音樂放松練習(xí)對緩解乳腺癌患者化療期間焦慮及不良反應(yīng)的效果研

1、音樂放松練習(xí)對緩解乳腺癌患者化療期間焦慮及不良反應(yīng)的效果研        【中文摘要】研究背景乳腺癌是一種全身性疾病,是輕易發(fā)生血道轉(zhuǎn)移的疾病,近年來乳腺癌的發(fā)病率呈上升趨勢,因而乳腺癌患者經(jīng)過手術(shù)治療后,化療是治療腫瘤的常用手段,它可彌補(bǔ)手術(shù)及放療的不足,預(yù)防腫瘤復(fù)發(fā)和轉(zhuǎn)移。化療藥物在應(yīng)用的同時(shí)也會(huì)給患者生理及心理上帶來了很多不良反應(yīng),部分患者由于不能忍受化療所帶來的不良反應(yīng),而不得不放棄或中斷化療,影響治療效果。本研究旨在將音樂治療、漸進(jìn)性肌肉放松及引導(dǎo)性意象作為一種補(bǔ)充替換療法幫助患者往積極應(yīng)對不良的化療副反

2、應(yīng),減輕這些副反應(yīng)對患者的影響程度,緩解乳腺癌患者術(shù)后化療期間焦慮程度,進(jìn)步乳腺癌患者的生活質(zhì)量,為制定乳腺癌患者術(shù)后整體康復(fù)措施提供依據(jù)。目的探討音樂放松練習(xí)對緩解乳腺癌術(shù)后患者化療引起焦慮和不良反應(yīng)的效果。方法采用方便抽樣的方法將進(jìn)選條件的乳腺癌術(shù)后患者分為干預(yù)組(55名)和對照組(55名),兩組在年齡、文化程度、月經(jīng)情況、病理類型、分級等方面差異無統(tǒng)計(jì)學(xué)意義(P0.05)。經(jīng)過知情同意后,對照組患者按照乳腺癌術(shù)后化療的護(hù)理常規(guī)進(jìn)行護(hù)理,干預(yù)組患者在接受常規(guī)護(hù)理的同時(shí),給予2個(gè)化療周期的音樂放松練習(xí)(音樂治療、漸進(jìn)性肌肉放松及引導(dǎo)性意象)。以狀態(tài)焦慮問卷和Rotterdam癥狀檢丈量表的評

3、定為主要指標(biāo),分別在第2次化療前、第3次化療前對干預(yù)效果進(jìn)行評價(jià)。結(jié)果干預(yù)后干預(yù)組患者的Rotterdam癥狀檢丈量表總分、生理緯度得分、心理緯度得分的上升趨勢明顯低于對照組,差別有統(tǒng)計(jì)學(xué)意義(P0.05),兩組間Rotterdam癥狀檢丈量表總分、生理緯度得分在第2次化療前、第3次化療前隨訪時(shí),差別有統(tǒng)計(jì)學(xué)意義(P0.05)。兩組間心理緯度得分在第3次化療前隨訪時(shí),差別有統(tǒng)計(jì)學(xué)意義(P0.05);干預(yù)后干預(yù)組患者在“食欲減退”、“缺乏精力”、“惡心”、“返酸”、“口腔潰瘍”、“咳嗽”6項(xiàng)癥狀的發(fā)生率不隨時(shí)間的變化而變化,差別無統(tǒng)計(jì)學(xué)意義(P0.05),而對照組患者上述6項(xiàng)癥狀的發(fā)生率隨時(shí)間的

4、變化而變化,差別有統(tǒng)計(jì)學(xué)意義(P0.05),對照組和干預(yù)組的該6項(xiàng)癥狀發(fā)生率的差別也有統(tǒng)計(jì)學(xué)差異(P0.05);干預(yù)后干預(yù)組在“背痛”癥狀的發(fā)生率隨時(shí)間的變化而變化,差別有統(tǒng)計(jì)學(xué)意義(P0.05),而對照組在該項(xiàng)癥狀的發(fā)生率不隨時(shí)間的變化而變化,差別無統(tǒng)計(jì)學(xué)意義(P0.05),對照組和干預(yù)組的“背痛”癥狀發(fā)生率的差別也有統(tǒng)計(jì)學(xué)意義(P0.05);對照組和干預(yù)組患者在“緊張”癥狀的發(fā)生率的差別無統(tǒng)計(jì)學(xué)意義(P0.05),但對照組和干預(yù)組患者在“緊張”癥狀的發(fā)生率隨時(shí)間的變化而變化,差別有統(tǒng)計(jì)學(xué)意義(P0.05),兩者變化的趨勢不同,干預(yù)組的癥狀發(fā)生率隨著化療的進(jìn)行發(fā)生率有降低趨勢,而相對于對照組

