【摘要】：目的:了解膠質(zhì)瘤化療患者以焦慮、抑郁為主的負(fù)性情緒現(xiàn)狀和主觀(guān)幸福感水平,探討認(rèn)知行為療法對(duì)膠質(zhì)瘤化療患者焦慮和抑郁的干預(yù)效果;分析認(rèn)知行為療法對(duì)膠質(zhì)瘤化療患者主觀(guān)幸福感的干預(yù)效果;找出更適合患者的認(rèn)知行為療法方案。方法:根據(jù)納入標(biāo)準(zhǔn)和排除標(biāo)準(zhǔn),選取174例在2015年12月~2016年12月期間,入住吉林大學(xué)第一醫(yī)院神經(jīng)腫瘤外科且首次接受化療的膠質(zhì)瘤患者,采用隨機(jī)數(shù)字表法,將其分為對(duì)照組、腹式呼吸訓(xùn)練組、音樂(lè)療法組、聯(lián)合組四組。其中,對(duì)照組實(shí)施常規(guī)護(hù)理干預(yù),腹式呼吸訓(xùn)練組實(shí)施認(rèn)知干預(yù)和腹式呼吸訓(xùn)練,音樂(lè)療法組采取認(rèn)知干預(yù)和音樂(lè)療法,聯(lián)合組實(shí)施認(rèn)知干預(yù)和腹式呼吸訓(xùn)練及音樂(lè)療法。在干預(yù)前第1次化療后和第4次化療后分別采用焦慮自評(píng)量表(SAS)、抑郁自評(píng)量表(SDS)及總體幸福感量表(GWBS)對(duì)四組患者焦慮得分、抑郁得分及主觀(guān)幸福感得分進(jìn)行測(cè)評(píng)。結(jié)果:1.膠質(zhì)瘤化療患者普遍存在焦慮(53.82±2.18)、抑郁(59.56±3.74),主觀(guān)幸福感得分(68.57±9.97)低于中國(guó)常模(71.00±18.00)。2.干預(yù)后三組患者焦慮得分均降低,以聯(lián)合組降低尤為明顯,其次為音樂(lè)療法組,腹式呼吸訓(xùn)練組,各組間差異均具有統(tǒng)計(jì)學(xué)意義(P0.05)。3.干預(yù)后三組患者抑郁得分降低,抑郁情緒得到明顯改善,以聯(lián)合組最為明顯,依次為腹式呼吸訓(xùn)練組、音樂(lè)療法組,各組間差異顯著,有統(tǒng)計(jì)學(xué)意義(P0.05)。4.干預(yù)后三組患者的主觀(guān)幸福感水平升高,以聯(lián)合組主觀(guān)幸福感得分最高,其次為音樂(lè)療法組、腹式呼吸訓(xùn)練組,該三組與對(duì)照組相比,存在差異,且差異具備統(tǒng)計(jì)學(xué)意義(P0.05),聯(lián)合組與腹式呼吸訓(xùn)練組、音樂(lè)療法組相比均有統(tǒng)計(jì)學(xué)差異(P0.05),但腹式呼吸訓(xùn)練組與音樂(lè)療法組得分尚不具備統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.膠質(zhì)瘤化療患者普遍存在焦慮、抑郁,主觀(guān)幸福感水平較低,亟待實(shí)施干預(yù)措施加以改善。2.認(rèn)知行為療法能明顯改善患者焦慮情緒,且聯(lián)合腹式呼吸訓(xùn)練和音樂(lè)療法的行為干預(yù)方案效果最好,音樂(lè)療法次之,兩者均優(yōu)于腹式呼吸訓(xùn)練。3.認(rèn)知行為療法可減輕患者抑郁程度,且聯(lián)合腹式呼吸訓(xùn)練和音樂(lè)療法的行為干預(yù)方案效果最好,腹式呼吸訓(xùn)練次之,兩者均優(yōu)于音樂(lè)療法。4.認(rèn)知行為療法可提高患者主觀(guān)幸福感水平,聯(lián)合干預(yù)方法效果較為突出。
[Abstract]:Objective: to explore the effect of cognitive behavior therapy on anxiety and depression in glioma chemotherapy patients. Objective: to analyze the effect of cognitive behavioral therapy on subjective well-being of glioma patients after chemotherapy, and to find out a more suitable cognitive behavior therapy scheme for glioma patients. Methods: according to the inclusion criteria and exclusion criteria, 174 patients with glioma admitted to neurooncology surgery in the first Hospital of Jilin University from December 2015 to December 2016 and received chemotherapy for the first time were selected. They were divided into four groups: control group, abdominal breathing training group, music therapy group and combined group. The control group received routine nursing intervention, the abdominal breathing training group received cognitive intervention and abdominal breathing training, the music therapy group received cognitive intervention and music therapy, and the combined group received cognitive intervention and abdominal breathing training and music therapy. After the first chemotherapy before intervention and after the fourth chemotherapy, the anxiety scores of the four groups were assessed with (SAS), depression self-rating scale (SDS) and general well-being scale (GWBS) respectively. The scores of depression and subjective well-being were measured. The result is 1: 1. Anxiety (53.82 鹵2.18), depression (59.56 鹵3.74) and subjective well-being (68.57 鹵9.97) in glioma chemotherapy patients were significantly lower than those in Chinese norm (71.00 鹵18.00). After intervention, the anxiety scores of the three groups were all decreased, especially in the combined group, followed by music therapy group, abdominal breathing training group, the differences among groups were statistically significant (P0.05). After intervention, the depression scores of the three groups decreased, and the depression mood improved significantly, especially in the combined group, followed by abdominal respiratory training group and music therapy group, the difference was significant among the three groups (P0.05). 4. After intervention, the subjective well-being level of the three groups increased, with the combined group having the highest score, followed by music therapy group, abdominal breathing training group, the three groups were different from the control group. And the difference was statistically significant (P0.05), the combination group and abdominal breathing training group, music therapy group compared with statistical difference (P0.05), But abdominal breathing training group and music therapy group score is not statistically significant (P0.05). Conclusion: 1. There are anxiety, depression and low subjective well-being in patients with glioma chemotherapy. Cognitive behavior therapy can obviously improve the anxiety of patients, and the combination of abdominal breathing training and music therapy has the best effect, music therapy takes the second place, both of them are better than abdominal breathing training. Cognitive behavioral therapy can reduce depression, and the combination of abdominal breathing training and music therapy has the best effect, abdominal breathing training is the second, both of them are better than music therapy. 4. Cognitive behavioral therapy can improve the level of subjective well-being of patients, and the combined intervention method is more effective.
【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R473.73

