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  本文關(guān)鍵詞： 抑郁、焦慮患者 睡眠質(zhì)量 調(diào)查 干預(yù)研究　出處：《山西醫(yī)科大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：睡眠障礙是抑郁、焦慮患者臨床發(fā)生率較高的軀體癥狀之一,主要有入睡時間延長、睡眠輕淺及早醒三個癥狀。睡眠障礙與抑郁、焦慮情緒互相影響,互相作用,對抑郁、焦慮癥的預(yù)后及復(fù)發(fā)有著重要的影響。目的:調(diào)查了解抑郁、焦慮患者的睡眠質(zhì)量、睡眠信念與態(tài)度及應(yīng)對方式的現(xiàn)況,并探討影響患者睡眠質(zhì)量的影響因素之間的關(guān)系。通過對一例抑郁障礙伴失眠患者進行心理干預(yù),研究認知行為療法對患者抑郁情緒及睡眠障礙的緩解情況。對象:以某醫(yī)科大學(xué)附屬醫(yī)院精神衛(wèi)生科2016年9月到12月的135名抑郁、焦慮患者為研究對象。對其中符合入組條件的135名患者進行問卷調(diào)查,對其中一名抑郁伴失眠患者進行心理干預(yù)。方法:1.調(diào)查研究:采用方便抽樣的方法,對135抑郁、焦慮住院患者進行調(diào)查。使用匹茲堡睡眠質(zhì)量指數(shù)量表、睡眠個人信念及態(tài)度量表、漢密爾頓抑郁量表、漢米爾頓焦慮量表量表及特質(zhì)應(yīng)對方式量表進行調(diào)查。2.干預(yù)研究:采用個體心理治療結(jié)合團體心理治療的方法,對一名抑郁癥伴睡眠障礙的患者進行心理干預(yù)。其中個體心理治療分為四次,中間穿插兩次團體心理治療,兩次團體治療的主題分別為認識我們的睡眠和如何拯救我們的睡眠。在個體心理治療過程中,一方面通過失眠的認知行為療法對患者的不良睡眠認知及錯誤的睡眠行為進行矯正;另一方面,通過精神分析的方法,對患者的失眠根源進行發(fā)掘,處理患者心中的創(chuàng)傷,使患者正確面對生命中的重大喪失。結(jié)果:1.調(diào)查研究結(jié)果:(1)約有61.5%的被調(diào)查者存在睡眠紊亂的情況,其中在入睡時間和睡眠效率上問題較為突出,且79%的患者在入院前一個月有規(guī)律服用催眠類藥物的情況�；颊邔κ咴虻恼J識及對睡眠的期望有較多錯誤的認知。(2)睡眠質(zhì)量差對男性日間功能的影響要顯著高于女性(t=2.16,p=0.033);未婚患者入睡時間(t=-2.15,p=0.040)及睡眠效率(t=-4.53,p=0.000)要明顯好于已婚患者,且對控制和預(yù)測睡眠能力(t=2.27,p=0.029)的評價要好于已婚患者;不同文化程度的患者在對失眠原因的理解上有顯著差異(F=3.40,p=0.004)。(3)在睡眠認知上,患者的睡眠質(zhì)量與患者對失眠后果的估計及對控制和預(yù)測睡眠能力的評價呈負相關(guān),與患者對睡眠的期望呈正相關(guān);在情緒上,患者的睡眠質(zhì)量與患者的軀體性焦慮及抑郁、焦慮的嚴重程度呈正相關(guān)。(4)患者對睡眠的期望、對控制和預(yù)測睡眠能力的評價及軀體性焦慮對患者的睡眠質(zhì)量有顯著的預(yù)測作用,而患者焦慮的嚴重程度對患者睡眠信念與態(tài)度和睡眠質(zhì)量之間有顯著的調(diào)節(jié)作用。2.干預(yù)研究結(jié)果:通過記錄患者在干預(yù)前及干預(yù)后的變化,說明心理干預(yù)對抑郁伴失眠患者的抑郁情緒的改善及失眠的緩解有一定的效果。結(jié)論:1.抑郁、焦慮患者有不同程度的睡眠問題,且較多人選擇服用催眠類藥物來緩解睡眠問題,且對于睡眠問題的認知較差。不同性別、婚姻狀況及文化程度的患者間存在差異。2.抑郁、焦慮患者的睡眠質(zhì)量與其自身對睡眠的認知及抑郁、焦慮情緒的嚴重程度有密切的關(guān)系。3.焦慮情緒通過睡眠信念與態(tài)度對睡眠質(zhì)量的影響起調(diào)節(jié)作用。4.心理干預(yù)對患者的抑郁情緒及失眠的癥狀有一定的改善作用。
[Abstract]:Sleep disorder is one of the physical symptoms of depression, a higher rate of clinical anxiety patients, mainly in sleep time, sleep Qingqian wake up three early symptoms. Sleep disorders and depression, anxiety, mutual influence, interaction, on depression, has an important influence on the prognosis and recurrence of anxiety disorders. Objective: To investigate the depression the anxiety, sleep quality, sleep status beliefs and attitudes and coping style, and to explore the relationship between the factors affecting the quality of sleep in patients with psychological intervention. Through a case of depression in patients with insomnia, relief of cognitive behavioral therapy on mood and sleep disorders in patients with depression. Object: to the Department of mental health the Affiliated Hospital of a Medical University in September 2016 to 135 in December the depression, anxiety patients as the research object. In which 135 patients were eligible for questionnaire survey, one of A depression with insomnia patients with psychological intervention. Methods: 1. investigation: using convenience sampling method, 135 depression, anxiety inpatients were investigated. Using the Pittsburgh sleep quality index scale, personal beliefs and sleep attitude scale, Hamilton depression scale, the Milton anxiety scale and trait coping style scale amount table.2.: research methods of individual psychological intervention therapy combined with psychotherapy, psychological intervention of a depression with sleep disorder. The individual psychological treatment is divided into four times, two times in between the inserted group psychotherapy, two group therapy subjects were sleep and we know how to save we sleep. In individual psychotherapy, one of the patient's poor sleep cognition and wrong sleep behavior through cognitive behavioral therapy for insomnia correction; another Hand, through spiritual analysis, to explore the root of insomnia patients, treatment of patients with heart trauma, make the patient to face a major loss of life. Results: 1. research results: (1) sleep disorders are about 61.5% of the respondents of the situation, the problems in sleep latency and sleep efficiency is more prominent, and 79% of the patients had regular use of hypnotic drugs in a month before admission. There are many wrong understanding of the causes of insomnia patients with cognitive and expectations for sleep. (2) poor sleep quality and daytime function influence on male is significantly higher than that of female (t=2.16, p=0.033); unmarried patients sleep time (t=-2.15, p=0.040) and sleep efficiency (t=-4.53, p=0.000) was significantly better in married patients, and to control and predict the ability to sleep (t=2.27, p=0.029) evaluation is better than the married patients; the different cultural degree in patients with insomnia There are significant differences in the understanding of the reasons (F=3.40, p=0.004). (3) in sleep cognition, negative correlation to estimate the consequences of insomnia and sleep quality of patients and to evaluate the prediction and control of the ability to sleep, positively correlated with patient expectations to sleep; in the mood, sleep quality and patients' the somatic anxiety and depression, anxiety was positively correlated with the severity of. (4) patients expected to sleep, to evaluate the ability of control and predict sleep and somatic anxiety had significant predictive effect on the sleep quality of patients, and the severity of patients with anxiety have significant moderating effect on the results of the intervention of.2. between the patients' sleep quality and sleep: the beliefs and attitudes were recorded before and after intervention changes, improvement and insomnia and depression psychological intervention on depression associated with insomnia relief conclusion have a certain effect: 1. patients with depression, anxiety and sleep problems in different degree, and more people choose to use hypnotic drugs to alleviate sleep problems, and poor sleep for cognitive problems. There are differences in different gender, marital status and education level of.2. depression among patients, anxiety and sleep quality in patients with their sleep cognition and depression, severe the degree of anxiety related.3. anxiety closely affected by sleep beliefs and attitudes on sleep quality play an important role in the regulation of.4. psychological intervention on depression and insomnia symptoms have certain effect.

