基于正念的音乐疗法对乳腺癌化疗患者认知功能及情绪的影响

Effect of mindfulness-based music therapy on cognitive function and emotion of breast cancer patients during chemotherapy

目的探讨基于正念的音乐疗法(mindfulness-based music reduction,MBMT)对乳腺癌化疗患者认知功能及情绪的干预效果,为临床实践提供理论参考和实证支持。方法采用目的抽样法选取2015年1—7月杭州师范大学附属医院符合入组标准的72例术后化疗的乳腺癌患者,患者随机抽取编号(1:干预组,2:对照组)后分至干预组(正念音乐组)和对照组各36人。对照组进行常规健康教育,干预组在此基础上进行每周2次,每次30 min,共6周的团体正念音乐疗法。干预前后采用简易精神状态量表(the mini-mental state examination,MMSE)和简式心理状态剖面图(profile of mood states,POMS)对2组患者进行测评,比较2组患者认知功能和情绪的差异,评估干预效果。结果干预过程中,干预组和对照组分别流失2例和1例,最终进入统计分析的人数为69人;经t检验分析结果显示:6周干预后,干预组患者定向力、记忆力、注意力、回忆力和MMSE总分在干预前后差异有统计学意义(均P<0.05),干预组患者认知功能得分及各维度得分显著高于对照组;干预组TMD总分、愤怒、疲劳、精力、自尊感显著低于对照组得分,2组得分差异具有统计学意义(P<0.05),而紧张(P=0.247)、压抑(P=0.066)、慌乱(P=0.095)这3个维度2组得分差异无统计学意义(P>0.05),干预组消极情绪得分显著低于对照组得分,2组得分差异具有统计学意义(P<0.05)。结论基于正念的音乐疗法能够有效改善乳腺癌化疗患者的认知功能和负性情绪。

Objective To explore the effect of mindfulness-based music therapy（MBMT） on the cognitive function and e- motion in breast cancer patients during chemotherapy and provide support for psychology health practice. Methods The purposive sampling method was used to choose 72 breast cancer patients who had chemotherapy after surgery. They were randomly divided into MBMT group and control group. Both groups received routine nursing care, while the intervention group also received MBMT two times once a week for six weeks. The MMSE scale and POMS scale were used after the in- tervention to investigate the effect of MBMT on cognitive function and emotion. Results There- were no significant differ- ence between the two groups at baseline in all scales（ P 〉 0.05 ）. There were two patients run off in MBMT group and one patients run off in the control group. Only 34 patients in the MBMT group and 35 in the control group completed the scales. The t-test showed the directional ability, memory, attention, memory and MMSE total score were improved after the six weeks intervention（ P 〈 0.05 ） ,the cognitive function and each dimension score in the MBMT group were higher than those in the control group;TMD total scores, anger, tiredness, energy, self-esteem in MBMT group were obviously lower than those in control group, there were significant difference （ P 〈 0.05 ） ; but not in tension （ P = 0.247 ）, depression （ P = 0. 066） and confusion （P = 0.095 ） between two group. The score for negative emotion in the MBMT group was lower than that in the control group with a statistical significant （ P 〈 0.05 ）. Conclusion MBMT showed a trend toward improving psychological outcomes by enhancing cognitive function and negative emotion in breast cancer patients.