摘要
目的:探讨心理干预对前列腺增生症患者心理状态及生活质量的影响。方法:选择2002-12/2004-12阳春市人民医院泌尿外科前列腺增生症住院患者65例作为观察对象。随机分成干预组(35例)及对照组(30例),对照组采用常规药物治疗及对症处理。干预组在此基础上增加心理疗法。心理干预采用集中健康教育,调整生活方式;行为疗法;心理疏导及要求家属协助治疗等方法。采用症状自评量表评定患者心理健康水平,并以正常人常模为对照。症状自评量表评定采用5级评分(0～4级,0从无,l轻度,2中度,3相当重,4严重)。得分越高,心理问题越重。于患者入院后次日在病房测评。采用抑郁自评量表和焦虑自评量表测评患者抑郁、焦虑症状情况。抑郁自评量表及焦虑自评量表的主要统计指标是总分及20个项目,按症状出现频度评定分4个等级:没有或很少时间;少部分时间;相当多时间;绝大部分或全部时间。若为正向评分,依次评为粗分1,2,3,4,反向评分则评为4,3,2,1。待自评结束后,把20个项目中的各项分数相加,即得到总粗分,然后通过公式转换:Y=int(1.25×粗分),即用粗分乘以1.25后,取其整数部分,就得到标准总分Y。患者得分越高,焦虑、抑郁情绪越明显。选用普适性生活质量量表测评前列腺增生症患者生活质量。普适性生活质量量表共有36个条目,包含躯体功能、躯体角色、机体疼痛、总的健康状况、活力、社会功能、情绪角色和心理卫生8个领域。采用4级评分。各项得分越高,说明生活质量越高。于出院前3d进行抑郁自评量表、焦虑自评量表及普适性生活质量量表测试。组间采用t检验。结果:65份问卷均完整合格。①前列腺增生症患者症状自评量表各因子评分与正常人常模比较:躯体化、强迫、抑郁、焦虑、恐怖、偏执和精神病性因子评分明显高于正常人常模数据(t=2.016-2.902,P<0.05)。②干预组患者的抑郁、焦虑评分明显低于对照组(t=3.070,t=2.542,P<0.05)。③干预组普适性生活质量量表的总评分、总的健康、躯体角色、活力、情绪角色、心理卫生平均评分明显高于对照组(t=2.114-3.496,P<0.05)。结论:前列腺增生症患者在症状自评量表的9项因子中除人际关系和敌对两项外,因子分均高于人常模数据,说明存在不同程度的心理功能障碍。进行药物及对症治疗的同时,实施有效的心理干预可以改善患者的不良情绪,改善患者对疾病的接受程度,有助于提高生活质量。
AIM：To investigate the effects of psychological intervention on mental state and quality of life of patients with benign prostatic hypertrophy （BPH）. METHODS：Sixty-five patients with BPH, over 60 years of age, who were hospitalized in the Department of Urinary Surgery, People＇s Hospital of Yangchun City from December 2002 to Decemb, 2004, were enrolled in the study. All the subjects were randomized into intervention group （n=35） receiving mental intervention plus routine treatment and symptomatic treatment, and control group （n=30） only receiving routine treatment and symptomatic treatment. Mental intervention included centralized health education, regulating living style, behavior therapy, mental leading, and requesting relatives participating in the treatment, etc. Symptom checklist 90 （SCL90） was adopted to analyze patients mental state with Chinese norm as control, SCL-90 included grade 0 to grade 4, grade 0 as no, 1 as mild, 2 as moderate, 3 as bad, and 4 as severe. The higher the score was, the more severe the mental problem was. Patients received scoring on the morrow after hospitalization. Self-rating depression scale （SDS） and self- rating anxiety scale （SAS） were adopted to assess patients＇ depressive and anxious symptoms, which consisted of 20 items and 4 grades （without or with little time, a little time, much time, and most or full time）. Positive scoring was 1, 2, 3, 4 in order, and reverse scoring was 4, 3, 2, 1 in order. Scores of 20 items were added together to obtain total raw score and then calculate standard score Y： Y=int（1.25×raw score）. The higher the scores were, the more remarkable the depressive and anxious symptoms were. And medical outcomes study 36-item short-form healthy survey （MOS SF-36） was conducted to assess patients＇ quality of life, including 36 items, 8 aspects （physical functioning, somatic role, bodily pain, general health, vitality, social function, emotional role and mental health） and 4 grades. The higher the score was, the better the quality of life was. SDS, SAS and MOS SF-36 were conducted 3 days before discharge. Intra-group comparison was done with t test. RESULTS ：Sixty-five questionnaires were complete and qualified. ①SCL-90 scores and Chinese norm： Scores on somatization, obsessive-compulsive, depression, anxiety, phobic anxiety, paranoid ideation, and psychoticism in BPH patients were significantly higher than those of the Chinese norm （t=2.016-2.902, P 〈 0.05）. ②Scores on SDS and SAS were lower in the intervention group than in the control gruup（t=3.070,t=2.542, P 〈 0.05）. ③Total score of MOS SF-36 and scores on somatic role, general health, vitality, emotional role and mental health were higher in the intervention group than in the control group（t=2.114-3.496, P 〈 0.05）. CONCLUSION：In SCL-90 measurement, scores on somatization, obsessive-compulsive, depression, anxiety, phobic anxiety, paranoid ideation, and psychoticism are higher in the patients with BPH as compared with the Chinese norm, indicating that mental disorder exist in BPH patients. Consequently, routine drug treatment and symptomatic treatment combined with mental intervention can improve patients＇ emotion, and promote the acceptance of patients＇to disease which is beneficial to improve patients＇quality of life.
出处
《中国临床康复》
CSCD
北大核心
2005年第24期44-46,共3页
Chinese Journal of Clinical Rehabilitation
