本文關(guān)鍵詞： 人格 心理健康 脊髓型頸椎病 心理干預(yù)　出處：《鄭州大學》2009年碩士論文　論文類型：學位論文

【摘要】：目的探討脊髓型頸椎病患者的術(shù)前心理健康狀況及其相關(guān)心理社會因素:通過了解該類患者圍術(shù)期間介入心理干預(yù)治療,與單純手術(shù)治療的差異,為脊髓型頸椎病手術(shù)治療的同時采取相應(yīng)心理干預(yù)措施提供科學依據(jù)。 方法選擇100例住院準備手術(shù)治療的脊髓型頸椎病患者,在收入院后兩天內(nèi)應(yīng)用一般情況調(diào)查表、癥狀自評量表(SCL-90)、艾森克人格問卷(EPQ)、社會支持評定量表(SSRS)、日本骨科學會(JOA)脊髓功能評定表進行患者的一般情況、心理健康狀況、人格個性特征、社會支持情況及脊髓功能的測查。再以入院先后次序按數(shù)字表法將患者隨機分為心理干預(yù)組(在進行常規(guī)住院手術(shù)治療的同時,施加心理干預(yù))、對照組(常規(guī)住院手術(shù)治療)。所有患者在術(shù)后再進行癥狀自評量表及脊髓功能評定表的測查。其中100例患者入院時的癥狀自評量表、艾森克人格問卷及社會支持量表結(jié)果分別以相應(yīng)的中國常模作為對照進行分析,并通過分析探討人格個性特征及社會支持情況與心理健康的關(guān)系;通過了解心理干預(yù)組與對照組手術(shù)前后的SCL-90及JOA結(jié)果的不同,以了解手術(shù)及心理干預(yù)對患者的影響。 結(jié)果①脊髓型頸椎病患者癥狀自評量表的總分、總均分、軀體化、強迫狀態(tài)、抑郁、焦慮、恐怖、精神病性因子分均高于中國常模,有顯著性差異(P＜0.01);人際關(guān)系敏感因子分低于中國常模,有顯著性差異(P＜0.01)。②脊髓型頸椎病患者EPQ各因子分與中國常模相比較,患者的EPQ中神經(jīng)質(zhì)分和精神質(zhì)分顯著高于中國常模,差異有顯著性意義(P＜0.05)。③脊髓型頸椎病患者EPQ中神經(jīng)質(zhì)因子分與SCL-90各因子分均呈正相關(guān),精神質(zhì)因子分與軀體化、抑郁、焦慮、精神病性因子分呈正相關(guān),掩飾因子分與總分、焦慮、敵對、恐怖因子分呈負相關(guān),內(nèi)外向因子分與恐怖因子分呈負相關(guān)。④脊髓型頸椎病患者術(shù)前社會支持水平高于正常人群(P＜0.01)。⑤脊髓型頸椎病患者術(shù)前在社會支持方面水平高者其心理狀況優(yōu)于社會支持水平低者(P＜0.01)。⑥心理干預(yù)組和對照組兩組脊髓型頸椎病患者手術(shù)前,SCL-90各因子分無統(tǒng)計學差異:術(shù)后對照組在軀體化、抑郁、焦慮因子分上與術(shù)前比較有組內(nèi)差異(P＜0.05);術(shù)后心理干預(yù)組在軀體化、抑郁、焦慮、恐怖因子分上與術(shù)前比較有組內(nèi)差異(P＜0.05);術(shù)后心理干預(yù)組在軀體化、抑郁、焦慮、恐怖因子分上與對照組比較有組間差異(P＜0.05)。⑦心理干預(yù)組與對照組間的術(shù)后改善率比較差異有顯著性意義(P＜0.05)。 結(jié)論①脊髓型頸椎病患者術(shù)前存在抑郁、焦慮、恐怖等多種心理癥狀。②脊髓型頸椎病患者心理癥狀出現(xiàn)與其人格特征(特別是神經(jīng)質(zhì)及精神質(zhì))相關(guān)。③良好的社會支持有利于脊髓型頸椎病患者的心身健康。④心理干預(yù)措施有利于改善脊髓型頸椎病手術(shù)患者的心理癥狀及軀體功能恢復(fù)。
[Abstract]:Objective to investigate the preoperative mental health status of patients with cervical Spondylotic myelopathy (CSM) and its related psycho-social factors. To provide scientific basis for the surgical treatment of cervical Spondylotic myelopathy and the corresponding psychological intervention measures. Methods A total of 100 patients with cervical Spondylotic myelopathy who were hospitalized for surgical treatment were investigated with general information questionnaire within two days after admission. SCL-90, Eysenck Personality questionnaire (Eysenck Personality questionnaire), Social support scale (SSRS), Japanese Orthopedic Society (JOA), Spinal Cord function Assessment (SCL-90) were used to assess the general situation, mental health status and personality characteristics of the patients. Social support and spinal cord function were measured. Then the patients were randomly divided into psychological intervention group according to the order of admission. Psychological intervention was given to the control group (routine operation in hospital). All patients were examined with symptom checklist and spinal cord function scale again after operation. 