【作者】 李萍；

【导师】 孙宏伟；

【作者基本信息】 潍坊医学院 ， 应用心理学， 2008， 硕士

【摘要】 目的:探讨心理干预对哮喘患者生活质量的影响,以期为哮喘患者提供一套简便、易行、有效的心理干预方法,更好地提高其生活质量。方法:将符合条件的哮喘患者随机分为干预组(110例)和非干预组(106例),在入院第二天使用哮喘患者一般情况调查表、述情障碍(TAS-26)、简式简明心境问卷测查(POMS-SF)、社会支持评定量表(SSRS)、医用应对问卷(MCMQ)、哮喘生活质量评估表(AQLQ)对患者进行测查。非干预组行常规治疗,干预组在常规治疗的基础上进行心理干预。两组患者在出院前一天,应用TAS-26、POMS-SF、SSPS、MCMQ及AQLQ进行测查。干预组出院后给予《超级放松》、《放松意象想象》光盘及相关内容的材料,指导其进行肌肉放松训练和意象想象练习,要求每天练习1-2次,持续3个月。3个月后对两组进行随访及一般情况调查表、AQLQ测查。对收集到的数据运用SPSS13.0进行卡方检验及T检验。结果:1、除因子Ⅲ外,哮喘患者组的TAS各因子分及总分与常模比较有统计学意义(P＜0.01),哮喘患者组均高于常模。干预后两组除因子Ⅰ、Ⅲ外,其余各因子得分及总分比较均有统计学意义(P＜0.01或P＜0.01),干预组均低于非干预组;除因子Ⅲ外,两组TAS各因子得分及总分在干预后与干预前的差值比较有统计学意义(P＜0.01或P＜0.01),干预组降低的分值均高于非干预组。2、干预后,两组患者POMS各负性因子分及总分比较均有统计学意义(P＜0.01),干预组均低于非干预组;干预后与干预前两组POMS各负性因子分及总分差值比较均有统计学意义(P＜0.01),干预组降低的分值均高于非干预组;干预后两组POMS的VA因子比较有统计学意义(P＜0.01),干预组高于非干预组。干预后与干预前两组POMS的VA得分差值比较有统计学意义(P＜0.01),干预组VA提高的分值高于非干预组。3、干预后,两组的主观支持、对支持的利用度及社会支持总分比较有统计学意义(P＜0.01),干预后与干预前两组的主观支持、对支持的利用度及社会支持总分差值的比较均有统计学意义(P＜0.01),干预组均高于非干预组。4、干预后,两组应对方式的面对因子比较有统计学意义(P＜0.01),干预后与干预前两组的面对因子差值比较有统计学意义(P＜0.01),干预组高于非干预组。干预后,两组回避、屈服因子得分比较有统计学意义(P＜0.01或P＜0.01),干预组低于非干预组。干预后与干预前回避、屈服因子差值比较有统计学意义(P＜0.01),干预组减低的分值大于非干预组。5、干预后及干预三个月后,两组AQLQ各因子得分及总分比较均有统计学意义(P＜0.01),干预组均高于非干预组;干预后与干预前、干预三个月后与干预前两组AQLQ各因子得分及总分差值比较均有统计学意义(P＜0.01),干预组提高的分值均高于非干预组;干预三个月后与干预后两组AQLQ的活动受限、对自身健康的关心及总分差值的比较均有统计学意义(P＜0.01),干预组提高的分值显著高于非干预组。结论:1、哮喘患者存有明显的述情障碍,心理干预能改善其述情障碍;2、与非干预组比较,干预组患者的情绪明显改善;3、心理干预后,干预组患者的主观支持、对支持的利用度明显提高;4、干预组患者较多运用面对的应对方式,较少运用回避、屈服应对方式;5、经三个月的心理干预,干预组患者的生活质量得到明显改善。更多还原

