癌症患者创伤后成长心理干预的研究进展

目的 了解国内外癌症患者的创伤后成长干预研究进展,为干预实践提供参考依据。方法 回顾国内外文献,对个体、夫妻/家庭及团体3种形式的心理干预方法进行综述。结果 不同形式的干预方法能够促进癌症患者创伤后成长的发生发展,但干预对象多集中在乳腺癌患者,干预方法多缺乏理论框架,干预措施在短期内能够促进成长,长期效果不明显,且评价工具多采用自我报告的量表。结论 癌症患者的创伤后成长干预方法具有各自的显著特性,未来应借鉴国内外相关研究的优势和相关理论,进一步拓展癌症患者的干预领域,以明确不同形式的干预方式在不同类型的癌症患者中的干预效果,探索出适合我国国情和满足患者需求的创伤后成长干预模式,以提高患者生活质量,促进身心康复。     

癌症患者创伤后成长的概念分析

创伤是实际存在或潜在的使生命受到威胁或严重伤害的事件,包括身体完整性受损、严重创伤以及由此引发的一系列反应［1］。一直以来,人们普遍关注创伤事件给个体带来的不良刺激和心理反应,然而,随着积极心理学的发展,越来越多的研究表明,类似重大疾病的创伤事件在给患者带来消极影响的同时可促进个体的正性人格改变和成长,这种正性变化称之为创伤后成长（PTG）［2］。有研究发现,53%~95%的癌症患者都存在一定程度上的创伤后成长［3］。虽然创伤后成长是癌症患者常见的心理反应,但在实践中常与心理韧性、应对等概念混淆,故笔者将对此概念进行系统的分析,帮助广大医护人员更好地理解创伤后成长的概念,使医护人员在诊疗和护理过程中积极发掘癌症患者的正性成长和变化,并通过相应的干预方案和措施,促使癌症患者恢复身心健康,提高其生命质量。     

癌症病人创伤后成长研究进展

介绍了创伤后成长的概念及影响因素,综述了创伤后成长在癌症病人中的研究现状,为护理心理学的发展提供新的线索.     

癌症患者创伤后成长的现况调查与影响因素分析

【摘要】目的：调查癌症患者创伤后成长现况,分析癌症患者创伤后成长与特质应对方式、社会支持的相关性,为临床心理护理提供指导。方法：采用现况调查法、方便抽样,应用人口学问卷、特质应对问卷、社会支持评定量表、简体中文版创伤后成长评定量(PTGI),于2017年6月至2018年3月在复旦大学附属华东医院肿瘤内科,对符合纳入标准的120例确诊癌症大于3个月患者进行问卷调查。结果：不同性别、教育程度、年龄、婚姻状况、工作状况、宗教信仰间PTG总分无统计学差异(P>0.05),不同病种间有显著性统计学差异(F=3.970,P<0.05)。PTGI总分与积极应对、主观支持、支持利用度有显著正相关(P<0.05),与客观支持没有相关性(P>0.05)。回归分析结果显示,回归方程为：Y=4.674+3.500*疾病+1.036*主观支持+3.282*支持利用度(F=23.988, P<0.05),模型有统计学意义。结论：癌症患者普遍存在创伤后成长,疾病是影响癌症患者创伤后成长的重要人口学因素;癌症患者创伤后成长的重要影响因素有应对方式和社会支持;积极应对和主观支持及对支持的利用度能促使癌症患者创伤后的成长。     

妇科癌症患者创伤后成长现状及其影响因素分析

目的 调查妇科癌症患者创伤后成长现状,分析其影响因素。方法 采用创伤后成长评定量表、痛苦表露指数问卷、领悟社会支持量表,对272例妇科癌症患者进行调查。采用多元线性回归分析其创伤后成长的影响因素。结果 妇科癌症患者创伤后成长总分为（56.11±12.77）分;多元线性回归分析结果显示：文化程度、工作情况、疾病分期、自我表露及社会支持进入回归方程（P<0.05）。结论 妇科癌症患者的创伤后成长处于中等水平,其文化程度、工作情况、疾病分期、自我表露、社会支持是主要影响因素。医护人员在治疗和护理妇科癌症患者的同时,也应注意到患者经历的积极变化,根据其影响因素,促进患者自我表露,提高社会支持水平,帮助其产生更高水平的创伤后成长。     

正念疗法在癌症患者创伤后成长干预中的应用进展

癌症会导致患者产生沉重的心理负担已成共识,然而,越来越多证据表明癌症也可以给患者带来积极的影响.创伤后成长作为个人在经历生活压力或挑战性事件后的重大积极变化,对衡量癌症患者患病后积极变化具有重要意义.正念疗法是近年来新兴的心理干预方法,对改善癌症患者的创伤后成长水平具有明显效果,本文主要从正念疗法的概述、正念疗法干预癌...     

