心理干预对改善脑卒中患者心身状况的研究
摘要
现代社会随着经济的飞速发展,人们普遍出现因快节奏、压力和竞争带来的各种情绪反应,如紧张、焦虑、恐惧甚至抑郁。各种情绪的产生原本是人对环境的适应性反应,但这种应激反应变得过分持久,就会危害人的身心健康。近年来,心理干预在临床中的作用越来越引起人们的重视,尤其对癌症患者的治疗,取得较好的疗效。就目前对脑卒中患者的心理干预相关研究来看,此方面研究尚不多。本研究认为关注脑卒中患者的临床心理干预研究,对于改善脑卒中患者的生活质量,提高其临床疗效都具有重要的理论与实践意义。
本研究基于良好的临床研究条件,采用自编患者一般情况调查表、焦虑自评量表、抑郁自评量表、症状自评量表、自理能力评定量表、神经功能评定量表,选取吉林省电力医院神经内科住院脑卒中患者80名作为被试,旨在探讨三个问题:1.脑卒中患者的心身状况;2.探讨在常规治疗基础上,加以相应的心理干预,对脑卒中患者负性情绪、心理状况的影响作用;3.探讨在常规治疗基础上,加以相应的心理干预,对脑卒中患者生活自理能力和神经功能缺损的影响作用。结果表明:心理干预对脑卒中患者负性情绪、心理健康状况及生活自理能力和神经功能缺损的恢复和好转,具有积极的促进作用。
With the rapid development of economy in this modern society, people always have the emotional reflections such as nervousness, anxiousness, fear and depression because of fast rhythm ,competition and pressure. The appearances of the sentiments are adaptable reaction to environment. However, the excessive lasting of this reaction will harm people’s physical and psychological health. Together with traditional biological medicine’s change to modern biology-psychology-social medicine model, people attached more and more importance to psychological factors’influence to people’s physical and psychological health.
Cerebral apoplexy is also called apoplexy. Patients always appeared the phenomenon of physical dysfunction, social hypofunction and role alleosis. All these factors affected the patients and brought serious psychological pressure and impediments of different extent. These psychological impediments have severe negative influence to patients’organism functional rehabilitation。According to the relative research to mental intervention of cerebral apoplexy patients, there are few reports. In the author’s opinion, comprehending of cerebral apoplexy patients’negative emotions and physical and psychological condition and then giving them correspondent mental intervention are especially significant to enhance cerebral apoplexy patients to go back to society and elevate their quality of life.
This research based on good clinical research condition, chooses 80 cerebral apoplexy patients in Nervous Medical Department of Jilin Electric Power Hospital as objectives and divides them into intervention group and control group according to the random matching principle. Together with the conventional therapy, the author gives patients of intervention group three-week psychological behavior intervention. Meanwhile, control group was only given the conventional therapy patients of intervention group got. The author made a research on patients’negative emotions, neurologic defections and self-care functions before and after intervention by SDS, SAS, SCL-90, ADL and CSS with the aim of approach of three problems: 1. Cerebral apoplexy patients’physical and psychological conditions. 2. Approach to the psychological intervention’s influence of cerebral apoplexy patients’negative emotions and psychological conditions together with correspondent mental intervention. 3. Approach to the psychological intervention’s influence of cerebral apoplexy patients’self-care ability and neurologic impairment together with conventional therapy. Results: 1. Psychological intervention is effective in improving cerebral apoplexy patients’negative emotions and physical and psychological conditions. 2. Psychological intervention has energetic promotion in cerebral apoplexy patients’self-care ability and neurologic impairment. 3. Psychological intervention is helpful to establish new treatment model of cerebral apoplexy. 4. Psychological intervention is helpful to stimulate cerebral apoplexy patients’activeness and compliance during treatment course.
本研究基于良好的临床研究条件,采用自编患者一般情况调查表、焦虑自评量表、抑郁自评量表、症状自评量表、自理能力评定量表、神经功能评定量表,选取吉林省电力医院神经内科住院脑卒中患者80名作为被试,旨在探讨三个问题:1.脑卒中患者的心身状况;2.探讨在常规治疗基础上,加以相应的心理干预,对脑卒中患者负性情绪、心理状况的影响作用;3.探讨在常规治疗基础上,加以相应的心理干预,对脑卒中患者生活自理能力和神经功能缺损的影响作用。结果表明:心理干预对脑卒中患者负性情绪、心理健康状况及生活自理能力和神经功能缺损的恢复和好转,具有积极的促进作用。
With the rapid development of economy in this modern society, people always have the emotional reflections such as nervousness, anxiousness, fear and depression because of fast rhythm ,competition and pressure. The appearances of the sentiments are adaptable reaction to environment. However, the excessive lasting of this reaction will harm people’s physical and psychological health. Together with traditional biological medicine’s change to modern biology-psychology-social medicine model, people attached more and more importance to psychological factors’influence to people’s physical and psychological health.