5、的癥狀發(fā)生率卻隨著化療的進(jìn)行發(fā)生率有升高趨勢;干預(yù)后干預(yù)組的焦慮得分趨勢明顯低于對照組,差別有統(tǒng)計(jì)學(xué)意義(P0.05),兩組間狀態(tài)焦慮得分在第2次化療前、第3次化療前隨訪時(shí),差別有統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論音樂放松練習(xí)能減輕患者化療的不良反應(yīng),減輕患者化療期的焦慮程度,在對乳腺癌術(shù)后化療患者的心理行為干預(yù)中具有可操縱性。');【Abstract】 Background Breast cancer is a kind of systemic disease which is easily metastasizes through blood route.Recently the in

6、cidence of breast cancer is evidencing a gradual rise.Chemotherapy is a one of the routine regimens for the breast cancer patients after operation,which may retrieve the deficiency of operation and radiotherapy,and prevent cancer occurrence or metastasis.Breast cancer patient will experience a lot o

7、f adverse reactions on physiological function and psychological function during chemotherapy.A part of patients had to quit the treatment because of the side effects of chemotherapy.Therefore the purpose of this study is to identify the effects of the music relaxation therapy on anxiety and adverse

8、reaction of the breast cancer patient after modified radical mastectomy during the chemotherapy.This study is significant in improving the quality of life and implementing holistic rehabilitative program for breast cancer patients after modified radical mastectomy.Objective To evaluate the effective

9、ness of the music relaxation therapy on anxiety and adverse reaction of the breast cancer patient after modified radical mastectomy during the chemotherapy.Methods 110 breast cancer patients were recruited from Breast Cancer Inpatients Units and then divided into intervention group and control group

10、.There were no statistic differences in age,education,emmenia condition, pathologic types,and stages of cancer.Those in the intervention group received 2 chemotherapy cycle' s music relaxation therapy in addition routine care,while the control group received routine care only.The music relaxatio

11、n therapy consisted of music therapy,progressive muscle relaxation and guided inner image.State Anxiety Inventory and the Rotterdam symptom checklist(RSCL) were administered before the 2(nd) chemo-cycle and before the 3rd chemo-cycle.And the differences were compared using repeated measures ANOVA,MO

12、NOVA and Cochran-Mantel-Hansel Analysis. ResultsThere was trend of lower scores on the Rotterdam symptom checklist total score,physiological function score and psychological function score in intervention group than in control group(P0.05).It evident that there were statistical difference in the Rot

13、terdam symptom checklist total score and physiological function score during 2follow-up(P0.05).It evident that there were statistical difference in the Rotterdam symptom checklist psychological function score during the 2(nd) follow-up(P0.05).No statistic difference was evidenced for the occurrence

14、of the symptom of Lack of appetite,Lack of energy, nausea,Acid ingestion,Sore mouth,cough,during chemotherapy in the intervention group(P0.05).There were statistic differences in the above-mentioned symptom in the control group(P0.05).There was trend of increasing occurrence of the symptom in the co

15、ntrol group.There were statistic differences for the occurrence of the above-mentioned symptom between groups(P0.05).There was statistic difference for the occurrence of the symptom of the back pain during chemotherapy in the intervention group(P0.05).No statistic difference was evidenced for the oc

16、currence of the symptom of the above-mentioned symptom in the control group(P0.05).There was statistic difference for the occurrence of the above-mentioned symptom between groups(P0.05).There was no statistic difference for the occurrence of the symptom of the tension between groups(P0.05),However t

17、here was statistic difference for the occurrence of the symptom of the tension in the both group(P0.05),The trends of two groups are different.There was a lower tendency in the intervention group and an increasing tendency in the control group during chemotherapy.There was trend of lower scores on the State Anxiety score in intervention group than in control group(P0.05).It evident that there were statistical difference in the State Anxiety score during 2 follow-up(P0.05).Co