截肢患者创伤后成长的研究进展

<正>因疾病或伤口复杂感染等因素,截肢患者可能会面临多次手术,导致创伤后应激障碍,对患者的身心、生活质量及社交产生一定的负面影响,但同时还可能存在创伤后成长(PTG)等积极的影响^[1]。随着积极心理学的发展,PTG在改善患者心理结局方面的作用不容忽视。截肢作为一种创伤事件,是个体重新评价其世界观的催化剂,给个体带来痛苦的同时也会带来各种形式的积极作用,即个体实现PTG^[2]。     

乳腺癌患者创伤后成长的研究进展

创伤事件是实际存在或潜在的,使生命受到威胁或严重伤害的事件,包括死亡的威胁、严重的创伤或身体完整性的丧失,以及由此引发的一系列反应[1]。癌症作为一种严重的疾病创伤,能引起患者生理、心理、社会等方面一系列改变[1]。早期研究重点关注了创伤事件对当事人导致的负性影响,及其     

创伤亲历者的韧性及创伤后成长的研究进展

大多数人在其一生中至少会经历一次创伤性事件~([1]),创伤体验以不同方式影响着人们的生活,人们对创伤事件的反应和应对方式有显著的个体差异.     

临床护理人员创伤后成长的研究进展

通过检索国内外医学数据库,获取与临床护理人员相关的创伤后成长文献,对临床护理人员主观经历的创伤事件、创伤后成长水平进行了总结;讨论创伤事件特征、社会人口学资料、社会支持、应对方式方面对临床护理人员创伤后成长的影响.     

乳腺癌患者术后化疗期创伤后成长的质性研究

目的了解女性乳腺癌患者术后化疗期创伤后成长状况。方法采用现象学研究的方法对10例女性乳腺癌术后化疗期患者进行访谈,现场记录资料,并运用Claizzi分析程序进行分析。结果乳腺癌术后化疗期患者负性心理和与负性事件抗争的意识并存,在与疾病抗争中萌芽信心,并开始重新审视生命和健康,规划未来,积极应对。结论乳腺癌术后化疗期患者存在明显的创伤后成长,挖掘创伤后患者正性的心理资源成为乳癌患者心理护理的新视角。     

Predictors of post-traumatic headache severity among deployed military personnel

(Headache 2011;51:945‐953) Objective.— The current study used a cross‐sectional observational design to evaluate the relationship between psychological, physiological, and contextual factors and headache severity among 133 deployed military personnel and 4 civilian contractors diagnosed with mild traumatic brain injury (mTBI) referred to a combat support hospital in Iraq. Background.— Although TBI and headache sequelae have been documented for military combatants, little is known about factors associated with headache severity. Methods.— Military personnel (n = 157) and civilian (n = 4) contractors referred to a combat support hospital in Iraq underwent a standardized intake evaluation which included computerized neurocognitive testing, psychological and physical health questionnaires, a clinical interview, and a physical examination by a physician. Results.— Results of zero‐inflated Poisson regression modeling suggest that insomnia is associated with increased likelihood for endorsement of any headache, but loss of consciousness, post‐traumatic stress disorder symptoms, and slowed reaction time only are predictive of headache severity. Among the subset of patients presenting to the combat support hospital within 7 days of mTBI (n = 101), number of TBI symptoms demonstrated a non‐significant trend toward increased likelihood of headache endorsement of any kind, with loss of consciousness, post‐traumatic stress disorder, and slowed reaction time demonstrating significant relationships with headache severity. Conclusion.— Knowledge of predictors of post‐concussive headache onset and severity may assist clinicians in making important decisions regarding treatment recommendations for veterans with mTBI.     

Post‐Traumatic Headaches in Civilians and Military Personnel: A Comparative,Clinical Review

Post‐traumatic headache (PTH) is the most frequent symptom after traumatic brain injury (TBI). We review the epidemiology and characterization of PTH in military and civilian settings. PTH appears to be more likely to develop following mild TBI (concussion) compared with moderate or severe TBI. PTH often clinically resembles primary headache disorders, usually migraine. For migraine‐like PTH, individuals who had the most severe headache pain had the highest headache frequencies. Based on studies to date in both civilian and military settings, we recommend changes to the current definition of PTH. Anxiety disorders such as post‐traumatic stress disorder (PTSD) are frequently associated with TBI, especially in military populations and in combat settings. PTSD can complicate treatment of PTH as a comorbid condition of post‐concussion syndrome. PTH should not be treated as an isolated condition. Comorbid conditions such as PTSD and sleep disturbances also need to be treated. Double‐blind placebo‐controlled trials in PTH population are necessary to see whether similar phenotypes in the primary headache disorders and PTH will respond similarly to treatment. Until blinded treatment trials are completed, we suggest that, when possible, PTH be treated as one would treat the primary headache disorder(s) that the PTH most closely resembles.     

