【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)狀和主觀幸福感水平,探討認(rèn)知行為療法對膠質(zhì)瘤化療患者焦慮和抑郁的干預(yù)效果;分析認(rèn)知行為療法對膠質(zhì)瘤化療患者主觀幸福感的干預(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,將其分為對照組、腹式呼吸訓(xùn)練組、音樂療法組、聯(lián)合組四組。其中,對照組實施常規(guī)護(hù)理干預(yù),腹式呼吸訓(xùn)練組實施認(rèn)知干預(yù)和腹式呼吸訓(xùn)練,音樂療法組采取認(rèn)知干預(yù)和音樂療法,聯(lián)合組實施認(rèn)知干預(yù)和腹式呼吸訓(xùn)練及音樂療法。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量表(SAS)、抑郁自評量表(SDS)及總體幸福感量表(GWBS)對四組患者焦慮得分、抑郁得分及主觀幸福感得分進(jìn)行測評。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),主觀幸福感得分(68.57±9.97)低于中國常模(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,其次為音樂療法組,腹式呼吸訓(xùn)練組,各組間差異均具有統(tǒng)計學(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、音樂療法組,各組間差異顯著,有統(tǒng)計學(xué)意義(P0.05)。4.干預(yù)后三組患者的主觀幸福感水平升高,以聯(lián)合組主觀幸福感得分最高,其次為音樂療法組、腹式呼吸訓(xùn)練組,該三組與對照組相比,存在差異,且差異具備統(tǒng)計學(xué)意義(P0.05),聯(lián)合組與腹式呼吸訓(xùn)練組、音樂療法組相比均有統(tǒng)計學(xué)差異(P0.05),但腹式呼吸訓(xùn)練組與音樂療法組得分尚不具備統(tǒng)計學(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,主觀幸福感水平較低,亟待實施干預(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)練和音樂療法的行為干預(yù)方案效果最好,音樂療法次之,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)于音樂療法。4.認(rèn)知行為療法可提高患者主觀幸福感水平,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)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.73

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