本文選題：癌癥患者家屬 + 綜合心理干預(yù)�。� 參考：《山西醫(yī)科大學(xué)》2013年碩士論文

【摘要】：目的：測查癌癥晚期患者家屬的負(fù)性情緒、壓力、疲勞的現(xiàn)狀,了解晚期癌癥患者家屬的負(fù)性情緒、照顧者壓力、疲勞狀況的關(guān)系。探討綜合性心理干預(yù)對癌癥晚期患者家屬負(fù)性情緒的作用,提高其生活質(zhì)量。 對象：以山西省腫瘤醫(yī)院寧養(yǎng)院2012年3月到11月的癌癥晚期患者的家屬為研究對象。對符合入組條件的218人進(jìn)行問卷調(diào)查。對其中有焦慮、抑郁的患者家屬86人進(jìn)行干預(yù)研究。 方法：1.調(diào)查研究：通過面對面的訪談和問卷調(diào)查的方式對218名家屬進(jìn)行調(diào)查,研究工具包括家屬的人口統(tǒng)計學(xué)資料、焦慮自評量表(SAS)、抑郁自評量表(SDS)、照顧者壓力量表(CBI)、照顧者疲勞量表(FAI)。 2.干預(yù)研究：將符合條件的86人隨機(jī)分為兩組,每組43人。對照組,不進(jìn)行系統(tǒng)的心理干預(yù),對干預(yù)組進(jìn)行綜合心理干預(yù)：包括認(rèn)知療法、心理支持、身心靈全人健康模式等團(tuán)體輔導(dǎo)方式。團(tuán)體活動分為4次活動,每次60分鐘左右。干預(yù)結(jié)束后,采用焦慮、抑郁問卷進(jìn)行后測。對照組不參加本次系統(tǒng)的心理干預(yù)。 結(jié)果：1.在患者家屬中,女性的比例(65.1%)比男性的比例(34.9%)高；漢族的比例(94.0%)比少數(shù)民族的高。文化程度中,高中的比例(24.8%)最高,而小學(xué)的比例為22.5%,初中的為44.0%,大學(xué)及以上的為8.3%。在有無宗教信仰上,有宗教信仰的比例(10.6%)高于無宗教信仰的比例(89.4%)；經(jīng)濟(jì)收入月平均收入小于300元的比例為34.0%,收入為300-600元的比例為42.7%,收入為600元以上的比例為24.4%；家屬的角色中,配偶的比例為33.0%,子女的比例為56.9%,兄弟姐妹的比例為6.0%,父母的比例為4.1%。 2.在患者家屬中,有焦慮情緒的家屬為97人,比例為44.5%,有抑郁情緒的家屬人數(shù)為121,比例為55.5%。無焦慮的比例為55.5%,得分為38.79±5.21輕度焦慮的家屬的比例為40.4%,得分為53.23±2.20；,中度焦慮的家屬比例為3.20%,得分為62.71±2.36,重度焦慮的家屬比例為0.90%,得分為70.50±0.71。女性和男性在有無焦慮情緒比較中,差異有統(tǒng)計學(xué)意義(P0.001)；在民族上,漢族和少數(shù)民族在不同焦慮情緒等級比較中,差異無統(tǒng)計學(xué)意義(P=0.304)；在文化程度上,小學(xué)、初中、高中和大學(xué)及以上在不同焦慮情緒等級的比較差異無統(tǒng)計學(xué)意義(P=0.437)；在宗教信仰上的不同焦慮情緒等級比較中,差異無統(tǒng)計學(xué)意義(P=0.584);在經(jīng)濟(jì)收入中,月平均收入小于300元、300-600元、600元以上在不同焦慮情緒等級的比較差異有統(tǒng)計學(xué)意義(P0.05)；家庭角色中,配偶、子女、兄弟姐妹、父母在不同焦慮情緒等級的比較差異有統(tǒng)計學(xué)意義(P0.05)。 3.無抑郁情緒的家屬的比例為50%,得分為43.16±6.62,輕度抑郁的家屬的比例為45.41%,得分為55.67±2.18；中度抑郁的家屬比例為3.21%,得分為64.57±2.15;重度抑郁的家屬比例為1.38%,得分為73.33±0.58。女性和男性在不同抑郁情緒等級比較中,差異有統(tǒng)計學(xué)意義(P0.05)；在民族上,漢族和少數(shù)民族在不同抑郁情緒等級比較中,差異有統(tǒng)計學(xué)意義(P0.001)；在文化程度上,小學(xué)、初中、高中和大學(xué)及以上在不同抑郁情緒等級的比較差異無統(tǒng)計學(xué)意義(P=0.071)；在宗教信仰上的不同抑郁情緒等級比較中,差異有統(tǒng)計學(xué)意義(P=0.002)；在經(jīng)濟(jì)收入中,月平均收入小于300元、300-600元、600元以上在不同抑郁情緒等級的比較差異有統(tǒng)計學(xué)意義(P=0.442)；家庭角色中,配偶、子女、兄弟姐妹、父母在不同抑郁情緒等級的比較差異有統(tǒng)計學(xué)意義(P0.001)。 4.患者家屬的壓力水平中,輕度壓力的比例為4.59%,得分25.30±8.67；中度壓力的比例為86.24%,得分為50.48±7.29；重度的壓力比例為9.17%,得分為51.33±11.21�；颊呒覍俚钠诔潭戎�,輕度疲勞的比例為5.05%,疲勞的得分為59.55±11.35,中度疲勞的比例為92.2%,得分為91.98±11.95；重度的疲勞比例為2.75%,得分為144.33±5.05。經(jīng)濟(jì)情況好較經(jīng)濟(jì)情況差的家屬的壓力、疲勞水平低。 5.在相關(guān)分析中,焦慮與抑郁存在高度相關(guān)(r=0.625,P0.001)；焦慮、壓力呈高度相關(guān)(r=0.543,P0.001)；抑郁與疲勞呈高度相關(guān)(r=0.564,P0.001)。在有其他因素的影響的偏相關(guān)中,焦慮和抑郁存在高度相關(guān)(r=0.514,P0.001)；焦慮和壓力呈高度相關(guān)(r=0.522,P0.001)；焦慮和疲勞呈高度相關(guān)(r=0.513,P0.001)。 6.調(diào)查研究顯示,符合入組條件的218人中,有焦慮抑郁情緒者86人,焦慮抑郁的檢出率為39.45%。干預(yù)組患者家屬焦慮情緒得到明顯改善,前后比較有顯著性差異(t=4.225,P0.001)；干預(yù)組患者家屬抑郁情緒得到明顯改善,前后比較有顯著性差異t=4.345,P0.001)。 結(jié)論：1.晚期癌癥病人的家屬普遍存在焦慮、抑郁情緒,壓力和疲勞水平較高,不同性別、年齡、文化程度、照顧者角色的負(fù)性情緒、壓力、疲勞存在差異。 2癌癥晚期患者家屬的負(fù)性情緒與壓力、疲勞程度存在相關(guān)關(guān)系。 3綜合心理干預(yù)對癌癥晚期患者家屬的負(fù)性情緒有一定的改善。
[Abstract]:Objective : To investigate the relationship between negative emotion , pressure and fatigue of family members of patients with advanced cancer .

