基于正念的音乐疗法对脑出血急性应激障碍伴睡眠障碍患者的影响
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摘要
目的探讨基于正念的音乐疗法对脑出血急性应激障碍伴睡眠障碍患者的影响。方法将70例脑出血急性应激障碍并存睡眠障碍的患者随机分为两组,每组35例,对照组实施常规护理,干预组在常规护理的基础上进行正念舒缓音乐训练,连续干预14 d。干预前后采用多导睡眠监测(PSG)、斯坦福急性应激反应问卷(SASRQ)及匹兹堡睡眠质量指数量表(PSQI)测评两组非快动眼各期睡眠的差异、主观睡眠质量及急性应激障碍情况。结果干预后,干预组SASRQ总得分显著低于对照组,总睡眠时间占记录时间比例、NREM持续时间、3期及4期持续时间显著多于对照组(P<0.05,P<0.01)。结论正念音乐疗法可有效增加脑出血急性应激障碍伴睡眠障碍患者深度睡眠时间及所占比例,提高其睡眠质量,减轻患者的急性应激反应。
Objective To explore the effect of mindfulness-based music therapy on cerebral hemorrhage patients with acute stress disorder and sleep disturbance. Methods Seventy cerebral hemorrhage patients with acute stress disorder and sleep disturbance were randomized into a control group and an intervention group, with 35 patients in each group. The control group accepted routine nursing, while the intervention group additionally received mindfulness-based soothing music training for 14 days. The polysomnography(PSG), Stanford Acute Stress Reaction Questionnaire(SASRQ) and The Pittsburgh Sleep Quality Index(PSQI) were utilized before and after the intervention to measure the difference in each phase of Non-rapid Eye Movement(NREM), subjective sleep quality and acute stress response between the two groups. Results After the intervention, the total SASRQ score of the intervention group was significantly lower than that of the control group,while the proportion of the total sleep time accounting for the recorded time, NREM duration, duration of phase 3 and 4 were significantly more than those of the control group(P<0.05, P<0.01). Conclusion Mindfulness-based music therapy could effectively increase the deep sleep time and its proportion for cerebral hemorrhage patients with acute stress disorder and sleep disturbance, improve their sleep quality, and relieve their acute stress response.
Objective To explore the effect of mindfulness-based music therapy on cerebral hemorrhage patients with acute stress disorder and sleep disturbance. Methods Seventy cerebral hemorrhage patients with acute stress disorder and sleep disturbance were randomized into a control group and an intervention group, with 35 patients in each group. The control group accepted routine nursing, while the intervention group additionally received mindfulness-based soothing music training for 14 days. The polysomnography(PSG), Stanford Acute Stress Reaction Questionnaire(SASRQ) and The Pittsburgh Sleep Quality Index(PSQI) were utilized before and after the intervention to measure the difference in each phase of Non-rapid Eye Movement(NREM), subjective sleep quality and acute stress response between the two groups. Results After the intervention, the total SASRQ score of the intervention group was significantly lower than that of the control group,while the proportion of the total sleep time accounting for the recorded time, NREM duration, duration of phase 3 and 4 were significantly more than those of the control group(P<0.05, P<0.01). Conclusion Mindfulness-based music therapy could effectively increase the deep sleep time and its proportion for cerebral hemorrhage patients with acute stress disorder and sleep disturbance, improve their sleep quality, and relieve their acute stress response.
引文
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[4] Buysse D J,Reynolds C F,Monk T H,et al.The Pittsburgh sleep quality index:a new instrument for psychiatric practice and research[J].Psychiatry Res,1989,28(2):193-213.
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[6] Hu R J.Diagnostic and Statistical Manual of Mental Di-sorders (DSM-IV)[J].J Neurol Sci,2003,25(2):4-8.
[7] Kabat-Zinn J,Massion A O,Kristeller J,et al.Effectiveness of a meditation-based stress reduction program in the treatment of anxiety disorders[J].Am J Psychiatry,1992,149(7):936-943.
[8] Morgan D,Segal Z,Williams M,et al.Mindfulness-based cognitive therapy for depression:a new approach to preventing relapse[J].Psychother Res,2003,13(1):123-125.
[9] 李阳,陈长香.斯坦福急性应激反应问卷在创伤性骨折患者中的应用[J].中国康复理论与实践,2015,21(6):717-722.
[10] 路桃影,李艳,夏萍,等.匹兹堡睡眠质量指数的信度及效度分析[J].重庆医学,2014,43(3):260-263.
[11] 王倩,董立焕,成杰,等.脑卒中患者急性应激障碍与睡眠及认知的相关研究[J].重庆医学,2018,47(33):4242-4245.
[12] Cordi M J,Schlarb A A,Rasch B.Deepening sleep by hypnotic suggestion[J].Sleep,2014,37(6):1143-1152.
[13] 王潇,张燕,孙梦夕,等.青少年精神分裂症首次发病患者脑灰质体积与认知功能的相关性[J].临床精神医学杂志,2016,26(6):365-367.
[14] 王杰,刘娜,孙维嘉,等.正念干预促进孕妇身心健康的研究进展[J].护理学杂志,2018,33(15):95-98.
[15] 马雪莲,蒋维连,欧丽嫦.基于正念减压疗法的心理干预对择期手术患者应激反应的影响[J].护理管理杂志,2015,15(9):656-658.
[16] Hoge E A,Bui E,Palitz S A,et al.The effect of mindfulness meditation training on biological acute stress responses in generalized anxiety disorder[J].Psychiatry Res,2017,262(1):328-332.
[17] Jezova D,Hlavacova N,Makatsori A,et al.Increased anxiety induced by listening to unpleasant music during stress exposure is associated with reduced blood pressure and ACTH responses in healthy men[J].Neuroendocrinology,2013,98(2):144-150.