音乐放松练习对缓解乳腺癌患者化疗期间焦虑及不良反应的效果研

1、音乐放松练习对缓解乳腺癌患者化疗期间焦虑及不良反应的效果研        【中文摘要】研究背景乳腺癌是一种全身性疾病,是轻易发生血道转移的疾病,近年来乳腺癌的发病率呈上升趋势,因而乳腺癌患者经过手术治疗后,化疗是治疗肿瘤的常用手段,它可弥补手术及放疗的不足,预防肿瘤复发和转移。化疗药物在应用的同时也会给患者生理及心理上带来了很多不良反应,部分患者由于不能忍受化疗所带来的不良反应,而不得不放弃或中断化疗,影响治疗效果。本研究旨在将音乐治疗、渐进性肌肉放松及引导性意象作为一种补充替换疗法帮助患者往积极应对不良的化疗副反

2、应,减轻这些副反应对患者的影响程度,缓解乳腺癌患者术后化疗期间焦虑程度,进步乳腺癌患者的生活质量,为制定乳腺癌患者术后整体康复措施提供依据。目的探讨音乐放松练习对缓解乳腺癌术后患者化疗引起焦虑和不良反应的效果。方法采用方便抽样的方法将进选条件的乳腺癌术后患者分为干预组(55名)和对照组(55名),两组在年龄、文化程度、月经情况、病理类型、分级等方面差异无统计学意义(P0.05)。经过知情同意后,对照组患者按照乳腺癌术后化疗的护理常规进行护理,干预组患者在接受常规护理的同时,给予2个化疗周期的音乐放松练习(音乐治疗、渐进性肌肉放松及引导性意象)。以状态焦虑问卷和Rotterdam症状检丈量表的评

3、定为主要指标,分别在第2次化疗前、第3次化疗前对干预效果进行评价。结果干预后干预组患者的Rotterdam症状检丈量表总分、生理纬度得分、心理纬度得分的上升趋势明显低于对照组,差别有统计学意义(P0.05),两组间Rotterdam症状检丈量表总分、生理纬度得分在第2次化疗前、第3次化疗前随访时,差别有统计学意义(P0.05)。两组间心理纬度得分在第3次化疗前随访时,差别有统计学意义(P0.05);干预后干预组患者在“食欲减退”、“缺乏精力”、“恶心”、“返酸”、“口腔溃疡”、“咳嗽”6项症状的发生率不随时间的变化而变化,差别无统计学意义(P0.05),而对照组患者上述6项症状的发生率随时间的

4、变化而变化,差别有统计学意义(P0.05),对照组和干预组的该6项症状发生率的差别也有统计学差异(P0.05);干预后干预组在“背痛”症状的发生率随时间的变化而变化,差别有统计学意义(P0.05),而对照组在该项症状的发生率不随时间的变化而变化,差别无统计学意义(P0.05),对照组和干预组的“背痛”症状发生率的差别也有统计学意义(P0.05);对照组和干预组患者在“紧张”症状的发生率的差别无统计学意义(P0.05),但对照组和干预组患者在“紧张”症状的发生率随时间的变化而变化,差别有统计学意义(P0.05),两者变化的趋势不同,干预组的症状发生率随着化疗的进行发生率有降低趋势,而相对于对照组

5、的症状发生率却随着化疗的进行发生率有升高趋势;干预后干预组的焦虑得分趋势明显低于对照组,差别有统计学意义(P0.05),两组间状态焦虑得分在第2次化疗前、第3次化疗前随访时,差别有统计学意义(P0.05)。结论音乐放松练习能减轻患者化疗的不良反应,减轻患者化疗期的焦虑程度,在对乳腺癌术后化疗患者的心理行为干预中具有可操纵性。');【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