Couple functioning and post-traumatic stress symptoms in US Army couples: the role of resilience

The purpose of this study was to investigate combat-related post-traumatic stress symptoms (PTSS) and couple relationships in Army couples. US Army combat veteran couples (N = 66 couples) completed self-report questionnaires on couple functioning, coercion, resilience, and PTSS. In 23% of the couples (n = 15), both members had PTSS above the clinical cut-off for suspected Post-traumatic Stress Disorder (PTSD). Higher levels of PTSS were associated with lower couple functioning and resilience. Individuals with high resilience scores reported higher couple functioning scores, regardless of PTSS (p = .004). Future researchers should focus on the role of resilience in relation to couple functioning, and ways to amplify resilience in military couples.     

颅脑外伤后综合征对患者生活质量的影响

目的 对颅脑外伤后综合征患进行多项目评估,颅脑外伤后综合征对患生活质量的。方法 评估２４例颅脑外伤患的一般状况、运动功能和心理状况。统计出各种症状出现的比例并分析各因素间的相关关系。结果 超过一半的病例出现头痛、头晕、记忆力下降、抑郁,超过１／３病例出现焦虑和失眠。头痛与头晕、焦虑和抑郁、换眠与淡漠、换眠与抑郁、淡漠与抑郁、头晕与ＡＤＬ、抑郁ＡＤＬ、,抑郁与赔偿以及焦与赔偿之间的相关关系有显     

Treatment outcomes of chronic post-traumatic headaches after mild head trauma in US soldiers: an observational study

(Headache 2011;51:932‐944) Background.— The effectiveness of medical therapies for chronic post‐traumatic headaches (PTHs) attributable to mild head trauma in military troops has not been established. Objective.— To determine the treatment outcomes of acute and prophylactic medical therapies prescribed for chronic PTHs after mild head trauma in US Army soldiers. Methods.— A retrospective cohort study was conducted with 100 soldiers undergoing treatment for chronic PTH at a single US Army neurology clinic. Headache frequency and Migraine Disability Assessment (MIDAS) scores were determined at the initial clinic visit and then again by phone 3 months after starting headache prophylactic medication. Response rates of headache abortive medications were also determined. Treatment outcomes were compared between subjects with blast‐related PTH and non‐blast PTH. Results.— Ninety‐nine of 100 subjects were male. Seventy‐seven of 100 subjects had blast PTH and 23/100 subjects had non‐blast PTH. Headache characteristics were similar for blast PTH and non‐blast PTH with 96% and 95%, respectively, resembling migraine. Headache frequency among all PTH subjects decreased from 17.1 days/month at baseline to 14.5 days/month at follow‐up (P = .009). Headache frequency decreased by 41% among non‐blast PTH compared to 9% among blast PTH. Fifty‐seven percent of non‐blast PTH subjects had a 50% or greater decline in headache frequency compared to 29% of blast PTH subjects (P = .023). A significant decline in headache frequency occurred in subjects treated with topiramate (n = 29, ?23%, P = .02) but not among those treated with a low‐dose tricyclic antidepressant (n = 48, ?12%, P = .23). Seventy percent of PTH subjects who used a triptan class medication experienced reliable headache relief within 2 hours compared to 42% of subjects using other headache abortive medications (P = .01). Triptan medications were effective for both blast PTH and non‐blast PTH (66% response rate vs 86% response rate, respectively; P = .20). Headache‐related disability, as measured by mean MIDAS scores, declined by 57% among all PTH subjects with no significant difference between blast PTH (?56%) and non‐blast PTH (?61%). Conclusions.— Triptan class medications are usually effective for aborting headaches in military troops with chronic PTH attributed to a concussion from a blast injury or non‐blast injury. Topiramate appears to be an effective headache prophylactic therapy in military troops with chronic PTH, whereas low doses of tricyclic antidepressants appear to have little efficacy. Chronic PTH triggered by a blast injury may be less responsive to commonly prescribed headache prophylactic medications compared to non‐blast PTH. These conclusions require validation by prospective, controlled clinical trials.     

社会支持对乳腺癌患者癌症复发恐惧与创伤后成长的中介作用

目的:采用结构方程模型探讨社会支持在乳腺癌患者癌症复发恐惧与创伤后成长间的中介作用.方法:采用一般资料调查表、中文版癌症复发恐惧量表(Fear of Cancer Recurrence Inventory-Chinese Version,FCRI-CV)、领悟社会支持量表(Perceived Social Suppor...