100 of them were admitted to hospital with SCL-90. The results of Eysenck Personality questionnaire and Social support scale were compared with Chinese norm, and the relationship between personality characteristics, social support and mental health was discussed. The results of SCL-90 and JOA before and after operation in the psychological intervention group and the control group were studied to understand the influence of the operation and psychological intervention on the patients. Results 1 the total score, mean score, somatization, obsessive-compulsive state, depression, anxiety, phobic anxiety, psychotic factor scores of the SCL-90 patients with cervical Spondylotic myelopathy were higher than those of the Chinese norm. There was significant difference (P < 0.01), the score of sensitive factor of interpersonal relationship was lower than that of Chinese norm, and the scores of EPQ in patients with cervical Spondylotic myelopathy were significantly higher than those in Chinese norm. The scores of neuroticism and psychoticism in EPQ were significantly higher than those in Chinese norm. The difference was significant (P < 0.05). There was a positive correlation between neuroticism factor score and SCL-90 factor score in EPQ, positive correlation between psychoticism factor score and somatization, depression, anxiety, psychotic factor score and total score, between neuroticism factor score and SCL-90 factor score in patients with cervical Spondylotic myelopathy (P < 0.05). Anxiety, hostility, terror factor scores were negatively correlated, Negative correlation between extroversion factor score and phobic factor score. 4. The preoperative social support level in patients with cervical Spondylotic myelopathy is higher than that in the normal population (P < 0.01). 5. The psychological status of the patients with cervical Spondylotic myelopathy before operation is superior to that of the society. The scores of SCL-90 in patients with cervical Spondylotic myelopathy before operation were not significantly different between the two groups (P < 0.01) and control group (P < 0.01). The scores of depression and anxiety factors were significantly higher than those before operation (P < 0.05); the scores of somatization, depression, anxiety and phobic anxiety were significantly higher in the post-operative psychological intervention group than before (P < 0.05); the scores of somatization, depression, anxiety in the postoperative psychological intervention group were significantly different from those before operation (P < 0.05). There was significant difference in the scores of phobic factors between the two groups (P < 0.05). There was significant difference in the postoperative improvement rate between the psychological intervention group and the control group (P < 0.05). Conclusion 1patients with cervical Spondylotic myelopathy have depression and anxiety before operation. Psychological symptoms of Cervical Spondylotic Spondylotic Spondylotic Myelopathy. The intervention is helpful to improve the psychological symptoms and the recovery of somatic function in patients with cervical Spondylotic myelopathy (cervical Spondylotic myelopathy).
【學位授予單位】：鄭州大學
【學位級別】：碩士
【學位授予年份】：2009
【分類號】：R395.5

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本文編號：1519190