认知行为干预联合支持性心理治疗对声带息肉摘除术患者焦虑抑郁水平、应对方式及生活质量的影响
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摘要
目的:探讨认知行为干预(CBI)联合支持性心理治疗(SP)对声带息肉摘除术患者焦虑抑郁水平、应对方式及生活质量的影响。方法:将我院190例择期行声带息肉摘除术患者随机等分为联合组和对照组,对照组围术期给予常规干预,联合组在常规干预的基础上给予CBI联合SP,比较两组患者心理健康状态、焦虑抑郁水平、应对方式和生活质量的变化。结果:干预后,联合组强迫症、人际关系、焦虑、躯体化、偏执、敌对、恐怖、抑郁、精神病性评分均低于对照组(t=-2.52,-2.66,-3.03,-3.27,-3.17,-3.14,-2.31,-3.38,-2.64;P<0.05),联合组汉密尔顿焦虑量表(HAMA-14)评分(t=-4.81,P<0.05)、汉密尔顿抑郁量表(HAMD-17)评分(t=-3.58,P<0.05)显著低于对照组,联合组积极应对评分(t=2.38,P<0.05)、消极应对评分(t=3.35,P<0.05)优于对照组;术后3个月,联合组饮食、睡眠、情绪状态、精神状态和日常生活评分均高于对照组(t=6.42,6.09,6.23,7.71,5.07;P<0.05)。结论:CBI联合SP可有效改善声带息肉摘除术患者心理健康状态和应对方式,缓解或消除焦虑、抑郁,提升生活质量。
Objective:To explore the effects of cognitive behavioral intervention(CBI)combined with supportive psychotherapy(SP)on anxiety,depression,coping styles and quality of life in patients with vocal cord polypectomy.Methods:A total of 190 cases of patients with elective vocal cord polypectomy in our hospital were randomly divided into combined group and control group.Control group was given routine intervene during perioperative period,and combined group was given CBI combined with SP on the basis of routine intervene.The mental health status,anxiety and depression level,coping styles and quality of life were compared between the two groups.Results:After intervention,the scores of obsessive-compulsive disorder,interpersonal relationship,anxiety,somatization,paranoid,hostility,horror,depression and psychoticism in combined group were all lower than those in control group(t=-2.52,-2.66,-3.03,-3.17,-3.14,-2.31,-3.38,-2.64;P<0.05),and the scores of HAMA-14(Hamilton Depression Rating Scale)(t=-4.81,P<0.05)and the HAMD-17(t=-3.58,P<0.05)were significantly lower than those in control group,and the scores of positive coping style(t=-3.62,P<0.05)and negative coping style(t=-3.36,P<0.05)were better than those in control group.The scores of diet(t=6.42,P<0.05),sleep,emotional status,mental status and daily life in combined group were higher than those in control group at 3 months after operation(t=6.42,6.09,6.23,7.71,5.07;P<0.05).Conclusion:CBI combined with SP can effectively improve the mental health status and coping styles,relieve or eliminate anxiety and depression,and improve the quality of life in the treatment of patients with vocal cord polypectomy.
Objective:To explore the effects of cognitive behavioral intervention(CBI)combined with supportive psychotherapy(SP)on anxiety,depression,coping styles and quality of life in patients with vocal cord polypectomy.Methods:A total of 190 cases of patients with elective vocal cord polypectomy in our hospital were randomly divided into combined group and control group.Control group was given routine intervene during perioperative period,and combined group was given CBI combined with SP on the basis of routine intervene.The mental health status,anxiety and depression level,coping styles and quality of life were compared between the two groups.Results:After intervention,the scores of obsessive-compulsive disorder,interpersonal relationship,anxiety,somatization,paranoid,hostility,horror,depression and psychoticism in combined group were all lower than those in control group(t=-2.52,-2.66,-3.03,-3.17,-3.14,-2.31,-3.38,-2.64;P<0.05),and the scores of HAMA-14(Hamilton Depression Rating Scale)(t=-4.81,P<0.05)and the HAMD-17(t=-3.58,P<0.05)were significantly lower than those in control group,and the scores of positive coping style(t=-3.62,P<0.05)and negative coping style(t=-3.36,P<0.05)were better than those in control group.The scores of diet(t=6.42,P<0.05),sleep,emotional status,mental status and daily life in combined group were higher than those in control group at 3 months after operation(t=6.42,6.09,6.23,7.71,5.07;P<0.05).Conclusion:CBI combined with SP can effectively improve the mental health status and coping styles,relieve or eliminate anxiety and depression,and improve the quality of life in the treatment of patients with vocal cord polypectomy.