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 程偉榮;;PDCA循環(huán)護(hù)理對(duì)惡性腦膠質(zhì)瘤術(shù)后尼卡地平化療不良反應(yīng)及生活質(zhì)量的影響[J];齊魯護(hù)理雜志;2016年14期

2 吳文桃;羅義瓊;劉梅;楊秀莉;劉佳;;綜合護(hù)理模式對(duì)卵巢癌住院患者焦慮抑郁情緒的影響[J];國(guó)際精神病學(xué)雜志;2016年02期

3 周妤;羅宏丹;楊紅梅;;個(gè)性化護(hù)理干預(yù)對(duì)腦膠質(zhì)瘤患者負(fù)面情緒及生活質(zhì)量的影響[J];中國(guó)腫瘤臨床與康復(fù);2016年02期

4 代雅琪;陳芳;裴大軍;周紀(jì)寧;劉娟;劉煒;;音樂(lè)療法在心血管疾病中的應(yīng)用進(jìn)展[J];中華全科醫(yī)學(xué);2015年09期

5 溫秀芬;陳云超;張暉;高虹;張雪燕;徐光蕓;駱如香;;放松訓(xùn)練聯(lián)合音樂(lè)療法在局麻手術(shù)病人中的應(yīng)用研究[J];護(hù)士進(jìn)修雜志;2014年19期

6 曾曉琴;陳幕瑤;徐碧金;何燕;;腦惡性膠質(zhì)瘤化療患者生存質(zhì)量及應(yīng)對(duì)方式的調(diào)查[J];現(xiàn)代臨床護(hù)理;2014年08期

7 陶玲t(yī)D;喻思紅;馮畢龍;;音樂(lè)療法在化療所致惡心嘔吐患者中的應(yīng)用及進(jìn)展[J];中國(guó)實(shí)用護(hù)理雜志;2014年13期

8 陳歡歡;周建婭;;非小細(xì)胞肺癌化療患者生活質(zhì)量與負(fù)性情緒的關(guān)系及影響因素分析[J];中國(guó)現(xiàn)代醫(yī)生;2014年07期

9 趙香蘭;黃笑燕;虞春華;;我國(guó)癌癥患者心理護(hù)理現(xiàn)狀及展望[J];中國(guó)醫(yī)學(xué)創(chuàng)新;2014年06期

10 趙紅;徐柳柳;;自我松弛音樂(lè)療法對(duì)精神分裂癥的康復(fù)治療作用研究[J];中國(guó)民康醫(yī)學(xué);2013年22期

相關(guān)碩士學(xué)位論文 前2條

1 謝王踢;調(diào)強(qiáng)適形放療聯(lián)合替莫唑胺治療惡性腦膠質(zhì)瘤的療效分析[D];中南大學(xué);2013年

2 張曉嵐;觸摸及音樂(lè)療法對(duì)剖宮產(chǎn)手術(shù)患者焦慮、疼痛及恢復(fù)的影響研究[D];華中科技大學(xué);2011年

，

本文編號(hào)：2319455