【學(xué)位授予單位】：山西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R749

【參考文獻】

相關(guān)期刊論文 前10條

1 林韻;黃麗萍;張秀蓮;邱潔華;許曉丹;許慕明;;潮汕地區(qū)鼻咽癌患者焦慮、抑郁發(fā)生情況及其影響因素[J];現(xiàn)代臨床護理;2016年01期

2 王麗;;面部燒傷瘢痕患者抑郁與社會支持及應(yīng)對方式的相關(guān)分析[J];中國健康心理學(xué)雜志;2015年02期

3 張靜;任冬梅;崔麗君;胡定偉;唐曉平;;正念訓(xùn)練對顱腦損傷病人術(shù)后睡眠質(zhì)量的影響[J];護理研究;2014年36期

4 李蓉蓉;鮮于云艷;張軍;;慢性阻塞性肺疾病病人睡眠質(zhì)量與睡眠信念態(tài)度的相關(guān)性分析[J];護理研究;2014年22期

5 林琦;龐程;黃艷益;祝立陽;;正念訓(xùn)練干預(yù)對中青年乳腺癌患者術(shù)后睡眠質(zhì)量的影響[J];護理管理雜志;2014年04期

6 徐愛紅;張蓉;劉冬蕾;;失眠的綜合心理生物抑制模型[J];中國社區(qū)醫(yī)師(醫(yī)學(xué)專業(yè));2013年03期

7 陸曉峰;孫林;張慧珍;張小莉;趙麗紅;趙來峰;惠峰;夏小軍;;睡眠障礙流行病學(xué)調(diào)查分析[J];甘肅中醫(yī);2011年02期

8 鄧玉琴;劉興華;梁耀堅;攸佳寧;唐一源;;覺知抗抑郁訓(xùn)練對參與者抑郁情緒干預(yù)初探[J];中國臨床心理學(xué)雜志;2010年06期

9 張紅菊;姚勇;張杰文;;認知-行為療法及結(jié)合藥物治療原發(fā)性失眠的對照研究[J];中國實用神經(jīng)疾病雜志;2010年10期

10 韓彥超;宗艷紅;張彥恒;王衛(wèi)華;回秀清;王向群;;117例抑郁癥患者的軀體癥狀和首診情況調(diào)查[J];中國心理衛(wèi)生雜志;2008年12期

，

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