Subjects : The family of patients with advanced cancer from March to November 2012 was investigated by questionnaires from 218 people who met the condition of enrollment . 86 patients with anxiety and depression were investigated .

Methods : 1 . Investigation and study : 218 family members were investigated by face - to - face interviews and questionnaires . The tools include family demographics , anxiety self - rating scale ( SAS ) , depression self - rating scale ( SDS ) , caregiver stress scale ( CBI ) , and caregiver fatigue scale .

2 . Intervention study : Eighty - six eligible persons were randomly divided into two groups , 43 in each group .

Results : 1 . In the family of patients , the proportion of female ( 65.1 % ) was higher than that of men ( 34.9 % ) ;
The proportion of the Han nationality ( 94.0 % ) is higher than that of the minority nationality . The proportion of high school is 22.5 % , the proportion of primary school is 44.0 % , the university and above are 8.3 % , and the proportion of religious belief ( 10.6 % ) is higher than that of non - religious belief ( 89.4 % ) .
The average monthly income of economic income is 34.0 % , the income is CNY 300 - 600 , the ratio is 42.7 % , and the proportion of income is CNY 600 or more ;
In the family ' s role , the proportion of spouses is 33.0 % , the proportion of children is 56.9 % , the ratio of siblings is 6.0 % , and the proportion of parents is 4.1 % .

