癌癥病人創(chuàng)傷后成長及其影響因素的研究
發(fā)布時間：2018-08-13 16:19
【摘要】：目的為了討論癌癥患者創(chuàng)傷后成長及其影響因素的研究,癌癥是非常嚴(yán)重的創(chuàng)傷事件,嚴(yán)重影響著人類的身體健康和生命,必然會對其身體和心理造成很大的影響,大多數(shù)學(xué)者研究癌癥創(chuàng)傷后造成其負(fù)面影響,但隨著西方積極心理學(xué)的興起,國外心理學(xué)學(xué)者Tedeschi等人首次創(chuàng)造性提出“創(chuàng)傷后成長(Posttraumatic Growth,PTG)這個新概念,癌癥病人創(chuàng)傷后成長主要是指在人際關(guān)系、新的可能性、個人力量、精神變化和欣賞生活等5個方面的成長,是指個體遭受癌癥這一重大創(chuàng)傷事件后,其認(rèn)知結(jié)構(gòu)發(fā)生重組。癌癥創(chuàng)傷后成長會比病前以新的視角去看待生活。隨著醫(yī)學(xué)技術(shù)的發(fā)展,癌癥病人十年生存率顯著增加,現(xiàn)在癌癥已成為慢性可治療疾病而非終極病,國內(nèi)外心理學(xué)者和醫(yī)學(xué)工作者也越來越關(guān)注癌癥患者的創(chuàng)傷后成長。臨床研究發(fā)現(xiàn),并非所有癌癥病人在初期得知病情后都只表現(xiàn)出負(fù)面心理狀態(tài),部分患者在與癌癥抗?fàn)幍倪^程中也體驗到心理方面的正性變化并獲得創(chuàng)傷后成長。國外多項研究已證實,創(chuàng)傷后成長的出現(xiàn)可以降低癌癥患者的負(fù)性心理狀況、提升治療效果、改善心理狀態(tài),進(jìn)而提高癌癥患者的生存質(zhì)量。我國對癌癥病人創(chuàng)傷后成長的相關(guān)研究尚處于引入階段,雖然有少量癌癥病人心理問題流行病學(xué)研究報告,但研究對癌癥病人特性研究及創(chuàng)傷后成長研究不多。本研究的目的亦是針對癌癥患者這一特殊人群,研究其創(chuàng)傷后成長的狀況及影響因素,全面了解患者的心理狀況,為臨床上如何恢復(fù)和提升患者的身心機能、指導(dǎo)其有效應(yīng)對、開展心理健康教育、促進(jìn)康復(fù)進(jìn)程提供科學(xué)依據(jù),使患者在住院治療期間獲得更好的心理治療,促進(jìn)身心康復(fù),最終提高患者的生活質(zhì)量。方法1、研究對象本課題擬在泰安市3所三級甲等醫(yī)院和各縣市區(qū)綜合醫(yī)院腫瘤科和各專科腫瘤醫(yī)院住院治療、被確診為癌癥半年以上且愿意參與本次調(diào)查研究的患者選取500名患者進(jìn)行調(diào)查。2、研究工具研究一在征得醫(yī)院批準(zhǔn),并得到臨床大夫配合,首先患者建立良好關(guān)系、獲得其信任下完成。所有問卷調(diào)查均在患者住院期間填寫,測試地點為病房,由經(jīng)過培訓(xùn)的調(diào)查員對患者進(jìn)行指導(dǎo),并統(tǒng)一指導(dǎo)語和填表方式。由于測試題量較大,患者在住院期間分5次完成問卷.選取創(chuàng)傷后成長評定量表(Posttraumatic Growth Inventory,PTGI)、心理彈性問卷(Connor-Davidson resilience scale)、防御方式問卷(Defensive style Questionnaire,DSQ)、人生意義問卷(Meaning in Life Questionnaire,MLQ)死亡態(tài)度描繪量表(修訂版)(Death Attitude Profile-Revised,DAP-R)等問卷進(jìn)行測量。研究二在研究一的基礎(chǔ)上進(jìn)行半結(jié)構(gòu)化深入訪談(Semi-Structured In-DepthInterview)。3.統(tǒng)計方法研究一數(shù)據(jù)采用SPSS17.0軟件進(jìn)行統(tǒng)計學(xué)處理,統(tǒng)計方法有t檢驗、相關(guān)分析、方差分析、多元回歸等分析方法。研究二采用根據(jù)自編的研究提綱,進(jìn)行詮釋現(xiàn)象學(xué)分析(Interpretative Phenomenological Analysis,IPA)進(jìn)行個案訪談的整理。結(jié)果研究一的結(jié)果為癌癥病人創(chuàng)傷后成長與心理彈性、生命意義、死亡態(tài)度、防御機制和心理健康相關(guān),通過回歸方程結(jié)果顯示,心理彈性、生命意義、死亡態(tài)度和防御機制4個變量進(jìn)入模型。多元相關(guān)系數(shù)0.471,共解釋變異量20.5%,回歸方程為:Y=-17.411+0.182X1+0.250X2+0.213X3+0.026X4(F=13.183,p0.05),回歸方程有效。研究二通過對6例個案分析和比較數(shù)據(jù),得出以下四個主題:即(1)積極自我;(2)積極調(diào)整與適應(yīng);(3)自我意識增強;(4)珍愛生命;(5)交友模式重組(6)人生哲學(xué)與態(tài)度的改變等6個主題和13個的亞主題。
[Abstract]:Objective To discuss the post-traumatic growth of cancer patients and its influencing factors. Cancer is a very serious traumatic event, which seriously affects human health and life, and will inevitably have a great impact on their physical and psychological. Most scholars have studied the negative effects of cancer after trauma, but with the development of positive psychology in the West. The rise of foreign psychologists Tedeschi and others for the first time creatively put forward the concept of "Posttraumatic Growth (PTG). The post-traumatic growth of cancer patients mainly refers to the growth of interpersonal relationships, new possibilities, personal strength, mental change and appreciation of life. It refers to the individual suffering from cancer as a