引文
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[14]庄燕,阚卫娟,汤夏冰.全方位舒适干预运用于声带息肉摘除术患者的临床效果观察[J].现代中西医结合杂志,2017,26(12):1353-1355
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[16]Zeng L W,Tang M M,Tang X H,et al.Cognitive behavior intervention on the burden of primary caregivers for intestinal cancer patients with chemotherapy[J].China Journal of Health Psychology,2017,25(1):43-47
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[2]杨越,吴海涛.1116例声带息肉临床和病理分析[J].临床耳鼻咽喉头颈外科杂志,2016,30(15):1187-1190
[3]杨莉,干强,杨贵军,等.女性声带息肉术后发声功能恢复的时间观察[J].第三军医大学学报,2016,38(24):2625-2628
[4]冯炜,倪晓光.窄带成像内镜在声带息肉样病变中的鉴别诊断作用[J].中华耳鼻咽喉头颈外科杂志,2017,52(2):157-158
[5]杨琛.支撑喉镜下二氧化碳激光切除术治疗声带息肉的疗效评估[J].中国内镜杂志,2016,22(7):18-21
[6]Sun F L,Zhang P L,Shan X Z,et al.Effect of cognitive behavioral therapy on anxiety and depression in patients with vestibular migrain[J].China Journal of Health Psychology,2016,24(8):1216-1219
[7]诸葛盼,尤慧华,王翰青,等.早期声带息肉患者发声训练与嗓音显微手术的疗效比较[J].中华全科医学,2017,15(1):48-50
[8]田勇泉.耳鼻咽喉-头颈外科学(供基础临床预防口腔医学类专业用)[M].6版,北京:人民卫生出版社,2006:362-365
[9]Jing L,Wang X,Meng H,et al.Systemic family therapy of comorbidity of anxiety and depression with epilepsy in adolescents[J].Psychiatry Investigation,2016,13(3):305-310
[10]Feng R,Wu H,et al.Psychological characteristics and GoNogo research of patients with functional constipation[J].Medicine,2016,95(52):e5685
[11]郭文俊,何霞,郝红丽,等.声带息肉诊断与治疗[J].国际耳鼻咽喉头颈外科杂志,2017,41(5):254-257
[12]景鹏,王飞娟.全麻支撑喉镜术与局麻纤维喉镜术治疗声带息肉的疗效对比分析[J].中国医刊,2017,52(6):67-70
[13]屈凤勤,李海霞,李梅生,等.声带息肉围手术期嗓音训练的临床疗效分析[J].中国耳鼻咽喉头颈外科,2017,24(3):156-158
[14]庄燕,阚卫娟,汤夏冰.全方位舒适干预运用于声带息肉摘除术患者的临床效果观察[J].现代中西医结合杂志,2017,26(12):1353-1355
[15]黄昆,刘玉,王蓓,等.个体化认知行为干预对乳腺癌术后化疗患者心理弹性的影响[J].中华现代干预杂志,2016,22(1):32-37
[16]Zeng L W,Tang M M,Tang X H,et al.Cognitive behavior intervention on the burden of primary caregivers for intestinal cancer patients with chemotherapy[J].China Journal of Health Psychology,2017,25(1):43-47
[17]王新华.早期被动功能锻炼结合认知行为干预对脑卒中患者生活质量和认知的影响[J].中华现代干预杂志,2017,23(13):1794-1796