老年慢性疼痛心理因素的质性研究
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摘要
疼痛是与组织损伤或潜在的组织损伤相联系的一种不愉快的躯体感觉和情绪经历。急性疼痛对人类的生存具有重要的意义,而慢性疼痛已失去了它的信号意义,带给人们的往往是痛苦。对护理医院的老人来说,慢性疼痛影响了他们的日常生活,探讨慢性疼痛的心理学因素,尝试使用心理学手段来缓解老年人的疼痛,有利于提高老人的生活质量,这是本研究的目的之所在。
整篇论文共分六个部分:第一部分综述了疼痛研究的理论及进展、疼痛心理学的相关研究、老年人疼痛的相关研究;第二部分介绍了研究问题的提出、自己对研究的探索之路及最终选择质性研究的过程;第三部分是样本的确定、资料的搜集与编码;第四部分对资料归类和深入分析,呈现了护理医院老人慢性疼痛的心理因素;第五部分选取了一个具体的个案进行心理干预;第六部分对该研究所用方法、老人疼痛心理的内外影响因素、躯体的疼痛和心灵的痛苦等进行了讨论。
本研究采用质性研究的方法,通过参与式观察、非正式交谈和半结构式深入访谈等方法,广泛收集了有关护理医院老年人的信息,在此基础上,确定了其中10位患慢性疼痛的老人作为本研究的样本。资料归类分析提示:焦虑、抑郁等情绪体验是老年人慢性疼痛的重要组成部分;信念及自我预期影响着老人慢性疼痛的感受和治疗;被抛弃感、刺激贫乏等导致的孤独感是老人慢性疼痛的强化剂;不合理的归因影响着老人对疼痛的认知;老人面对慢性疼痛,采用了求助、退缩、积极应对等不同的应付策略,由此导致疼痛的感受和疼痛治疗效果也是不同的。
本研究选取了一个样本进行了心理干预的尝试:通过疼痛教育项目,引导老人对慢性疼痛的正确认知、合理归因,帮助老人树立对付疼痛的积极信念;通过疼痛日记、呼吸放松训练、注意力训练、意象训练等应付疼痛技巧的练习,帮助老人增强控制感,缓解无助感;在整个心理干预的过程中,贯穿着研究者调整老人消极情绪、消除老人孤独感的努力。干预结果:患者自述疼痛得到了缓解。
针对老年慢性疼痛的心理因素进行干预是有效的。本研究认为:尊重理解老人,增强老人的价值感、缓解老人的孤独感、使老人获得控制感等能通过闸门控制系统影响老人的慢性疼痛,躯体上的疼痛与心灵上的痛苦存在相互作用,我们不仅要关心老年人生理的健康,而且要关注老人心理的健康。
Pain is an unpleasant sensation occurring in varying degrees of severity as a consequence of injury, disease, or emotional disorder. Acute-pain is important for the survival of human being, but chronic-pain has lost signal function and left only suffering. Chronic-pain affected the day life of old ages in nursing home, so it is meaningful and helpsychological factorsul to probe into psychological factors of chronic-pain and attempt to relax chronic-pain of old ages with psychological means. This study aims at improving the life of old ages of chronic-pain in nursing home.
The dissertation is composed of six parts. The first part introduces the theories and study progress of pain, relative studies of pain psychology and old ages pain. The second part put forward the question and introduces my exploring process that accounting why qualitative study method is selected.The thir part introduces the ways of subject-selection, data-collection and coding. The fourth part introduces the psychological factors of old ages in nursing home. The fifth part introduces a case study of psychological treatment.The sixth part discussess the study method, impersonal factors that affect psychology of old ages and the pain of body and suffering of mind.
This study selected 10 chronic-pain old ages as study subjects by using methods of qualitative study such as involving observation, informality interview and semi-structured interview to intensively collect the information of old ages in nursing home. Data analysise indicates that anxiety , dumps and so on are the main components of chronic-pain of old ages; faith and self- anticipation affect the sense and therapy of chronic-pain of old ages; the sense of going down the drain and stimulation- monotony intensify the chronic-pain of old ages; reasonless attribution affect the chronic-pain cognise of old ages. old ages adopt different strategies such as seeking help, cowering, and positive dealing. Hence the senses and therapy results of chronic-pain of old ages are different.
This study selects a subject to carry through a case study of psychological treatment. Through pain-education project, the old man is led to recognize pain correctly and attribute rationaly. The old man is also helped to be positive to dealing with chronic-pain. Pain-diary, breath-relax training, attention-training, image-training and so on help the old man to improve the sense of controlling and lighten the sense of helplessness. The endeavor of adjusting negative emotion and removing loneliness for the old man is impenetrated in the whole process of psychological treatment. The result is satisfactory for the old man's claiming that the pain is lightened. So the psychological treatment is effective.