major trauma. With the development of medical technology, the ten-year survival rate of cancer patients has increased significantly. Now cancer has become a chronic and treatable disease rather than an ultimate disease. Psychologists and medical workers at home and abroad are paying more and more attention to cancer patients. Clinical studies have found that not all cancer patients show only negative psychological state when they first learn the condition of the disease. Some patients also experience positive psychological changes and acquire post-traumatic growth in the process of fighting cancer. The study on post-traumatic growth of cancer patients in China is still in the stage of introduction. Although there are a few epidemiological studies on psychological problems of cancer patients, the study on the characteristics of cancer patients and post-traumatic growth is still in progress. The purpose of this study is to study the post-traumatic growth of cancer patients and its influencing factors, to fully understand the psychological status of patients, and to provide a scientific basis for how to restore and improve their physical and mental functions, guide their effective coping, carry out mental health education, and promote the rehabilitation process. During hospitalization, the patients received better psychotherapy, promoted physical and mental recovery, and ultimately improved the quality of life of patients. Methods 1. The subjects were planned to be hospitalized in the Department of oncology of three third-class first-class hospitals in Tai'an City, general hospitals in counties and cities, and specialized tumor hospitals. They were diagnosed with cancer for more than half a year and were willing to participate in the survey. Five hundred patients were selected for the study. Because of the large number of questions, the patients completed the questionnaire five times during hospitalization. Posttraumatic Growth Inventory (PTGI), Connor-Davidson Resilience Scale, Defensive Style Questionnaire (DSQ), and Me were selected. Study 2 was based on Study 1 and conducted semi-structured in-depth interviews (Semi-Structured In-Depth Interview). 3. Statistical methods The data were analyzed by SPSS17.0 software. Statistical methods include t-test, correlation analysis, variance analysis, multiple regression and so on. In study 2, case interviews were conducted with Interpretative Phenomenological Analysis (IPA) based on a self-compiled research outline. Significance, attitude to death, defense mechanism and mental health were correlated. The results of regression equation showed that psychological resilience, meaning of life, attitude to death and defense mechanism were involved in the model. Study 2: Through case study and comparative data analysis of 6 cases, the following four themes were obtained: (1) positive self; (2) positive adjustment and adaptation; (3) enhanced self-awareness; (4) cherishing life; (5) re-organization of friendship pattern; (6) change of philosophy and attitude of life, and 13 sub-themes.