Cerebral apoplexy is also called apoplexy. Patients always appeared the phenomenon of physical dysfunction, social hypofunction and role alleosis. All these factors affected the patients and brought serious psychological pressure and impediments of different extent. These psychological impediments have severe negative influence to patients’organism functional rehabilitation。According to the relative research to mental intervention of cerebral apoplexy patients, there are few reports. In the author’s opinion, comprehending of cerebral apoplexy patients’negative emotions and physical and psychological condition and then giving them correspondent mental intervention are especially significant to enhance cerebral apoplexy patients to go back to society and elevate their quality of life.
This research based on good clinical research condition, chooses 80 cerebral apoplexy patients in Nervous Medical Department of Jilin Electric Power Hospital as objectives and divides them into intervention group and control group according to the random matching principle. Together with the conventional therapy, the author gives patients of intervention group three-week psychological behavior intervention. Meanwhile, control group was only given the conventional therapy patients of intervention group got. The author made a research on patients’negative emotions, neurologic defections and self-care functions before and after intervention by SDS, SAS, SCL-90, ADL and CSS with the aim of approach of three problems: 1. Cerebral apoplexy patients’physical and psychological conditions. 2. Approach to the psychological intervention’s influence of cerebral apoplexy patients’negative emotions and psychological conditions together with correspondent mental intervention. 3. Approach to the psychological intervention’s influence of cerebral apoplexy patients’self-care ability and neurologic impairment together with conventional therapy. Results: 1. Psychological intervention is effective in improving cerebral apoplexy patients’negative emotions and physical and psychological conditions. 2. Psychological intervention has energetic promotion in cerebral apoplexy patients’self-care ability and neurologic impairment. 3. Psychological intervention is helpful to establish new treatment model of cerebral apoplexy. 4. Psychological intervention is helpful to stimulate cerebral apoplexy patients’activeness and compliance during treatment course.
引文
[1] 王建平,林文娟,蔺秀云.癌症病人的生活质量及心理干预研究[J].应用心理学,2002,8(4):36-40.
[2] 张淑琴主编.神经病学[M].高等教育出版社,2003,9第一版:121-122.
[3] 孙凤环,陈明霞.60 例脑卒中患者抑郁情绪调查分析及护理干预[J].现代护理,2006,12(15):1383.
[4] Pedretti LW.Occupational therapy:practice skills for physical dysfunction[J].Missouri:Mosby-Year Book,Inc 1996.
[5] 赵钛.现代偏瘫治疗学[M].北京:人民军医出版社,1997,144.
[6] 于宝成 ,孙新环 ,崔丽华 ,于凤香.A 型行为与脑梗死及血液流变学的相关性研究[J].中华老年心脑血管病杂志,2002,(2)1:34-36.
[7] 梁谷,廖晓平.A 型性格、紧张性生活事件与脑血管病的关系研究[J] . 广西预防医学,1999 ,5(5):283--285.
[8] R.S Lazarus.From Psychological Stressto The Emontion:A History of Changing Outlooks[J].Annual Review of Psychology,1993,44:1-21.
[9] Partricia D.Barry.Psychosocial Nursing Assessment and Intervention[M].NewYork:J.B. Lippincott Company, 1984.96-9.
[10]张宏卫,雷延梅.急性脑血管病患者心理状态的临床研究[J] .齐齐哈尔医学院学报,2002(23)11:1225.
[11]龙洁,蔡焯基,刘永珍.卒中后抑郁状态及其影响因素的相关研究[J].中国精神神经疾病杂志,2001,5(11):34.
[12]任巧玲.脑卒中后抑郁特点及相关因素分析[J].中国行为医学科学,2001,10(05):459.
[13]苏占清,邵伟波,翟毅等.脑卒中后抑郁障碍相关因素及症状特点的研究[J].中国临床康复,2001,5(11):34.
[14]陆雪松,陈青等.心理干预对脑卒中后抑郁偏瘫康复的临床疗效[J].临床荟萃,2003,18(5):259-260.
[15]Robinson RG.Murata Y,Shimmoda K.Dimmensions of social impairment and their effect on depreesion and recovery following stroke[J]. International,Psychogeriatric,1999,11(4):375-384.
[16]尹月娥.住院脑卒中患者抑郁情绪的相关因素分析及护理对策[J].中华实用中西医杂志,2004,4(17):2084-2085.
[18]车文博主编.心理治疗手册[M].吉林人民出版社,1990.2(1):16-19.
[19]唐钺.西方心理学史纲[M].北京大学出版社 .1994,7-8.
[20]何裕民.心身医学概论[M].上海中医学院出版社,1990, 7.
[21]李师郑编译.世界医学史话[M]. 中国台湾民生报社出版,1980, 545.
[22]何裕民.心身医学概论[M].上海中医学院出版社 1990,8.
[23]刘晓虹.中美临床心理护理模式的比较与思考(J).解放军护理杂志,2002,19(6):5-6.
[24]雎密太,张建新,云炜恒,王焕邦.关于大学生心理障碍干预模式的理论建构[J].心理科学2005,28(6):1463-1467.
[25]王登峰.临床心理学[M].北京:人民教育出版社,1999:157-158.
[26]李心天.医学心理学[M].北京:中国协和医科大学出版社,1998:43-47.
