【摘要】：目的探討根管治療患者的疼痛程度在疾病種類、性別、身體狀態(tài)、年齡、婚姻狀況、文化程度、經(jīng)濟(jì)條件等維度上的差異情況，以及患者的幸福感、應(yīng)對(duì)方式與根管治療疼痛程度的關(guān)系。以期為尋求臨床上減輕根管治療疼痛的方法提供針對(duì)性的措施，為根管治療的順利實(shí)施提供保障措施并完善理論。通過研究可以對(duì)患者的應(yīng)付行為進(jìn)行評(píng)估，從而指導(dǎo)患者采取積極的應(yīng)付方式，正確的幸福觀以及健康的心理狀態(tài)對(duì)待根管治療。 方法研究對(duì)象為北京煤炭總醫(yī)院干部門診被確診為牙髓炎、牙髓壞死以及根尖周炎（后磨牙）的患者，隨機(jī)抽取250人作為本課題的研究對(duì)象（排除牙周牙髓聯(lián)合病變的病例），共發(fā)放問卷250份，回收問卷234份，剔除10份無效問卷，收集到有效問卷224份，回收有效率達(dá)95.7％。其中，男性108人，年齡最大78歲，最小22歲，平均52歲，女性116人，年齡最大77歲，最小20歲，平均54歲。采用視覺模擬量表、總體幸福感量表及應(yīng)對(duì)方式問卷對(duì)研究對(duì)象進(jìn)行調(diào)查，對(duì)資料進(jìn)行整理，，使用SPSS13.0軟件進(jìn)行數(shù)據(jù)統(tǒng)計(jì)分析。 結(jié)果1患者在接受根管治療時(shí)，不同患者感受到的疼痛程度不同，平均為5.72分。2通過獨(dú)立樣本t檢驗(yàn)、方差分析可知，根管治療的疼痛程度（VAS）在疾病種類、性別、健康狀態(tài)、年齡、婚姻狀況、文化程度、收入高低等維度上存在差異，但無統(tǒng)計(jì)學(xué)意義。3224例研究對(duì)象的幸福感處于較高水準(zhǔn)，平均值達(dá)到118.82分。4解決問題的應(yīng)對(duì)方式的分值最高，平均分值達(dá)到0.84117分，有一部分人遇到問題時(shí)能夠主動(dòng)尋求他人幫忙，在別人的幫助下最終解決問題，有少數(shù)人采取合理化，自責(zé)，幻想，退避等應(yīng)付策略面對(duì)問題。5幸福感指數(shù)與根管治療疼痛程度（VAS）存在顯著負(fù)相關(guān),幸福感指數(shù)越高，根管治療疼痛程度的分值越低。解決問題、求助及成熟型因子與疼痛指數(shù)負(fù)相關(guān)，自責(zé)、退避、幻想、不成熟型四個(gè)因子與疼痛指數(shù)正相關(guān)。合理化、混合型應(yīng)對(duì)方式與疼痛指數(shù)的相關(guān)性檢測無統(tǒng)計(jì)學(xué)意義。6應(yīng)對(duì)方式與幸福感有密切的關(guān)系，解決問題、求助、成熟型、合理化、混合型五個(gè)因子與幸福感呈正相關(guān)關(guān)系；自責(zé)、幻想、退避、不成熟四個(gè)因子與幸福感呈負(fù)相關(guān)，相關(guān)系數(shù)達(dá)到顯著水平。7幸福感和應(yīng)對(duì)方式對(duì)根管治療疼痛程度有著顯著的預(yù)測作用，在幸福感及應(yīng)對(duì)方式各因子與VAS的回歸分析中，幸福感、解決問題因子、幻想因子及自責(zé)因子進(jìn)入回歸模型，標(biāo)注化回歸方程為：y=5.9782-0.98*幸福感-1.63*解決問題+1.98*幻想+2.39*自責(zé)。 結(jié)論1患者所感受到根管治療的疼痛程度處于中度水平，疼痛的不良感受對(duì)患者的身心造成一定的影響，因此應(yīng)予足夠的重視。2所有研究對(duì)象的幸福值得分較高，擁有正確幸福觀的人對(duì)生活充滿信心，遭遇挫折時(shí)能夠泰然處之，合理解決問題，因此應(yīng)該注重提高人們的生活幸福感。3根管治療患者最常采取解決問題的應(yīng)對(duì)方式，這種積極的人生態(tài)度使人們無論面對(duì)生活的苦難還是治療的痛苦經(jīng)歷都能夠沉著應(yīng)對(duì)，客觀分析，避免對(duì)自身產(chǎn)生不良的影響，應(yīng)該引導(dǎo)人們樹立積極向上的生活態(tài)度，勇于面對(duì)困難及挫折。4生活幸福感、應(yīng)付方式與根管治療的疼痛程度有密切關(guān)系，所以應(yīng)該提高患者的幸福感并引導(dǎo)患者采取積極的應(yīng)對(duì)策略解決問題，以此來降低根管治療疼痛對(duì)患者身心造成的影響。
[Abstract]:Objective To study the relationship between the degree of pain of the patients with root canal therapy, the type of disease, the sex, the physical state, the age, the marital status, the degree of culture and the economic condition, and the well-being of the patients, the coping style and the pain degree of root canal treatment. The aim of this paper is to provide a specific measure for the method of reducing the pain of root canal treatment, and to provide the safeguard measure and perfect the theory for the smooth implementation of root canal treatment. The study can be used to evaluate the patient's coping behavior, so as to guide the patient to take a positive coping style, correct the well-being and the healthy mental state to treat the root canal. Methods A total of 250 patients who were diagnosed as pulpitis, pulp necrosis and root tip (posterior molar) were randomly selected as the subject of the study. A total of 234 questionnaires were collected, and the effective questionnaires were collected in 224 parts. The effective rate was 95.7. %. Of these,108 men, the maximum age of 78, the minimum age of 22, the average age of 52, the female 116, the maximum age of 77, the minimum age of 20, the average of 54 The study object was investigated by using the visual analog scale, the overall well-being scale and the coping style questionnaire, and the data was collected by using the SPSS13.0 software. The results showed that, in the treatment of root