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腰椎間盤突出手術(shù)前后病人的心理特點和心理治療研究

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  本文關(guān)鍵詞: 貝克焦慮量表(BAI) 漢密頓抑郁量表(HAMD) 心理干預(yù) 出處:《山西醫(yī)科大學》2007年碩士論文 論文類型:學位論文


【摘要】: 目的:研究適合腰椎間盤突出手術(shù)患者心理特征的心理學量標、心理干預(yù)方案。 方法:選擇腰椎間盤突出手術(shù)患者120人,試驗組80人,對照組40人,試驗組分為兩組,醫(yī)生干預(yù)組和護士干預(yù)組。試驗組給予心理干預(yù),對照組不做心理干預(yù)。在心理干預(yù)前對對照組和試驗組的每個病人進行貝克焦慮量表(BAI)、漢密頓抑郁量表(HAMD)問卷調(diào)查。在進行心理干預(yù)后進行第二次問卷調(diào)查,調(diào)查時間選擇在病人手術(shù)后一周內(nèi)。貝克焦慮量表(BAI)由患者自己完成,漢密頓抑郁量表(HAMD)由調(diào)查員根據(jù)患者的敘述完成。心理干預(yù)措施為:傾聽、解釋、指導、鼓勵、漸進松馳療法、音樂療法。 結(jié)果:在進行腰椎間盤手術(shù)的患者中,心理干預(yù)實施前試驗組和對照組的BAI問卷得分、HAMD問卷得分均高于診斷標準分(p<0.01),心理干預(yù)實施前,試驗組和對照組的焦慮發(fā)生率在97.5%~100%,抑郁發(fā)生率在97.5%~100%,心理干預(yù)實施后醫(yī)生干預(yù)組、護士干預(yù)組的BAI問卷得分、HAMD問卷得分要低于焦慮診斷標準分(p<0.01),而對照組的BAI問卷得分、HAMD問卷得分要高于焦慮診斷標準分(p<0.01),心理干預(yù)實施后,醫(yī)生干預(yù)組、護士干預(yù)組和對照組的焦慮發(fā)生率分別為2.5%、30%和95%,抑郁發(fā)生率分別為5%、25%和92.5%。經(jīng)統(tǒng)計學檢驗,醫(yī)生干預(yù)組和護士干預(yù)組焦慮發(fā)生率抑郁發(fā)生率低于對照組,醫(yī)生干預(yù)組遠低于護士干預(yù)組、對照組。心理干預(yù)實施后,醫(yī)生干預(yù)組、護士干預(yù)組的BAI問卷、HAMD問卷得分和焦慮、抑郁發(fā)生率均低于均低于心理干預(yù)前,而未采取心理干預(yù)的對照組在手術(shù)前后無明顯變化;颊叱鲈簳r的滿意程度與心理干預(yù)后BAI問卷、HAMD問卷得分呈現(xiàn)負相關(guān)與干預(yù)類型、治療效果呈現(xiàn)正相關(guān)。從相關(guān)系數(shù)的大小可以看出干預(yù)類型、治療效果要高于焦慮、抑郁問卷得分。貝克焦慮量表(BAI)得分與漢密頓抑郁量表(HAMD)得分呈現(xiàn)正相關(guān)。 結(jié)論:腰椎間盤突出手術(shù)患者存在嚴重的焦慮、抑郁癥狀,實施心理干預(yù)能明顯緩解患者的焦慮、抑郁癥狀。影響患者滿意程度的因素大小依次為干預(yù)類型、治療效果、心理干預(yù)后的抑郁程度、焦慮程度。醫(yī)生對患者的干預(yù)要好于護士。貝克焦慮量表(BAI)與漢密頓抑郁量表(HAMD)對腰椎間盤突出手術(shù)患者進行焦慮、抑郁癥狀調(diào)查較為全面合理。
[Abstract]:Objective: to study the psychological scale and psychological intervention program for patients with lumbar disc herniation. Methods: 120 patients with lumbar disc herniation, 80 patients in the experimental group and 40 patients in the control group were selected. The experimental group was divided into two groups: the doctor intervention group and the nurse intervention group. Before the psychological intervention, each patient in the control group and the experimental group was investigated with the Baker anxiety scale (BAIN), the Hamilton Depression scale (Hamd) and the second questionnaire after psychological intervention. The investigation time was chosen within one week after the operation. The Beck anxiety scale (BAI) was completed by the patient himself, and the Hamilton Depression scale (Hamd) was completed by the investigator according to the patient's narration. The psychological intervention measures were: listening, explaining, guiding, encouraging. Progressive relaxation therapy, music therapy. Results: in the patients undergoing lumbar disc surgery, the scores of BAI questionnaire and Hamd questionnaire in the experimental group and the control group before psychological intervention were higher than those in the diagnostic standard (P < 0.01). The incidence of anxiety in the trial group and the control group was 97.50.The incidence of depression was 97.50.After the psychological intervention, the doctor's intervention group, The scores of BAI questionnaire and Hamd questionnaire in the nurses intervention group were lower than those in the anxiety diagnosis standard (P < 0.01), while the scores of the BAI questionnaire in the control group were higher than those in the anxiety diagnosis standard (P < 0.01). The incidence of anxiety and depression in the nurse intervention group and the control group were 2.5% and 95% respectively. The incidence of depression was 52.5% and 92.5% respectively. The incidence of anxiety and depression in the doctor intervention group and the nurse intervention group was lower than that in the control group. After psychological intervention, the scores of BAI questionnaire, anxiety and depression in the doctor intervention group and nurse intervention group were lower than those before psychological intervention. There was no significant change before and after operation in the control group without psychological intervention. There was a negative correlation between the degree of satisfaction at discharge and the score of BAI questionnaire / Hamd questionnaire after psychological intervention and the type of intervention. From the correlation coefficient, we can see that the intervention type is higher than that of anxiety, the score of depression questionnaire is higher, and the score of BAI is positively correlated with the score of Hamilton Depression scale (Hamd). Conclusion: the patients with lumbar disc herniation have serious anxiety and depression symptoms. Psychological intervention can obviously relieve the anxiety and depression symptoms of the patients. The factors influencing the patients' satisfaction are the type of intervention and the therapeutic effect. The degree of depression and anxiety after psychological intervention was better than that of nurses. Baker anxiety scale (BAI) and Hamilton Depression scale (Hamd) performed anxiety on patients with lumbar disc herniation.
【學位授予單位】:山西醫(yī)科大學
【學位級別】:碩士
【學位授予年份】:2007
【分類號】:R473.6;R395

【引證文獻】

相關(guān)期刊論文 前1條

1 牟志偉;熊雋;宋波濤;王廣勝;;臭氧結(jié)合物理治療對腰椎間盤突出癥的臨床療效及心理情緒的相關(guān)分析[J];中國醫(yī)藥導報;2012年08期

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本文編號:1528455

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