[27]姜乾金.医学心理学[M].人民卫生出版社2003,第6版:174-175.
[28]黄冬梅.心理卫生与心理咨询[M].吉林大学出版社,1999,3 第一版:406-408.
[29]Cross p.observations on the me of music in rehabilitation of stroke patient [J].Physiotherapy Conada,1984,6:197.
[30]Langendijk JA,ten Velde GP,Aaronson NK,et al.Quality of Life after Palliative radiotherapy in non-small cell lung cancer:aprospective study[J].Int J Radiat Oncol Biolphys 2000;47(1):149-155.
[31]王建平,陈仲庚,林文娟等.中国癌症病人生活质量的测定—EORTC QLQC-30 在中国的试用[J].心理学报,2000;32(4):64-69.
[32]王建平,陈仲庚,崔俊南. 癌症病人生活质量状况及影响因素研究[J].中国临床心理学杂志,2000;8(1):23-26.
[33]张亚哲,赵耕源,张书刚等.心理干预在冠心病治疗中的作用[J].中国行为医学科学,1997,6(1):39.
[34]Fawzy F I,Fawzy NW,Arndt LA,et al.Critical review of psychological intervention in cancer care[J].Arch Gen Psychiatry 1995;52:100-113.
[35]Lam DH, et prevention al. A randomized study of cognitive therapy for relapse for bipolar affective disorder: outcome of the first year[J].Arch Gen Psychiatry 2003 Feb;60(2):145-52.
[36]Embling S.The effectiveness of cognitive behavioural therapy in depression[J].Nurs Stand 2002 Dec 18-31;17(14-15):33-41.
[37]Sloman R.Relaxation and imagery for anxiety and depression control in community patients with advanced cancer[J].Cancer Nurs 2002 Dec;25(6):432-5.
[38]Sheu S, et al. Effects of progressive muscle relaxation on blood[J].2001,9(3):221.
[39]杨放如.心身放松疗法治疗原发性高血压的临床疗效观察[J].中国临床心理学杂志,2000,8(2):120-121.
[40]吕探云,杨英华,曹玉玲等. 上海市社区老年人的长期护理需要[J].中华护理杂志,2001 ,36( 8):566.
[41]谭艺真摘.中风患者自杀的危险[J].国外医学护理学分册,1998,17(6):273.
[42]邓钰金,徐玲.脑卒中康复期心理障碍的类型及治疗[J].中国康复,1999,14(1):44.
[43]Murphy E.Social origins of depression in old age : Br J Psychiatry,1982,141:135.
[44]翟书涛主编.危机干预与自杀预防[M].北京:人民卫生出版社,1997.15-39.
[45]李炳全.认识失调理论与心理治疗[J],医学与哲学,1999, 20 (5): 57-58.
[46]钱铭怡.心理治疗过程中认识改变的作用[J].中国心理卫生杂志,1994, 8(3): 122 一 124.
[47]孟家眉主编,神经内科临床新进展[M].北京:北京出版社。1994.12,138.
[48]杨放如.心身放松疗法治疗原发性高血压的临床疗效观察[J].中国临床心理学杂志,2000,8(2):122-123.
[49]王建平,林文娟,孙宏伟.中国癌症患者心理干预研究[J」.中国肿瘤临床,2002, 29 (5): 305-309.
[50]A. J. Cunningham, C.V.1.Edmonds, G. P.Jenkins, et al.A randomized controlled trial of the effects of group psychological therapy on survival in women with metastatic breast cancer [J]. Psycho-Oncology,1998, 7(6):508-517.
[51]David W.Kissane,Sidney Bloch, Patricia Miach, et al.Cognitive-existential group therapy for patients with primary breast cancer-techniques and themes [J], Psycho-Oncology, 1997,6(1):25-33.
[52]王登峰.临床心理学[M].北京:人民教育出版社,1999:157-158.
[53]马建青,田欣.论心理治疗的有效性[J].健康心理学,1995, 3 (1): 58-61.
[54]夏为民,胡艳秋.早期介入心理康复对脑卒中患者疗效的影响[J].中国临床康复,2003,7(28):38-42.
[55]刁建华,王桂波,牟玲,等.心理干预对脑中风患者心理障碍的效果观察[J].中国疗养医学,2001,10(6):27.
[56]BUSH B A.Major life events as risks factors for post-strike depression [J]:Brain Inj,1999,13(2):7-13.
[57]Andersen BL.Psychosocial interventions for Cancer patients to enhance quality of life.J Consult Clin Psychol 1992;60:552-568.
[58]Trijburg RW , Van Knippenberg FCE , Rijpma SE.Effect of psychological treatment on cancer patients:acritical review Psychosom Med 1992;54:489-517.
[59]Langendijk JA,ten Velde GP,Aaronson NK,et al.Quality of Life after Palliative radiotherapy in non-small cell lung cancer:aprospective study.Int J Radiat Oncol Biolphys 2000;47(1):149-155.
[60]叶志荣,杨菊贤.冠心病、高血压与心理障碍[J].中国行为医学科学,1997,6(4):313.