【Abstract】 Objective:To approach the effects of psychosocial intervention on the quality of life of asthma patients.To provide a reasonable and reliable psychological intervention instrument to improve their quality of life.Methods:The asthma patients were divided into the intervention group(110) and the non-intervention group(106) randomly.The asthma patients of two groups were investigated with general questionnaire,TAS-26,POMS-SF,SSRS,MCMQ and AQLQ at the second day after hospitalization.The non-intervention group only received routine therapy.On the base of conventional therapy,patients of the intervention group were given psychological intervention.All asthma patients of two groups were investigated with TAS-26,POMS-SF,SSRS,MCMQ and AQLQ at the day prior to discharge.The asthma patients of the intervention group were given "super relaxation","imagery fancy" CD and related materials,and were instructed to learn how to practice progressive muscle relaxation and imagination practice.They were required to practice it once or twice daily for three months.All asthma patients of two groups were investigated with follow-up general questionnaire and AQLQ at the end of three months.With the SPSS13.0,x~2 -test and t-test were carried out for the collected data.Results:1.Except forⅢ,there were statistical significance in the other factor scores and the total score of TAS between the group of asthma and the normal model. The asthma group was higher than the normal model.Except forⅠandⅢ,there were statistical significance in the other factor scores and the total score of TAS for the two groups after intervention(P＜0.05 or P＜0.01).The scores of the intervention group were lower than the non-intervention group.Except forⅢ,there were statistical significance in the difference of the other factor scores and the total score of TAS between after and before intervention of two groups(P＜0.05 or P＜0.01). The scores that decreased of the intervention group were higher than the non-intervention.2.There were statistical significance between each negative factor score and the total score of POMS after intervention in the two groups(P＜0.01).The scores of the intervention group were lower than the non-intervention group.There were statistical significance in the difference of the each negative factor score and the total score of POMS between after and before intervention of two groups (P＜0.01).The scores decreased in the intervention group were higher than the non-intervention group.There were significant differences in VA of POMS between the intervention group and the non-intervention group(P＜0.01).The score of VA of the intervention group was higher than the non-intervention group.There were statistical significance in the difference of the score of VA between after and before intervention of two groups(P＜0.01).The score that increased in intervention group was higher than the non-intervention group.3.There were significant differences in subjective support,utilization of support and the total score of social support of two groups after intervention(P＜0.01).There were statistical significance in the difference of the scores of subjective support,utilization of support and the total score of social support between after and before intervention of two groups(P＜0.01). The scores of the intervention group were higher than the non-intervention group. 4.There was statistical significance in confront between two groups after intervention(P＜0.01).There were statistical significance of two groups in the difference of the score of confront between after and before the intervention (P＜0.01).Confront score of the intervention group was higher than the non-intervention group.There were statistical significance in avoidance and acceptance-resignation of two groups after intervention(P＜0.05 or P＜0.01). Avoidance and acceptance -resignation score of the intervention group was lower than the non-intervention group.There were also statistical significance in the difference of the score of avoidance and acceptance-resignation between after and before intervention of two groups(P＜0.01).The scores decreased in the intervention group were higher than the non-intervention group.5.There were statistical significance in each of the factors and the total score of AQLQ of two groups after intervention and after intervention for three months(P＜0.01).The scores of the intervention group were higher than the non-intervention group.There were statistical significance in the difference of the each factor score and the total score of AQLQ after and before intervention,3 months later after the intervention and before intervention of two groups(P＜0.01).The score that increased of the intervention group was higher than the non-intervention group.There were statistical significance in the difference of activity limitation,attension to the self-health and the total score of AQLQ after intervention for three months and after intervention of two groups (P＜0.01).The score increased in the intervention group was higher than the non-intervention group.Conclusion:1.Asthma patients have alexithymia.Alexithymia can be improved by psychological intervention.2.Compared with the non-intervention group,the mood of asthma patients in the intervention group is obviously improved. 3.Subjective support and utilization of support of the intervention groupare better than the non-intervention group after the psychological intervention.4.Asthma patients of the intervention group have more coping strategies about confront and less avoidance and acceptance-resignation.5.The quality of life of the intervention group patients has increased after 3 months’ psychological intervention.更多还原