心理护理在改善胃癌患者围手术期焦虑及抑郁状况中的应用

论文编号:HL156  论文字数:10393.页数:21

论文题目：心理护理在改善胃癌患者围手术期焦虑及抑郁状况中的应用
摘　要
 目的：探讨胃癌患者围手术期抑郁焦虑心理影响因素及心理干预对胃癌患者围手术期的焦虑和抑郁的护理效果。
 方法：将 80例行胃癌的手术患者随机分为观察组 40例和对照组 40例,观察组采用心理护理, 对照组采用常规护理方法, 患者均采用抑郁 ( SDS)和焦虑自评量表 ( SAS)进行评价,并比较二者的护理效果。
 结果：应用抑郁和焦虑自评量表 (SDS 、SAS)对80名胃癌围手术期患者进行检测, 辅以自行设计影响因素调查表进行相关因素调查，对疾病和手术的恐惧感、 手术治疗效果、 医疗氛围、 家庭经济状况、 疼痛程度、 睡眠质量、 婚姻关系、 事业受影响、 对病情了解程度、 担心医护不精心10项因素与抑郁焦虑状态的发生显著相关。
 观察组抑郁和焦虑指数在治疗后比治疗前显著下降 ( P< 0.01), 而对照组治疗后比治疗前抑郁和焦虑指数下降不明显 ( P> 0.05) ,治疗后对照组的两项指数均明显高于观察组 ( P< 0 . 01)。
 结论：
 1、胃癌患者围手术期抑郁焦虑心理与疼痛、对疾病和手术的恐惧感、担心手术治疗效果等因素相关。
 2、对胃癌患者围术期进行心理干预, 可以有效降低患者的抑郁和焦虑程度,值得临床推广应用。
 
 关键词: 胃癌; 围手术期; 抑郁焦虑; 影响因素
 
Title: Psychological care in improving stomach cancer patients perioperative anxiety and depression in application
ABSTRACT
Objective
 Explore stomach cancer patients perioperative anxiety psychological factors and psychological intervention on patients with cancer of the stomach perioperative care effect of anxiety and depression．
Methods
 80 cases of gastric cancer will surgery patients were randomly divided into trial group and control group in 40 cases 40 cases, the observation group using psychological care, control group was used by routine care method, the patients were depression (SDS) and anxiety from rating scale (SAS) evaluation, and in comparison of the nursing effect.．
Results
 Application of depression and anxiety from rating scale (SDS, of 80 cancer of the stomach SAS) around the time of surgery patients for testing, complementary with self-designed questionnaire influence factors related factors to the disease, and surgery investigation of the fear and surgery, the effect, the medical atmosphere, family economic conditions, pain, the sleep quality, marriage, career affected, to know the degree, the worry about medical condition not elaborate ten of the factors and the anxiety of the state have significantly related.
 The observation group depression and anxiety index after the therapy before treatment than decreased significantly (P < 0.01), whereas the control after treatment than before treatment depression and anxiety exponential decline is not obvious (P > 0.05), after treatment of two index in the control group were significantly higher than that of the observation group (P < 0.05)．
Conclusion
 1, stomach cancer patients perioperative depression anxiety and pain, to the disease and the operation to fear, worry about surgical treatment effects related to such factors.
 2, to cancer of the stomach perioperative period in patients with psychological intervention, can effectively reduce the patients of depression and anxiety level, and clinical application．

Key words： Stomach cancer; Perioperative; Anxiety; Influence factors
 
目  录
 
摘　要 I
ABSTRACT III
目  录 3
1 绪论 3
1.1 背景及意义 3
1.2目的 4
1.3关键词及定义 4
1.4文献回顾 4
2研究设计 7
2.1研究设计 7
2.2研究对象 7
2.3研究工具 7
2.4研究方法 7
2.4.1术前心理干预: 7
2.4.2术中心理干预 8
2.4.3．术后心理干预。 8
2.5研究步骤 9
2.6统计分析 9
3研究结果 11
3．1抑郁焦虑测评结果 11
3．2胃癌患者围手术期抑郁焦虑心理影响因素分析 11
3．3两组患者手术前后抑郁自评量表评分比较 12
3．4两组患者手术前后焦虑自评量表评分比较 12
4讨论 13
4．1抑郁焦虑影响因素分析 13
4.2心理干预在胃癌患者围术期的应用 14
5 推论及建议 16
5.1结论 16
5.2建议 16
5.3本研究局限性及展望 16
致    谢 17
参考文献 18