[61]Manmck SB,Cohen S,Rabin BS,et al Individul differences in celluler immune response to stress Psychological Science,1991,(2):111-115.
[62]Busse WW,Kiecolt Glaser JK,Chritopher C,et al.Stress and Asthma,Am Respire Crit Care Med,1995,151:249-252.
[63]王俊华,吴建鸿.肺结核伴焦虑抑郁情绪障碍者的免疫功能测定.中国实用内科杂志,1996,16(4):328.
[64]洪军,裘示容,王升旭.剥夺睡眠 56 小时对正常人血细胞和免疫功能的影响.中国临床心理学杂志,2000,8(1):27-28.
[65]R.zachariae,J B Hansen et al.Changes in cellular immune function after immune specific guided imagery and relaxation in high and low hypnotizable healthy subjects.Psychother Psyhchother Psyhchhsom,1994,61:74-92.
[66]Fawzy,Hyun,Elashoff R,et al Maligantmel anoma:effects of an early Structured psychiatric intervention,Cop-ing,and affective state on recurrence and survival six years later.Psychiatric,1993,(50):681-689.
[1] 车文博主编.心理治疗手册[M].吉林人民出版社,1990.2(1):16-19
[2] 何裕民.心身医学概论[M] .上海中医学院出版社,1990, 7
[3] 雎密太.张建新.云炜恒.王焕邦.关于大学生心理障碍干预模式的理论建构[J].心理科学2005,28(6):1463-1467
[4] 李师郑编译.世界医学史话[M] .中国台湾民生报社出版,1980, 545
[5] 龙洁.蔡焯基.刘永珍.卒中后抑郁状态及其影响因素的相关研究[J].中国精神神经疾病杂志,2001,27(6):430
[6] 卢宁.几种心身疾病患者的心理卫生状况与个性特征[J].中国心理卫生杂志,1995,9(2):60-63
[7] 吕倩.林文娟.王建平.心理社会因素与人类免疫功能[J].心理学动态,2000,8(2):67-73
[8] 刘艳,林文娟等.心理行为干预对乳腺癌患者情绪反应及免疫功能的影响[J].心理学报,2001,33(5):437-441
[9] 刘艳,林文娟.肿瘤的心理神经免疫学研究进展[J].心理学动态,1997,5(4):10-15
[10]马锐华,刘永珍,龙洁.卒中后抑郁对住院患者康复的影响[J].中国心理卫生杂志,2002,16(6):400-401
[11] 钱 铭 怡 . 心 理 咨 询 与 心 理 治 疗 [M] . 北 京 : 北 京 大 学 出 版社,1994:157-259
[12]孙新兰.心理因素对人体免疫系统的影响[J].心理学动态,1998,6(2):11-15
[13]唐钺.西方心理学史纲[M].北京大学出版社 .1994,7-8
[14]王维治主编.神经病学[M].人民卫生出版社,2004.1第一版:118
[15]汪向东.心理卫生评定量表手册[M].北京:中国心理卫生杂志社,1999:88-95,127-132
[16]王登峰.临床心理学[M].北京:人民教育出版社,1999:157-158
[17]李心天.医学心理学[M].北京:中国协和医科大学出版社,1998:43-47
[18] 钱 铭 怡 . 心 理 咨 询 与 心 理 治 疗 [M]. 北 京 : 北 京 大 学 出 版社,1994:157-259
[19]徐斌,王效道.心身医学一心理生理医学的基础与临床[J].中国医药科技出版社,1990,5
[20][美]理查德?格里格,菲利普?津巴多.心理学与生活[M]. 王垒等译.人民邮电出版社,2004:355-375
[21]于宝成 ,孙新环 ,崔丽华 ,于凤香A 型行为与脑梗死及血液流变学的相关性研究[J].中华老年心脑血管病杂志 2002,( 2)1: 34-36
[22] 王 长 虹 , 丛 中 . 临 床 心 理 治 疗 学 [M]. 北 京 : 人 民 军 医 出 版社,2001:37-49
[23]翟书涛.危机干预与自杀预防[M].北京:人民卫生出版社,1997:300
[24]朱智先.梁虹.现代心身疾病治疗学[M]. 北京:人民军医出版社,2002:11-36
[25]张明圆.精神科评定量表手册[M].第二版,长沙:湖南科学技术出版社,1998:35-191
[26]张淑琴主编.神经病学[M].高等教育出版社,2003.9 第一版:121-122
[27]赵瑞祥.脑卒中患者心理健康状况的测评[J].中国临床心理学杂志,1999,(7):36-38
[28]郑艳红.305例住院患者心理护理需求调查分析[J].广西医科大学学报
[29]Anne A , Hoon W, Franzoni B , et al. Influence of mood and adjustment to cancer on compliance with chemotherapy among breast cancer patients[J]. Journal of Psychosomatic Research , 1994 , 38 ( 5) :393 —402
[30]Baider L , Kaplan D A. Psychological distress and intrusive thoughts in cancer patients[J].Journal of Nervous and MentalDisease ,1997 ,18 (5) :346～348
[31]Derogatis LR Psychology in Cancer Medicine :a perspective and Overview J Consult Clin Psychol , 1983 , 54 (5) : 632-638
[32]Davis H. Effects of biofeedback and cognitive therapy on stress in patients with breast cancer. Psychol Rep , 1986 , 59 :967 —974
[33]Donal G.Fortune,Helen L.Richards,Christopher E.M.Griffiths etc.Targeting cognitive-behaviour therapy to patients preference controlled trial.The British Journal of Clinical Psychology,2004,43(1):65-82
[34]Fawzy I , Cousins N , Fawzy W, et al. A structured psychiatric intervention for cancer patients I : Changes overtime in methods of coping and affective disturbance. Arch Gen Psychiatry , 1990 , 47 :720 —725
