.5). 6 + 7.89,35.45 + 4.54), the difference was significant (P0.05), but there was no significant difference between the "open-minded tolerance" dimension (36.27 + 3.55) and the intervention (36.01 + 4.06) before the intervention (P0.05), and the total score of the control group after 2 weeks (70.81 + 6.21,35.20 + 1.89) and the admission (71.11 + 8.30,35.09 + 1.21) had no statistical significance (p0.0 5); the dimension of "aggressive" (30.07 + 1.89) was lower than that of 2 weeks (34.11 + 2.11), and the difference was significant (P0.05). (6) the scale score of the life function index of cancer patients: the total average score of the ICGMT group, the "good body" dimension, the "good psychological" dimension, and the "social good" dimension (4.38 + 1.21,4.63 + 0.37,5.80 + 1.24) were higher than that of the entry. In hospital (4.13 + 0.67,4.34 + 1.31,4.86 + 0.88,5.67 + 1.15), the difference was significant (P0.05); "nausea" dimension (3.23 + 1.28,4.03 + 1.52) was lower than that of admission (3.72 + 1.54,4.78 + 1.82). The difference was significant (P0.01). In the control group, "good body" dimension and "good psychological" dimension (3.56 + 1.23,4.15) after 2 weeks. The difference was significantly lower than that of admission (4.11 + 0.98,4.77 + 1.22), and the difference was significant (P0.05); the dimension of "nausea" and "the difficulty of cancer" (4.47 + 2.01,3.33 + 1.29) were higher than that of admission (4.46 + 3.21,3.21 + 1.04), the total average, and the "good social" dimension (3.87 + 0.37,5.49 + 1.11) were lower than that of admission (3.88 + 0.52,5.55 + 4.11), but the difference was not (P0.05). (7) the hospital anxiety and Depression Scale score: the total score, the anxiety score and the depression score (13.23 + 3.12,5.99 + 2.13,7.87 + 2.24) in the group ICGMT were lower than that of the admission (16.12 + 3.67,6.67 2.31,9.45 + 2.78), and the difference was significant (P0.01); the total score, anxiety score, and depression score (19.23 + 3.16,8.99 + 4.13,10.87 + 2.24) in the control group were 2 weeks later. ) higher than the admission (17.13 + 4.57,6.98 + 2.39,9.85 + 2.18), the difference was significant (P0.01). (8) room tree man test: 2 weeks after the intervention of group ICGMT, the content of room tree man painting was more full, the layout of each part was complete and no missing, the proportion was moderate, the line head was continuous, the picture was clear, the pen touched the fruit, no repeated modification marks, the picture allegedly more active more sunshine, disappear. After 2 weeks of the control group, the overall picture clarity did not improve obviously, the whole picture was still incomplete, the picture was still monotonous, the whole image was seriously biased toward the drawing side, the size ratio was still unbalance, the pen was weak, the line was irresolute, the lines were bending, the picture implied negative sadness. The positive projection points significantly reduced the results of.3. patients' physiological index (1) group ICGMT after psychological intervention, systolic pressure, diastolic pressure, heart rate and respiratory value (129.55 + 7.23,80.31 + 8.09,84.55 + 4.38,17.47 + 1.35) were lower than those at admission (134.78 + 7.57,85.77 + 9.23,87.11 + 8.22,19.56 + 2.11), and the difference was statistically significant (P0.05). There was no significant difference between the group and the admission group. (2) the comparison of brain wave and skin electricity and skin temperature: after 2 weeks of ICGMT intervention, the value of alpha wave (35.94 + 0.98) was higher than that of admission (34.85 + 1.69), and the value of theta wave (3.69 + 1.61) was lower than that of admission (4.68 + 1.78) (4.68 + 1.78), and the difference was all (P0.01). After the control group, theta wave (28.71 + 4.56) was higher than the admission (24.51) after 2 weeks (24.51). 8.21), the value of alpha wave (9.39 + 3.52) was lower than admission (11.65 + 4.94). The difference was significant (P0.01) in group.ICGMT and control group, there was no significant difference in skin electrical value, skin temperature, beta wave value and SMR wave value (P0.05). (3) immune cells Ig A, Ig G, Ig M, NK comparison: 2 weeks after ICGMT group intervention (2.55 + 3.) 23,14.87+4.27,1.48 + 0.13,0.35 + 0.47) was higher than that of admission (2.29 + 2.10,10.43+3.14,1.01 + 0.88,0.21 + 0.23), and the difference was significant (P0.05). After 2 weeks in the control group, Ig A, Ig G, Ig M, and NK cell values were lower than those of the admission (2.18 + and 2.18 + 0.21), and the difference was significant 0.05).4. clinical qualitative evaluation of most patients with middle and late stage lung cancer think that the computer game version of open-minded treatment is lively and interesting, close to life, reproduces the patient's innermost inner entanglement; rich philosophic, through the transfer of easy understanding to the patient, correct their distorted cognition and extreme ideas; simple operation, suitable for different age levels. Make patients suffer from different ages. No matter in heart and body condition, psychological coping, adjustment way, quality of life and physiological index, the patient is well received. Conclusion: the individual computer game version of open-minded treatment is a standard, vivid, practical and effective psychological intervention, helping the patients develop a positive and optimistic attitude towards life and achieve an open-minded life. This treatment has a positive effect on improving the psychosomatic condition, psychological response, adjustment mode, social function and quality of life for patients with middle and advanced lung cancer, and also has relatively large improvement on the patient's physiological index, especially the immune function. As an effective psychological intervention formula, it helps the patients with lung cancer improve the quality of life. The post cancer clinical work provides a strong empirical basis.
【学位授予单位】：广东药科大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R734.2
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