2 . In the family of the patients , there were 97 families with anxiety feeling , the proportion was 44.5 % , the number of family members with depressive emotion was 121 , the proportion was 55.5 % . The proportion of non - anxiety was 55.5 % , and the proportion of family members divided into 38.79 鹵 5.21 mild anxiety was 40.4 % , and the score was 53.23 鹵 2.20 ;
The proportion of family members with moderate anxiety was 3.20 % , and the proportion of family members was 62.71 鹵 2.36 . The proportion of family members with severe anxiety was 0.90 % , and the score was 70.50 鹵 0.71 . There was significant difference between women and men in the absence of anxiety . ( P 0.001 ) ;
There was no significant difference between the Han nationality and the ethnic minorities in different levels of anxiety and emotion ( P = 0.304 ) .
There was no significant difference in the levels of anxiety among primary , junior , high and high schools and above ( P = 0.437 ) .
There was no significant difference between different levels of anxiety and emotion in religious belief ( P = 0.584 ) ; in the economic income , monthly average income was less than 300 yuan , 300 - 600 yuan , more than 600 yuan had statistical significance at different levels of anxiety emotion ( P0.05 ) ;
In the family role , the differences between spouses , children , siblings and parents in different levels of anxiety were statistically significant ( P0.05 ) .

3 . The proportion of family members without depressive emotion was 50 % , which was 43.16 鹵 6.62 , and the proportion of family members with mild depression was 45.41 % , which was divided into 55.67 鹵 2.18 ;
The proportion of patients with moderate depression was 3.21 % , which was 64.57 鹵 2.15 ; the proportion of family members with severe depression was 1.38 % , which was 73.33 鹵 0.58 . There was significant difference between female and men in different depressive emotion levels ( P0.05 ) .
There was significant difference between the Han nationality and the national minorities in different depressive emotion levels ( P0.001 ) .
There was no significant difference in the levels of depression among primary , middle and high schools and above at the level of culture ( P = 0.071 ) .
There was a significant difference among different depressive emotion levels in religious belief ( P = 0.002 ) .
In the economic income , the monthly average income was less than 300 yuan , 300 - 600 yuan , more than 600 yuan had statistical significance in different depressive emotion levels ( P = 0.442 ) ;
In the family role , the differences between spouses , children , siblings and parents in different levels of depression were statistically significant ( P0.001 ) .

4 . The proportion of mild stress was 4.59 % and the score was 25.30 鹵 8.67 .
The proportion of moderate pressure was 86.24 % , which was divided into 50.48 鹵 7.29 ;
The proportion of severe fatigue was 9.17 % , which was 51.33 鹵 11.21 . The proportion of mild fatigue was 5.05 % , the fatigue score was 59.55 鹵 11.35 , the proportion of moderate fatigue was 92.2 % , and the score was 91.98 鹵 11.95 ;
The ratio of fatigue to severe fatigue was 2.75 % , and it was divided into 144.33 鹵 5.05 . The economic condition is better than that of families with worse economic conditions , and the fatigue level is low .

5 . There was a high correlation between anxiety and depression in the correlation analysis ( r = 0 . 625 , P 0 . 001 ) .
There was a high correlation between anxiety and stress ( r = 0.543 , P0.001 ) .
Depression and fatigue were highly correlated ( r = 0.564 , P0.001 ) . There was a high correlation between anxiety and depression in migraine with other factors ( r = 0.514 , P0.001 ) ;
There was a high correlation between anxiety and stress ( r = 0.522 , P0.001 ) .
There was a high correlation between anxiety and fatigue ( r = 0.513 , P0.001 ) .

6 . The study showed that 86 people who had anxiety and depression were among 218 people who met the condition of enrollment . The prevalence rate of anxiety and depression was 39.45 % . The anxiety of family members in the intervention group was significantly improved , and there was a significant difference between them ( t = 4.225 , P0.001 ) .
The depressed mood of family members was significantly improved in the intervention group ( t = 4.345 , P0.001 ) .

Conclusion : 1 . The family members of advanced cancer patients generally have higher anxiety , depression , stress and fatigue level , different sex , age , culture degree , negative emotion , pressure and fatigue of the role of caregivers .

The negative emotion of family members in late stage of cancer is related to stress and fatigue degree .

3 Comprehensive psychological intervention has some improvement to the negative emotion of family members of patients with advanced cancer .
【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】：2013
【分類號】：B842.6;R89

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