This study takes for that respecting and understanding old ages, building up the sense of selfe-value, lightening the sense of loneliness, improving the sense of controlling for the old man could lighten the sense of chronic-pain throurh system of strobe. Body pain interacted with mind suffering. We should care not only old ages' body but also their psychological health.
整篇论文共分六个部分:第一部分综述了疼痛研究的理论及进展、疼痛心理学的相关研究、老年人疼痛的相关研究;第二部分介绍了研究问题的提出、自己对研究的探索之路及最终选择质性研究的过程;第三部分是样本的确定、资料的搜集与编码;第四部分对资料归类和深入分析,呈现了护理医院老人慢性疼痛的心理因素;第五部分选取了一个具体的个案进行心理干预;第六部分对该研究所用方法、老人疼痛心理的内外影响因素、躯体的疼痛和心灵的痛苦等进行了讨论。
本研究采用质性研究的方法,通过参与式观察、非正式交谈和半结构式深入访谈等方法,广泛收集了有关护理医院老年人的信息,在此基础上,确定了其中10位患慢性疼痛的老人作为本研究的样本。资料归类分析提示:焦虑、抑郁等情绪体验是老年人慢性疼痛的重要组成部分;信念及自我预期影响着老人慢性疼痛的感受和治疗;被抛弃感、刺激贫乏等导致的孤独感是老人慢性疼痛的强化剂;不合理的归因影响着老人对疼痛的认知;老人面对慢性疼痛,采用了求助、退缩、积极应对等不同的应付策略,由此导致疼痛的感受和疼痛治疗效果也是不同的。
本研究选取了一个样本进行了心理干预的尝试:通过疼痛教育项目,引导老人对慢性疼痛的正确认知、合理归因,帮助老人树立对付疼痛的积极信念;通过疼痛日记、呼吸放松训练、注意力训练、意象训练等应付疼痛技巧的练习,帮助老人增强控制感,缓解无助感;在整个心理干预的过程中,贯穿着研究者调整老人消极情绪、消除老人孤独感的努力。干预结果:患者自述疼痛得到了缓解。
针对老年慢性疼痛的心理因素进行干预是有效的。本研究认为:尊重理解老人,增强老人的价值感、缓解老人的孤独感、使老人获得控制感等能通过闸门控制系统影响老人的慢性疼痛,躯体上的疼痛与心灵上的痛苦存在相互作用,我们不仅要关心老年人生理的健康,而且要关注老人心理的健康。
Pain is an unpleasant sensation occurring in varying degrees of severity as a consequence of injury, disease, or emotional disorder. Acute-pain is important for the survival of human being, but chronic-pain has lost signal function and left only suffering. Chronic-pain affected the day life of old ages in nursing home, so it is meaningful and helpsychological factorsul to probe into psychological factors of chronic-pain and attempt to relax chronic-pain of old ages with psychological means. This study aims at improving the life of old ages of chronic-pain in nursing home.
The dissertation is composed of six parts. The first part introduces the theories and study progress of pain, relative studies of pain psychology and old ages pain. The second part put forward the question and introduces my exploring process that accounting why qualitative study method is selected.The thir part introduces the ways of subject-selection, data-collection and coding. The fourth part introduces the psychological factors of old ages in nursing home. The fifth part introduces a case study of psychological treatment.The sixth part discussess the study method, impersonal factors that affect psychology of old ages and the pain of body and suffering of mind.
This study selected 10 chronic-pain old ages as study subjects by using methods of qualitative study such as involving observation, informality interview and semi-structured interview to intensively collect the information of old ages in nursing home. Data analysise indicates that anxiety , dumps and so on are the main components of chronic-pain of old ages; faith and self- anticipation affect the sense and therapy of chronic-pain of old ages; the sense of going down the drain and stimulation- monotony intensify the chronic-pain of old ages; reasonless attribution affect the chronic-pain cognise of old ages. old ages adopt different strategies such as seeking help, cowering, and positive dealing. Hence the senses and therapy results of chronic-pain of old ages are different.
This study selects a subject to carry through a case study of psychological treatment. Through pain-education project, the old man is led to recognize pain correctly and attribute rationaly. The old man is also helped to be positive to dealing with chronic-pain. Pain-diary, breath-relax training, attention-training, image-training and so on help the old man to improve the sense of controlling and lighten the sense of helplessness. The endeavor of adjusting negative emotion and removing loneliness for the old man is impenetrated in the whole process of psychological treatment. The result is satisfactory for the old man's claiming that the pain is lightened. So the psychological treatment is effective.
This study takes for that respecting and understanding old ages, building up the sense of selfe-value, lightening the sense of loneliness, improving the sense of controlling for the old man could lighten the sense of chronic-pain throurh system of strobe. Body pain interacted with mind suffering. We should care not only old ages' body but also their psychological health.
引文
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