音乐及情绪松弛训练干预对乳腺肿瘤患者围手术期焦虑的作用

 　目的　探讨音乐加情绪松弛训练干预法对围手术期乳腺肿瘤患者焦虑的作用。方法　采用病例对照方法，对108例行乳腺肿块切除术或改良根治术的乳腺肿瘤患者，进行音乐加放松训练，并与手术前1天、术前30～60 min及术后第3天，连续3次进行临床评估，其中52例进行音乐加情绪松弛训练，56例常规处理。测查一般资料和生理指标（收缩压、舒张压和脉率）；评定状态-特质焦虑量表（STAT）、社会支持量表（SSRS）和艾森克个性问卷（EPQ）。结果　在手术前1天和术前30～60 min两个阶段进行训练，两组患者间收缩压和脉率的差异均有统计学意义（收缩压：t＝3.114，P＜0.01；脉率：t＝3.03，P＝0.01）。Repeated Measures方差分析显示，不同时间段和不同干预水平下，二组焦虑分值差异均有统计学意义（不同时间：F＝18.61，P＜0.01；有无干预：F＝7.001，P＜0.05）；多元线性逐步回归结果显示，影响术前焦虑的危险因素包括特质焦虑、无哺乳史、有乳腺肿块家族史、年龄偏大、经济状况较差和EPQ-N分。结论　音乐加情绪松弛训练干预法可以明显减轻乳腺肿瘤患者的术前焦虑及改善伴随的生理指标。乳腺肿瘤患者术前焦虑水平受多种因素影响，包括特质焦虑、哺乳史、乳腺肿块家族史、年龄、经济状况以及平常情绪。

Effect of music and mood relaxation training for anxiety reduction in patients with breast tumor before operation

Objective To evaluate the effect of music and mood relaxation training for the anxiety in patients with breast tumor before operation. Methods With case-contrast method, 108 patients with breast tumor (52 patients with intervention, 56 with routine treatment) week assessed continuously. All cases were investigated on their common information, physiological indexes and psychological scales, including State-Trait Anxiety Inventory (STAI-Form Y), Social Support Rating Scale (SSRS) and Eysenck Personality Questionaire (EPQ). Results There were significant statistical difference in systolic pressure and pulse rate between two groups on one day (t =3.114, P ＜0.01) and 30-60 minutes (t =3.03, P=0.01) before the operation. There was remarkable difference for anxiety between two groups and among different interventions periods by Repeated Measures ANOVA analysis (Periods: F=18.61, P ＜0.01; Groups: F =7.001, P ＜0.05). Results of Stepwise regression analysis: The influencing factors on anxiety in patients with breast tumor before operation were trait anxiety, breast-feeding history, family history of breast tumor, age, economy and EPQ-N. Conclusion Relaxation music and mood relaxation training can reduce the level of anxiety and related physiological indexes on patients with breast tumor before operation. The influencing factors on anxiety in patients with breast tumor before operation are multi level factors, such as trait anxiety, breast-feeding history and so on.