TOMATIS听觉训练对乳腺癌化疗患者认知功能及创伤后应激障碍的影响
Effect of TOMATIS auditory training on cognition and post-traumatic stress disorder in breast canc-er chemotherapy patients
目的 观察TOMATIS听觉训练改善乳腺癌患者化疗后认知及创伤后心理应激障碍的效果.方法 收集2016年10月到2017年9月期间在河北省唐山市人民医院乳腺一科接受化疗的乳腺癌浸润性导管癌且存在认知障碍和创伤后应激障碍的患者80例,采用随机数字表法,将患者分成对照组(n=40)和试验组(n=40).试验组给予TOMATIS高低音频转换听觉训练,对照组给予普通音乐训练.干预前、后分别对两组患者进行蒙特利尔认知功能评估量表(MoCA)中文版及创伤后应激障碍自评量表(PTSD-SS)的测评.结果 干预后试验组在视结构技能[(3.83±0.71)分,(2.68±0.57)分]、执行功能[(2.23±0.53)分,(1.55±0.50)分]、注意与集中[(1.55±0.78)分,(1.23±0.53)分]、语言[(1.50±0.75)分,(1.08±0.47)分]、计算[(2.00±0.60)分,(1.45±0.75)分]、抽象思维[(1.63±0.54)分,(1.00±0.51)分]、记忆[(4.68±0.47)分,(2.70±0.72)分]、定向力[(5.25±0.54)分,(3.90±0.81)分]及总分[(22.65±2.89)分,(15.58±2.10)分]9项评分均比对照组提升,差异有统计学意义(均P<0.05);干预后试验组在对创伤事件的主观评定[(2.60±0.63)分,(3.98±0.62)分]、反复重现体验[(24.05±2.72)分,(26.70±2.28)分]、回避症状[(24.35±1.64)分,(26.40±1.19)分]、警觉性增高[(24.23±1.80)分,(25.45±1.20)分]、社会功能受损[(7.28±1.01)分,(8.68±0.66)分]及总分[(85.85±5.13)分,(94.63±2.92)分]比对照组明显下降,差异有统计学意义(均P<0.01).结论 TOMATIS听觉训练可以有效改善乳腺癌化疗患者的认知功能及心理状态,具有较好的推广应用前景.
更多Objective To observe the effect of TOMATIS auditory training on improving cognitive and post-traumatic stress disorder in patients after breast cancer chemotherapy. Methods Eighty invasive ductal carcinoma of breast cancer patients with cognition and psychological disorders were selected in the breast department of Tangshan People's Hospital from October 2016 to September 2017. All patients were randomly divided into control group ( n=40) and experimental group ( n=40) . The experimental group was given the TOMATIS high and low audio frequency auditory training,and the control group was given ordinary music training. Before and after the intervention, the Chinese version of the Montreal cognitive assessment scale ( MoCA) and the post-traumatic stress disorder scale ( PTSD-SS) were evaluated for both groups of pa-tients. Results After the intervention,the experimental group had significantly higher scores in visual struc-ture skills((3. 83±0. 71)vs(2. 68±0. 57)),executive function ((2. 23±0. 53)vs(1. 55±0. 50)),attention and concentration((1. 55±0. 78)vs(1. 23±0. 53)),language((1. 50±0. 75)vs(1. 08±0. 47)),calculation ((2. 00±0. 60)vs(1. 45±0. 75)),abstract thinking((1. 63±0. 54)vs(1. 00±0. 51)),memory((4. 68± 0. 47)vs(2. 70±0. 72)),directive force((5. 25±0. 54)vs(3. 90±0. 81)) and total score((22. 65±2. 89)vs (15. 58±2. 10))than the control group(all P<0. 05). After intervention,the scores of subjective assessment of traumatic events((2. 60±0. 63)vs(3. 98±0. 62)),repeated recurring experiences((24.05±2.72)vs (26. 70±2. 28)),avoidance symptoms((24. 35±1. 64)vs(26. 40±1. 19)),increased alertness((24. 23± 1. 80)vs(25. 45±1. 20)),impaired social function((7. 28±1. 01)vs(8. 68±0. 66)),and total scores((85. 85±5. 13)vs(94. 63±2. 92)) in the experimental group were significantly lower than those in the control group,and the differences were statistically significant ( all P<0. 01) . Conclusion TOMATIS auditory train-ing can effectively improve the cognitive function and psychological state in breast cancer chemotherapy pa-tients,which is worthy of popularization and application.
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