目的:研究音乐疗法对改善血液透析患者抑郁情绪的临床效果。方法:挑取2015年11月至2016年3月在天津武警医院的70例维持性血液透析病人作为研究对象,并将他们分为实验组和对照组,两组具有可比性,实验组接受一般常规治疗和音乐治疗,对照组只进行一般常规治疗。之后观察两组患者的血压、心率及进行Zung氏抑郁自评量表(SDS)评定。结果:血液透析之前和之后实验组SDS评分有很明显的不同(P < 0.05)。透析后实验组的SDS评分对比对照组差别明显(P < 0.05)。与对照组相比,实验组病人的情绪低落的抑郁程度得到改善(P < 0.05),血压心率较稳定(P < 0.05)。结论:适合的乐曲在病患血液透析治疗中有改善抑郁情绪的作用,可将音乐疗法用于透析治疗中。 Objective: To study the clinical effect of music therapy on improving depression in hemodialysis patients. Methods: 70 cases of maintenance hemodialysis patients in Tianjin Armed Police Hospital from November 2015 to March 2016 were selected as research objects, and they were divided into experimental group and control group. The two groups were comparable. The experimental group received general routine treatment and music therapy, while the control group only received general routine treatment. After that, the blood pressure, heart rate and Zung’s Self-rating Depression Scale (SDS) were observed. Results: The SDS scores of the experimental group were significantly different before and after hemodialysis (P < 0.05). After dialysis, the SDS scores of the experimental group were significantly different from those of the control group (P < 0.05). Compared with the control group, the depression degree of the patients in the experimental group was improved (P < 0.05), and the blood pressure and heart rate were more stable (P < 0.05). Conclusion: Appropriate music can improve the depression of patients in hemodialysis, and music therapy can be used in hemodialysis.
目的:研究音乐疗法对改善血液透析患者抑郁情绪的临床效果。方法:挑取2015年11月至2016年3月在天津武警医院的70例维持性血液透析病人作为研究对象,并将他们分为实验组和对照组,两组具有可比性,实验组接受一般常规治疗和音乐治疗,对照组只进行一般常规治疗。之后观察两组患者的血压、心率及进行Zung氏抑郁自评量表(SDS)评定。结果:血液透析之前和之后实验组SDS评分有很明显的不同(P < 0.05)。透析后实验组的SDS评分对比对照组差别明显(P < 0.05)。与对照组相比,实验组病人的情绪低落的抑郁程度得到改善(P < 0.05),血压心率较稳定(P < 0.05)。结论:适合的乐曲在病患血液透析治疗中有改善抑郁情绪的作用,可将音乐疗法用于透析治疗中。
音乐疗法,血液透析,抑郁
Wenjia Dong, Jieting Fan, Zhaolin Yi, Mei Ye*
PLA Rocket Force Characteristic Medical Center, Beijing
Received: Sep. 30th, 2021; accepted: Oct. 24th, 2021; published: Nov. 1st, 2021
Objective: To study the clinical effect of music therapy on improving depression in hemodialysis patients. Methods: 70 cases of maintenance hemodialysis patients in Tianjin Armed Police Hospital from November 2015 to March 2016 were selected as research objects, and they were divided into experimental group and control group. The two groups were comparable. The experimental group received general routine treatment and music therapy, while the control group only received general routine treatment. After that, the blood pressure, heart rate and Zung’s Self-rating Depression Scale (SDS) were observed. Results: The SDS scores of the experimental group were significantly different before and after hemodialysis (P < 0.05). After dialysis, the SDS scores of the experimental group were significantly different from those of the control group (P < 0.05). Compared with the control group, the depression degree of the patients in the experimental group was improved (P < 0.05), and the blood pressure and heart rate were more stable (P < 0.05). Conclusion: Appropriate music can improve the depression of patients in hemodialysis, and music therapy can be used in hemodialysis.
Keywords:Music Therapy, Hemodialysis, Depressed
Copyright © 2021 by author(s) and Hans Publishers Inc.