[35]Fawzy I , Fawzy W, Hyun Cs. Malignant melanoma. Effect of an early structures psychiatric intervention , coping and effective state on recurrence and survival 6 year later. Arch Gen Psychiatry , 1993 , 50 (9) :681 —689
[36]Gieta van der P , Antoni H , Visser A , et al. Adjustment to breast cancer. The psychobiological effects of psychosocial interventions.Patient Education and Counseling , 1996 , 28 (2) :209 —219
[37]Gieta van der P , Duivenvoorden J , Antoni H , et al. Effectivenessof a shortterm group psychotherapy program on endocrine and immune function in breast cancer patients : An exploratory study.Journal of Psychosomatic Research , 1997 , 42 (5) :453 —466
[38]Greers S , Morris T , Pettingale W, et al. Psychological response to breast cancer and 15 years out come. Lancet , 1990 , I :49-50
[39]Osoba D , Tannock L F , Ernst D S , et al.Healthrelated quality of life in men with metastatic prostate cancer reated with prednisone alone or mitoxant rone and prednisone. Journal of Psychosocial Oncology ,1999 ,17 (6) :1654-1663
[40]P.Kennedy,J.Duff,M.Evans etc.Coping effectiveness training reduces depression and anxiety following traumatic spinal cord injuries.the british Journal of Clinical Psychology,2003,42(1):41-52
[41]Pamela J.Goodwin.Psychosocial support for women with advanced breast cancer.Breast Cancer Research and Treatment,2003,81:103-110
[42]Partricia D.Barry Psychosocial Nursing Assessment and Inter –vention .New York:J.B.Lippincott Company,1984.96-99,183-196
[43]P.Kennedy,J.Duff,M.Evans etc.Coping effectiveness training reduces depression and anxiety following traumatic spinal cord injuries.the british Journal of Clinical Psychology,2003,42(1):41-52
[44]Spiegel D. Health caring : psychosocial support for patients with cancer. Cancer ,1994 , 74 (Suppl.) : 1453-1457
[45]Spiegel D , Bloom J , Yalom ID. Group support for patients with metastatic breast cancer. Arch Gen. Psychiatry ,1981 , 38 : 527-533
[46]Spiegel D , Bloom J , Kraemer HC , et al. Effect of psychosocialtreatment on survival of patients with metastatic breast cancer patients. Lancet ,1989 , 2 : 888-891
[47]Sandro Panpallona,Paola Bollini,Giuscppe Tibaldi D ect.Combined Pharmac therapy and Psychological Treatment forDeprssion:A systematic Review.Archive of General Psychiatry,2004,61(7):714-719
[48]Zabora J R ,Blanchard C G, Smith E D , et al. Prevalence of psychological dist ress across the disease continue. Journal of Psychosocial Oncology ,1997 ,15 (1) :73-87
[2] 张淑琴主编.神经病学[M].高等教育出版社,2003,9第一版:121-122.
[3] 孙凤环,陈明霞.60 例脑卒中患者抑郁情绪调查分析及护理干预[J].现代护理,2006,12(15):1383.
[4] Pedretti LW.Occupational therapy:practice skills for physical dysfunction[J].Missouri:Mosby-Year Book,Inc 1996.
[5] 赵钛.现代偏瘫治疗学[M].北京:人民军医出版社,1997,144.
[6] 于宝成 ,孙新环 ,崔丽华 ,于凤香.A 型行为与脑梗死及血液流变学的相关性研究[J].中华老年心脑血管病杂志,2002,(2)1:34-36.
[7] 梁谷,廖晓平.A 型性格、紧张性生活事件与脑血管病的关系研究[J] . 广西预防医学,1999 ,5(5):283--285.
[8] R.S Lazarus.From Psychological Stressto The Emontion:A History of Changing Outlooks[J].Annual Review of Psychology,1993,44:1-21.
[9] Partricia D.Barry.Psychosocial Nursing Assessment and Intervention[M].NewYork:J.B. Lippincott Company, 1984.96-9.
[10]张宏卫,雷延梅.急性脑血管病患者心理状态的临床研究[J] .齐齐哈尔医学院学报,2002(23)11:1225.
[11]龙洁,蔡焯基,刘永珍.卒中后抑郁状态及其影响因素的相关研究[J].中国精神神经疾病杂志,2001,5(11):34.
[12]任巧玲.脑卒中后抑郁特点及相关因素分析[J].中国行为医学科学,2001,10(05):459.