【學(xué)位授予單位】：曲阜師范大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：B845.67
本文編號：2181524
[Abstract]:Objective To discuss the post-traumatic growth of cancer patients and its influencing factors. Cancer is a very serious traumatic event, which seriously affects human health and life, and will inevitably have a great impact on their physical and psychological. Most scholars have studied the negative effects of cancer after trauma, but with the development of positive psychology in the West. The rise of foreign psychologists Tedeschi and others for the first time creatively put forward the concept of "Posttraumatic Growth (PTG). The post-traumatic growth of cancer patients mainly refers to the growth of interpersonal relationships, new possibilities, personal strength, mental change and appreciation of life. It refers to the individual suffering from cancer as a major trauma. With the development of medical technology, the ten-year survival rate of cancer patients has increased significantly. Now cancer has become a chronic and treatable disease rather than an ultimate disease. Psychologists and medical workers at home and abroad are paying more and more attention to cancer patients. Clinical studies have found that not all cancer patients show only negative psychological state when they first learn the condition of the disease. Some patients also experience positive psychological changes and acquire post-traumatic growth in the process of fighting cancer. The study on post-traumatic growth of cancer patients in China is still in the stage of introduction. Although there are a few epidemiological studies on psychological problems of cancer patients, the study on the characteristics of cancer patients and post-traumatic growth is still in progress. The purpose of this study is to study the post-traumatic growth of cancer patients and its influencing factors, to fully understand the psychological status of patients, and to provide a scientific basis for how to restore and improve their physical and mental functions, guide their effective coping, carry out mental health education, and promote the rehabilitation process. During hospitalization, the patients received better psychotherapy, promoted physical and mental recovery, and ultimately improved the quality of life of patients. Methods 1. The subjects were planned to be hospitalized in the Department of oncology of three third-class first-class hospitals in Tai'an City, general hospitals in counties and cities, and specialized tumor hospitals. They were diagnosed with cancer for more than half a year and were willing to participate in the survey. Five hundred patients were selected for the study. Because of the large number of questions, the patients completed the questionnaire five times during hospitalization. Posttraumatic Growth Inventory (PTGI), Connor-Davidson Resilience Scale, Defensive Style Questionnaire (DSQ), and Me were selected. Study 2 was based on Study 1 and conducted semi-structured in-depth interviews (Semi-Structured In-Depth Interview). 3. Statistical methods The data were analyzed by SPSS17.0 software. Statistical methods include t-test, correlation analysis, variance analysis, multiple regression and so on. In study 2, case interviews were conducted with Interpretative Phenomenological Analysis (IPA) based on a self-compiled research outline. Significance, attitude to death, defense mechanism and mental health were correlated. The results of regression equation showed that psychological resilience, meaning of life, attitude to death and defense mechanism were involved in the model. Study 2: Through case study and comparative data analysis of 6 cases, the following four themes were obtained: (1) positive self; (2) positive adjustment and adaptation; (3) enhanced self-awareness; (4) cherishing life; (5) re-organization of friendship pattern; (6) change of philosophy and attitude of life, and 13 sub-themes.
【學(xué)位授予單位】：曲阜師范大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2015
【分類號】：B845.67
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