canal, the degree of pain of different patients was different, with an average of 5.72. According to the analysis of variance, the degree of pain (VAS) of root canal treatment was found in the type of disease, sex, health status, age, marriage, There is a difference in the degree of marriage, culture, income and so on, but there is no statistical significance. The well-being of the 3224 subjects is at a higher level, and the average value is 118.82. The score of the coping style of the problem is the highest, and the average score is 0.841. 17 points, when some people encounter problems, they can actively seek help from others, and finally solve the problem with the help of others. There are few people to adopt the coping strategies such as rationalization, self-accusation, illusion and retreat. The 5-well-being index and the root canal treatment pain degree (VAS) are significant. Negative correlation, the higher the well-being index, the degree of root canal treatment pain. The lower the value. The problem, the help and the mature factor are negatively correlated with the pain index, self-blame, back-off, fantasy, immature four-factor and pain index There is no statistical significance in the correlation between the rational, the mixed coping style and the pain index. The relationship between the coping style and the well-being is closely related, the problem is solved, the help, the maturity type, the rationalization, the mixed type of five factors are in the positive relation with the well-being, and the self-accusation, the illusion There was a negative correlation between the four factors and the well-being, and the correlation coefficient reached a significant level. The 7-well-being and the coping style had a significant effect on the degree of pain of the root canal. In the regression analysis of the factors of well-being and coping style and the VAS, the well-being and the solution to the question were solved. The problem factor, the fantasy factor and the self-blame factor enter the regression model. The labeling equation is: y = 5.9782-0.98 * well-being-1.63 * problem-solving + 1.98 * fantasy + 2.39 * Self-blame. Conclusion 1 The degree of pain in the root canal treatment is at a moderate level, and the bad feeling of pain will have a certain effect on the physical and mental health of the patient. Therefore, it should be paid enough attention. The well-being of all the subjects of the study should be higher and the person with the right and the right to be happy We should pay attention to the improvement of people's well-being.3. The most common problem in root canal treatment is to solve the problem. In the way of coping, this kind of positive people's ecological degree enables people to deal with, objective analysis and avoid the bad influence on themselves, regardless of the suffering of life or the pain of treatment, and should guide people to set up a positive attitude of life and face difficulties and setbacks. The well-being of life and coping style are closely related to the degree of pain of root canal treatment, so the well-being of the patient should be improved and the patient should be guided to take a positive coping strategy to solve the problem, so as to reduce the pain of root canal treatment to the mind and body of the patient.
【學(xué)位授予單位】：河北聯(lián)合大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2014
【分類號(hào)】：R781.05

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