[13]苏占清,邵伟波,翟毅等.脑卒中后抑郁障碍相关因素及症状特点的研究[J].中国临床康复,2001,5(11):34.
[14]陆雪松,陈青等.心理干预对脑卒中后抑郁偏瘫康复的临床疗效[J].临床荟萃,2003,18(5):259-260.
[15]Robinson RG.Murata Y,Shimmoda K.Dimmensions of social impairment and their effect on depreesion and recovery following stroke[J]. International,Psychogeriatric,1999,11(4):375-384.
[16]尹月娥.住院脑卒中患者抑郁情绪的相关因素分析及护理对策[J].中华实用中西医杂志,2004,4(17):2084-2085.
[18]车文博主编.心理治疗手册[M].吉林人民出版社,1990.2(1):16-19.
[19]唐钺.西方心理学史纲[M].北京大学出版社 .1994,7-8.
[20]何裕民.心身医学概论[M].上海中医学院出版社,1990, 7.
[21]李师郑编译.世界医学史话[M]. 中国台湾民生报社出版,1980, 545.
[22]何裕民.心身医学概论[M].上海中医学院出版社 1990,8.
[23]刘晓虹.中美临床心理护理模式的比较与思考(J).解放军护理杂志,2002,19(6):5-6.
[24]雎密太,张建新,云炜恒,王焕邦.关于大学生心理障碍干预模式的理论建构[J].心理科学2005,28(6):1463-1467.
[25]王登峰.临床心理学[M].北京:人民教育出版社,1999:157-158.
[26]李心天.医学心理学[M].北京:中国协和医科大学出版社,1998:43-47.
[27]姜乾金.医学心理学[M].人民卫生出版社2003,第6版:174-175.
[28]黄冬梅.心理卫生与心理咨询[M].吉林大学出版社,1999,3 第一版:406-408.
[29]Cross p.observations on the me of music in rehabilitation of stroke patient [J].Physiotherapy Conada,1984,6:197.
[30]Langendijk JA,ten Velde GP,Aaronson NK,et al.Quality of Life after Palliative radiotherapy in non-small cell lung cancer:aprospective study[J].Int J Radiat Oncol Biolphys 2000;47(1):149-155.
[31]王建平,陈仲庚,林文娟等.中国癌症病人生活质量的测定—EORTC QLQC-30 在中国的试用[J].心理学报,2000;32(4):64-69.
[32]王建平,陈仲庚,崔俊南. 癌症病人生活质量状况及影响因素研究[J].中国临床心理学杂志,2000;8(1):23-26.
[33]张亚哲,赵耕源,张书刚等.心理干预在冠心病治疗中的作用[J].中国行为医学科学,1997,6(1):39.
[34]Fawzy F I,Fawzy NW,Arndt LA,et al.Critical review of psychological intervention in cancer care[J].Arch Gen Psychiatry 1995;52:100-113.
[35]Lam DH, et prevention al. A randomized study of cognitive therapy for relapse for bipolar affective disorder: outcome of the first year[J].Arch Gen Psychiatry 2003 Feb;60(2):145-52.
[36]Embling S.The effectiveness of cognitive behavioural therapy in depression[J].Nurs Stand 2002 Dec 18-31;17(14-15):33-41.
[37]Sloman R.Relaxation and imagery for anxiety and depression control in community patients with advanced cancer[J].Cancer Nurs 2002 Dec;25(6):432-5.
[38]Sheu S, et al. Effects of progressive muscle relaxation on blood[J].2001,9(3):221.
[39]杨放如.心身放松疗法治疗原发性高血压的临床疗效观察[J].中国临床心理学杂志,2000,8(2):120-121.
[40]吕探云,杨英华,曹玉玲等. 上海市社区老年人的长期护理需要[J].中华护理杂志,2001 ,36( 8):566.
[41]谭艺真摘.中风患者自杀的危险[J].国外医学护理学分册,1998,17(6):273.
[42]邓钰金,徐玲.脑卒中康复期心理障碍的类型及治疗[J].中国康复,1999,14(1):44.
[43]Murphy E.Social origins of depression in old age : Br J Psychiatry,1982,141:135.
[44]翟书涛主编.危机干预与自杀预防[M].北京:人民卫生出版社,1997.15-39.
[45]李炳全.认识失调理论与心理治疗[J],医学与哲学,1999, 20 (5): 57-58.
[46]钱铭怡.心理治疗过程中认识改变的作用[J].中国心理卫生杂志,1994, 8(3): 122 一 124.
[47]孟家眉主编,神经内科临床新进展[M].北京:北京出版社。1994.12,138.
[48]杨放如.心身放松疗法治疗原发性高血压的临床疗效观察[J].中国临床心理学杂志,2000,8(2):122-123.
[49]王建平,林文娟,孙宏伟.中国癌症患者心理干预研究[J」.中国肿瘤临床,2002, 29 (5): 305-309.
[50]A. J. Cunningham, C.V.1.Edmonds, G. P.Jenkins, et al.A randomized controlled trial of the effects of group psychological therapy on survival in women with metastatic breast cancer [J]. Psycho-Oncology,1998, 7(6):508-517.
