【摘要】：目的 探討應(yīng)用放松治療和音樂治療法的心理干預(yù)措施對于胃腸道腫瘤患者圍術(shù)期焦慮及術(shù)后疼痛的影響,以了解心理干預(yù)措施對于胃腸道腫瘤人群圍術(shù)期心理健康及康復(fù)中的作用,為腫瘤人群心理健康及疾病康復(fù)提供理論依據(jù),并在臨床推廣。方法 選取安徽省某三甲醫(yī)院胃腸外科2014年4月至2014年10月期間手術(shù)治療的胃腸道腫瘤患者110例,采用隨機(jī)數(shù)字法分為試驗組58例和對照組52例。對照組采用常規(guī)護(hù)理,試驗組在常規(guī)護(hù)理的基礎(chǔ)上采用放松療法和音樂治療法的心理行為干預(yù)治療,術(shù)后72小時內(nèi)進(jìn)行術(shù)后疼痛及焦慮評價,并進(jìn)行兩組患者術(shù)后住院時間的比較。結(jié)果 兩組患者的一般流行病學(xué)資料及兩組患者入院時SAI和TAI焦慮評分(t值分別為0.63,0.97；P值分別為0.53,0.33),對比無顯著性差異。干預(yù)后試驗組患者的焦慮程度低于對照組患者；重復(fù)測量的方差分析顯示,干預(yù)后試驗組患者圍手術(shù)的SAI及TAI均低于對照組,兩組之間的差異有統(tǒng)計學(xué)意義(F值分別為6.55,6.92；P值分別為0.01,0.01)；同一時間點的t檢驗顯示,試驗組術(shù)前一日SAI分值(t=2.75,P=0.01)、TAI分值(t=2.38,P=0.02)及術(shù)后三日SAI分值(t=2.85,P=0.01)、TAI分值(t=3.05,P=0.00)均低于對照組,兩組之間的差別有統(tǒng)計學(xué)意義,術(shù)后隨著時間的延長,對照組患者的焦慮逐漸增加,試驗組患者的焦慮逐漸減低。試驗組患者的疼痛程度低于對照組患者。重復(fù)測量的方差分析顯示,試驗組患者術(shù)后不同時點的NRS分值低于對照組,兩組之間差別有統(tǒng)計學(xué)意義(F=6.88,P--0.01),組別與不同時間點之間無交互作用；兩組術(shù)后同一時點疼痛分值t檢驗顯示,兩組術(shù)后24小時的NRS分值差別有統(tǒng)計學(xué)意義(t=2.46,P=0.02),術(shù)后隨著時間的延長,患者的疼痛逐漸減低。試驗組患者在住院天數(shù)及術(shù)后住院天數(shù)均短于對照組,兩組差別有統(tǒng)計學(xué)意義(t值分別為2.59,2.69;P值均0.01)。結(jié)論 通過圍術(shù)期放松療法和音樂治療法相結(jié)合的心理干預(yù)措施,能夠減輕胃腸道腫瘤患者圍術(shù)期的焦慮狀態(tài)及焦慮特質(zhì),使胃腸道腫瘤患者術(shù)后的疼痛程度降低；在胃腸道腫瘤人群圍術(shù)期開展規(guī)范、有效心理干預(yù)的不僅可以促進(jìn)胃腸道腫瘤人群的心理衛(wèi)生健康,還能夠減少術(shù)后疼痛,還能促進(jìn)患者術(shù)后康復(fù),使患者術(shù)后住院天數(shù)縮短,增加醫(yī)療資源的利用率,提高公共衛(wèi)生資源利用度,使社會受益。
[Abstract]:Objective to explore the effect of relaxation therapy and music therapy on perioperative anxiety and postoperative pain in patients with gastrointestinal cancer. To understand the effect of psychological intervention on the mental health and rehabilitation of patients with gastrointestinal cancer during perioperative period, to provide theoretical basis for mental health and disease rehabilitation of tumor population, and to promote it in clinical practice. Methods from April 2014 to October 2014, 110 patients with gastrointestinal neoplasms were selected and randomly divided into trial group (n = 58) and control group (n = 52). The control group was treated with routine nursing, the experimental group was treated with psychological and behavioral intervention of relaxation therapy and music therapy, and the postoperative pain and anxiety were evaluated within 72 hours after operation. The postoperative hospitalization time was compared between the two groups. Results the general epidemiological data of the two groups and the SAI and TAI anxiety scores of the two groups were not significantly different when they were admitted to hospital (t = 0.633 鹵0.97, P = 0.53 鹵0.33, respectively). After intervention, the anxiety degree of the patients in the trial group was lower than that in the control group, and the analysis of variance of repeated measurements showed that the SAI and TAI of the patients in the experimental group were lower than those in the control group after intervention, and the difference between the two groups was statistically significant (F = 6.55 鹵6.92, respectively). T test at the same time point showed that the SAI scores of the two groups were significantly lower than those of the control group in the first day before operation (t = 2.75) and the SAI scores at 3 days after operation (t = 2.88 / P ~ (0.01) (t3.05 / P0. 00), and the difference between the two groups was statistically significant, and the difference between the two groups was significant with the prolongation of postoperative time. Anxiety increased in the control group and decreased in the trial group. The degree of pain in the trial group was lower than that in the control group. The analysis of variance of repeated measurement showed that the scores of NRS at different time points after operation in the trial group were lower than those in the control group, and the difference between the two groups was statistically significant (F = 6.88 ~ (P--0.01), and there was no interaction between the two groups and different time points. T test of pain score at the same time after operation showed that the difference of NRS score at 24 hours after operation between the two groups was statistically significant (t = 2.46), and the pain gradually decreased with the prolongation of time after operation. The days of hospitalization and postoperative hospitalization in the trial group were shorter than those in the control group, and the difference between the two groups was statistically significant (t = 2.59 鹵2.69, P = 0.01, respectively). Conclusion the psychological intervention combined with relaxation therapy and music therapy during perioperative period can reduce the anxiety state and anxiety trait of patients with gastrointestinal cancer and reduce the degree of postoperative pain in patients with gastrointestinal cancer. During the perioperative period of gastrointestinal cancer population, effective psychological intervention can not only promote the mental health of gastrointestinal cancer population, but also reduce postoperative pain, promote postoperative rehabilitation, and shorten the postoperative hospital stay. Increase the utilization rate of medical resources, improve the utilization of public health resources, so as to benefit the society.
【學(xué)位授予單位】：安徽醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：R473.73

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