This work is licensed under the Creative Commons Attribution International License (CC BY 4.0).
http://creativecommons.org/licenses/by/4.0/
血液透析(HD)是一种终末期尿毒症患者替代治疗的方法。由于病情持续时间长,费用多,患者在治疗中容易产生抑郁等精神障碍 [
以2015年11月至2016年3月进行维持性血液透析的70位病人作研究的对象。纳入标准为终末期尿毒症:GFR < 5 mL/min,BUN > 21.42 mmol/L,Cr > 442 umol/L,MHD > 3个月;采取Zung氏抑郁自评量表评分。排除标准:原发或由尿毒症引起的精神异常;急性肾小球肾炎等导致的肾功能衰竭,或其他脏器活动性病变患者;生活不能自理者。
在进行音乐疗法前要先对10名参与此次试验的护士介绍此疗法的知识及相关注意事项。
1) 对照组
常规血液透析:① 透析前,护士首先了解患者情绪适当安慰,其次向患者介绍环境,使其正视病情,减轻抑郁情绪;② 使患者了解具体的血液透析的操作流程、和相关的注意事项;③ 透析过程中要严密观察患者的生命体征,多与患者交流。
2) 实验组
在对照组基础上给病患应用音乐治疗:① 首先要为患者配备音乐疗法的设备,给每位患者发放耳机和音乐播放器;② 此音乐治疗和血液透析一起进行,护士要按照病人的兴趣和赏识程度,选用谐调的乐曲进行播放;③ 音乐疗法控制:教患者集中注意力再给患者播放音乐,病人欣赏音乐至到透析完毕。一个疗程分十次进行,一共用两个疗程。之后与对照组比较。
1) 对抑郁的程度来进行分析测定
音乐疗法的前后均采用SDS评分,10分一梯度。≥50为阳性,50~59为轻度,60~69为中度,70以上为重度抑郁,病人自行填写报告。
2) 血压及脉搏的测量
测量两组血液透析病人在透析前后的心率及血压,而且要求严格测量的位置均在相同部位。
数据采纳SPSS19.0处理,计数资料用卡方检验,计量的资料用t检验。
每组病人的透析时间均为4小时,一周透析3次。实验组:35例,男18例,女17例,平均年龄(49.9 ± 1.5)岁;平均透析时间(4.8 ± 0.5)年;对照组:35例,男17例,女18例,平均年龄(50.1 ± 1.9)岁;平均透析时间(4.5 ± 0.7)年。两组患者的年龄、性别、病程病情、血透时间的长短等都基本相似,无统计学差异(P > 0.05),有可比性。
组别 | 例数 | 干预前 | 干预后 | t | P |
---|---|---|---|---|---|
实验组 | 35 | 58.7 ± 13.21 | 53.1 ± 13.10 | 2.44 | <0.05 |
对照组 | 35 | 58.8 ± 12.92 | 60.4 ± 12.81 | 1.30 | >0.05 |
t | 0.85 | 3.50 | |||
p | >0.05 | <0.05 |
表1. 两组病患透析前后SDS评分对比(分, x ¯ ± s )
干预前和干预后测验组SDS评分均有不同有统计学意义(P < 0.05)。
组别 | 例数 | 干预前 | 干预后 | t | P |
---|---|---|---|---|---|
实验组 | 35 | 79.21 ± 4.80 | 78.10 ± 7.93 | 1.43 | <0.05 |
对照组 | 35 | 80.10 ± 5.30 | 84.03 ± 8.10 | 2.64 | >0.05 |
t | 0.83 | 2.97 | |||
p | >0.05 | <0.05 |
表2. 两组患者干涉前后的心率(次/分, x ¯ ± s )
两组患者干预前心率对比的差别无统计学意义(P > 0.05),音乐疗法后两组患者心率对比的差异具有统计学意义(P < 0.05)。
患者需长期进行血液透析来延长寿命,大约每周3~4次与医院进行透析,每次时间控制在4.5小时,所以使患者产生抑郁的原因主要有:尿毒症这种疾病本身的不可完全治愈性,使患者丧失康复的信心 [
Katon [
经调查表明音乐疗法对心律失常的改善有显著的效果,对非器质性心律失常的改善效果尤为显著,使用音乐疗法后,发现可以降低患者室性期前收缩的次数,经患者反应,心慌等不适现象有所改善 [
音乐疗法是利用音乐艺术调节人的心神,促进患者身心康复的一种方法 [
董文佳,樊洁婷,扆兆琳,叶 梅,nullnull. 音乐疗法对血液透析患者抑郁情绪的影响 Influence of Music Therapy on Depression of Hemodialysis Patients[J]. 护理学, 2021, 10(06): 623-627. https://doi.org/10.12677/NS.2021.106101