[51]David W.Kissane,Sidney Bloch, Patricia Miach, et al.Cognitive-existential group therapy for patients with primary breast cancer-techniques and themes [J], Psycho-Oncology, 1997,6(1):25-33.
[52]王登峰.临床心理学[M].北京:人民教育出版社,1999:157-158.
[53]马建青,田欣.论心理治疗的有效性[J].健康心理学,1995, 3 (1): 58-61.
[54]夏为民,胡艳秋.早期介入心理康复对脑卒中患者疗效的影响[J].中国临床康复,2003,7(28):38-42.
[55]刁建华,王桂波,牟玲,等.心理干预对脑中风患者心理障碍的效果观察[J].中国疗养医学,2001,10(6):27.
[56]BUSH B A.Major life events as risks factors for post-strike depression [J]:Brain Inj,1999,13(2):7-13.
[57]Andersen BL.Psychosocial interventions for Cancer patients to enhance quality of life.J Consult Clin Psychol 1992;60:552-568.
[58]Trijburg RW , Van Knippenberg FCE , Rijpma SE.Effect of psychological treatment on cancer patients:acritical review Psychosom Med 1992;54:489-517.
[59]Langendijk JA,ten Velde GP,Aaronson NK,et al.Quality of Life after Palliative radiotherapy in non-small cell lung cancer:aprospective study.Int J Radiat Oncol Biolphys 2000;47(1):149-155.
[60]叶志荣,杨菊贤.冠心病、高血压与心理障碍[J].中国行为医学科学,1997,6(4):313.
[61]Manmck SB,Cohen S,Rabin BS,et al Individul differences in celluler immune response to stress Psychological Science,1991,(2):111-115.
[62]Busse WW,Kiecolt Glaser JK,Chritopher C,et al.Stress and Asthma,Am Respire Crit Care Med,1995,151:249-252.
[63]王俊华,吴建鸿.肺结核伴焦虑抑郁情绪障碍者的免疫功能测定.中国实用内科杂志,1996,16(4):328.
[64]洪军,裘示容,王升旭.剥夺睡眠 56 小时对正常人血细胞和免疫功能的影响.中国临床心理学杂志,2000,8(1):27-28.
[65]R.zachariae,J B Hansen et al.Changes in cellular immune function after immune specific guided imagery and relaxation in high and low hypnotizable healthy subjects.Psychother Psyhchother Psyhchhsom,1994,61:74-92.
[66]Fawzy,Hyun,Elashoff R,et al Maligantmel anoma:effects of an early Structured psychiatric intervention,Cop-ing,and affective state on recurrence and survival six years later.Psychiatric,1993,(50):681-689.
[1] 车文博主编.心理治疗手册[M].吉林人民出版社,1990.2(1):16-19
[2] 何裕民.心身医学概论[M] .上海中医学院出版社,1990, 7
[3] 雎密太.张建新.云炜恒.王焕邦.关于大学生心理障碍干预模式的理论建构[J].心理科学2005,28(6):1463-1467
[4] 李师郑编译.世界医学史话[M] .中国台湾民生报社出版,1980, 545
[5] 龙洁.蔡焯基.刘永珍.卒中后抑郁状态及其影响因素的相关研究[J].中国精神神经疾病杂志,2001,27(6):430
[6] 卢宁.几种心身疾病患者的心理卫生状况与个性特征[J].中国心理卫生杂志,1995,9(2):60-63
[7] 吕倩.林文娟.王建平.心理社会因素与人类免疫功能[J].心理学动态,2000,8(2):67-73
[8] 刘艳,林文娟等.心理行为干预对乳腺癌患者情绪反应及免疫功能的影响[J].心理学报,2001,33(5):437-441
[9] 刘艳,林文娟.肿瘤的心理神经免疫学研究进展[J].心理学动态,1997,5(4):10-15
[10]马锐华,刘永珍,龙洁.卒中后抑郁对住院患者康复的影响[J].中国心理卫生杂志,2002,16(6):400-401
[11] 钱 铭 怡 . 心 理 咨 询 与 心 理 治 疗 [M] . 北 京 : 北 京 大 学 出 版社,1994:157-259
[12]孙新兰.心理因素对人体免疫系统的影响[J].心理学动态,1998,6(2):11-15
[13]唐钺.西方心理学史纲[M].北京大学出版社 .1994,7-8
[14]王维治主编.神经病学[M].人民卫生出版社,2004.1第一版:118
[15]汪向东.心理卫生评定量表手册[M].北京:中国心理卫生杂志社,1999:88-95,127-132
[16]王登峰.临床心理学[M].北京:人民教育出版社,1999:157-158
[17]李心天.医学心理学[M].北京:中国协和医科大学出版社,1998:43-47
[18] 钱 铭 怡 . 心 理 咨 询 与 心 理 治 疗 [M]. 北 京 : 北 京 大 学 出 版社,1994:157-259
[19]徐斌,王效道.心身医学一心理生理医学的基础与临床[J].中国医药科技出版社,1990,5
[20][美]理查德?格里格,菲利普?津巴多.心理学与生活[M]. 王垒等译.人民邮电出版社,2004:355-375
[21]于宝成 ,孙新环 ,崔丽华 ,于凤香A 型行为与脑梗死及血液流变学的相关性研究[J].中华老年心脑血管病杂志 2002,( 2)1: 34-36
[22] 王 长 虹 , 丛 中 . 临 床 心 理 治 疗 学 [M]. 北 京 : 人 民 军 医 出 版社,2001:37-49
[23]翟书涛.危机干预与自杀预防[M].北京:人民卫生出版社,1997:300
[24]朱智先.梁虹.现代心身疾病治疗学[M]. 北京:人民军医出版社,2002:11-36
[25]张明圆.精神科评定量表手册[M].第二版,长沙:湖南科学技术出版社,1998:35-191
[26]张淑琴主编.神经病学[M].高等教育出版社,2003.9 第一版:121-122
[27]赵瑞祥.脑卒中患者心理健康状况的测评[J].中国临床心理学杂志,1999,(7):36-38
[28]郑艳红.305例住院患者心理护理需求调查分析[J].广西医科大学学报
[29]Anne A , Hoon W, Franzoni B , et al. Influence of mood and adjustment to cancer on compliance with chemotherapy among breast cancer patients[J]. Journal of Psychosomatic Research , 1994 , 38 ( 5) :393 —402
[30]Baider L , Kaplan D A. Psychological distress and intrusive thoughts in cancer patients[J].Journal of Nervous and MentalDisease ,1997 ,18 (5) :346～348
[31]Derogatis LR Psychology in Cancer Medicine :a perspective and Overview J Consult Clin Psychol , 1983 , 54 (5) : 632-638
[32]Davis H. Effects of biofeedback and cognitive therapy on stress in patients with breast cancer. Psychol Rep , 1986 , 59 :967 —974
[33]Donal G.Fortune,Helen L.Richards,Christopher E.M.Griffiths etc.Targeting cognitive-behaviour therapy to patients preference controlled trial.The British Journal of Clinical Psychology,2004,43(1):65-82
[34]Fawzy I , Cousins N , Fawzy W, et al. A structured psychiatric intervention for cancer patients I : Changes overtime in methods of coping and affective disturbance. Arch Gen Psychiatry , 1990 , 47 :720 —725
[35]Fawzy I , Fawzy W, Hyun Cs. Malignant melanoma. Effect of an early structures psychiatric intervention , coping and effective state on recurrence and survival 6 year later. Arch Gen Psychiatry , 1993 , 50 (9) :681 —689
[36]Gieta van der P , Antoni H , Visser A , et al. Adjustment to breast cancer. The psychobiological effects of psychosocial interventions.Patient Education and Counseling , 1996 , 28 (2) :209 —219
[37]Gieta van der P , Duivenvoorden J , Antoni H , et al. Effectivenessof a shortterm group psychotherapy program on endocrine and immune function in breast cancer patients : An exploratory study.Journal of Psychosomatic Research , 1997 , 42 (5) :453 —466
[38]Greers S , Morris T , Pettingale W, et al. Psychological response to breast cancer and 15 years out come. Lancet , 1990 , I :49-50
[39]Osoba D , Tannock L F , Ernst D S , et al.Healthrelated quality of life in men with metastatic prostate cancer reated with prednisone alone or mitoxant rone and prednisone. Journal of Psychosocial Oncology ,1999 ,17 (6) :1654-1663
[40]P.Kennedy,J.Duff,M.Evans etc.Coping effectiveness training reduces depression and anxiety following traumatic spinal cord injuries.the british Journal of Clinical Psychology,2003,42(1):41-52
[41]Pamela J.Goodwin.Psychosocial support for women with advanced breast cancer.Breast Cancer Research and Treatment,2003,81:103-110
[42]Partricia D.Barry Psychosocial Nursing Assessment and Inter –vention .New York:J.B.Lippincott Company,1984.96-99,183-196
[43]P.Kennedy,J.Duff,M.Evans etc.Coping effectiveness training reduces depression and anxiety following traumatic spinal cord injuries.the british Journal of Clinical Psychology,2003,42(1):41-52
[44]Spiegel D. Health caring : psychosocial support for patients with cancer. Cancer ,1994 , 74 (Suppl.) : 1453-1457
[45]Spiegel D , Bloom J , Yalom ID. Group support for patients with metastatic breast cancer. Arch Gen. Psychiatry ,1981 , 38 : 527-533
[46]Spiegel D , Bloom J , Kraemer HC , et al. Effect of psychosocialtreatment on survival of patients with metastatic breast cancer patients. Lancet ,1989 , 2 : 888-891
[47]Sandro Panpallona,Paola Bollini,Giuscppe Tibaldi D ect.Combined Pharmac therapy and Psychological Treatment forDeprssion:A systematic Review.Archive of General Psychiatry,2004,61(7):714-719
[48]Zabora J R ,Blanchard C G, Smith E D , et al. Prevalence of psychological dist ress across the disease continue. Journal of Psychosocial Oncology ,1997 ,15 (1) :73-87