【作者】 庄淑梅；

【导师】 赵岳；

【作者基本信息】 天津医科大学 ， 护理学， 2013， 博士

【摘要】 目的1.揭示影响女性海洛因戒毒者心理健康状况及其相关的人口社会学及临床因素,分析女性海洛因戒毒者心理健康状况及其影响因素的特征性变化。2.分析各种因素对女性海洛因戒毒者心理健康状况的影响,根据心理健康的影响因素制定并实施运动干预方法,分析运动干预对女性海洛因戒毒者心理健康的影响。3.以女性海洛因戒毒者为研究对象,通过临床对照试验,探讨两种运动干预方案对女性海洛因戒毒者心理健康状况的干预效果。方法1.从文献研究着手,结合相关学科对毒品成瘾、成瘾性疾病的矫正及影响因素的研究成果,确定影响女性海洛因戒毒者心理健康状况的相关因素。2.通过横断面研究的方法,以98例女性海洛因戒毒者为研究对象,采用心理健康评定量表进行测量,探讨和分析人口社会学及临床因素对女性海洛因戒毒者心理健康状况的影响。3.以计划行为理论,跨理论模型和社会认知理论为基础,根据女性海洛因戒毒者心理健康状况的影响因素,构建适合女性海洛因戒毒者的运动干预方法。4.采用随机对照研究的方法,将98例女性海洛因戒毒者随机分为实验组1、实验组2和对照组,实验组1采用有氧运动干预,实验组2采用瑜伽运动干预,对照组无运动干预,分别在干预前、干预3个月及干预6个月进行心理健康指标的测评,运用两因素方差分析及线性模型验证两种运动干预疗法对女性海洛因戒毒者心理健康状况的临床效果。结果1.女性海洛因戒毒者SCL-90总分及各因子得分、SDS和SAS得分明显高于国内常模(p<0.001)。2.影响女性海洛因戒毒者心理健康状况的因素主要包括年龄、婚姻、职业、吸毒时间、戒毒次数、吸毒方式、每日吸毒量、烟酒嗜好及运动习惯。3.焦虑、抑郁等负性情绪与女性海洛因戒毒者的运动习惯具有显著相关性,对心理健康状况具有预测作用。女性海洛因戒毒者心理健康水平的提高可以通过“运动习惯”这一因素的调节而实现。4.女性海洛因戒毒者在接受有氧运动和瑜伽运动干预后,同对照组相比,其心理健康状况显著改善。可见,运动干预能改善女性海洛因戒毒者心理健康状况。5.在运动干预过程中,有氧运动干预对女性海洛因戒毒者心理健康状况的改善作用显现较快,在干预3个月时即可显示。而瑜伽运动干预对女性戒毒者心理健康状况的影响显现较慢,需持续给予6个月的瑜伽干预方可明显。结论1.女性海洛因戒毒者SCL-90各因子及总分、SDS及SAS得分均明显高于国内常模,提示女性海洛因戒毒者的心理健康状况较差,抑郁和焦虑状况明显。2.女性海洛因戒毒者SCL-90各因子及总分、SDS及SAS得分均与年龄、婚姻、职业、戒毒次数、吸毒时间、每日吸毒量、烟酒嗜好及运动习惯具有相关性,文化程度及月收入也与除偏执因子以外的各心理健康指标具有相关性,而吸毒方式仅与SCL-90总分及强迫因子具有相关性。3.护理干预过程中应对年龄较大、离异、企事业工作、吸毒时间长、戒毒次数多、混合方式吸毒、每日吸毒量大、有烟酒嗜好及无运动习惯的女性海洛因戒毒者给予更多的关注和指导,改善其心理健康状况,提升其心理健康水平。4.本研究发现,有氧运动及瑜伽锻炼干预后,两运动干预组女性海洛因戒毒者的心理健康状况明显高于对照组,证实了运动干预对女性海洛因戒毒者的心理健康状况具有明显促进作用。运动干预可以作为一种行之有效的护理干预措施应用于女性海洛因戒毒康复治疗中,为改善女性海洛因戒毒者的心理健康状况、消除不良情绪反应和心理问题提供帮助。更多还原

【Abstract】 Objectives1. To explore the mental health of the detoxification women with heroin dependence and related factors (demographic status and clinical characteristics) and to analyze the characteristic changes of mental health and related factors.2. To analyze the mechanism of all kinds of related factors on mental health of the detoxification women with heroin dependence and on basis of the related factors, to establish the exercise intervention and analyze its effects.3. To test the clinical effectiveness of the exercise intervention in detoxification women with heroin dependence.Methods1. Bibliography retrospection study combining with related subjects about correction of drug addiction, addiction disease and its influential factors were used to identify the risk factors of the mental health of detoxification women with heroin dependence.2. The corss-sectional study was used. A convenience sample of98detoxification women with heroin dependence was recruited, psychosocial data were collected by the related scales and questionnaires. Interview method was also used.3. According to related factors, the theory of planned behavior, transtheoretical model and social cognitive theory were used to design the appropriate exercise intervention in detoxification women with heroin dependence.4. The randomized controlled trail was used.98detoxification women with heroin dependence were recruited and randomly separated into experimental group1, experimental group2and control group. Aerobic exercise intervention was used in experimental group1, and yoga was used in experimental group2. Control group have recieved no exercise intervention. The mental health data was collected at baseline,3months and6months (at the end of the intervention). Two-way ANOVA and linear model were used to evaluate the effectiveness.Results1. The total scores and each dimension of SCL-90, the scores of SDS and SAS in detoxification women with heroin dependence were significantly higher than domestic norm (p<0.001).2. Main factors of the mental health in detoxification women with heroin dependence were age, marriage status, employment status, duration of using heroin, times of abstinence, major method of heroin use, daily dose of heroin use, hobby of smoking and alcohol and exercise habit.3. Anxiety, depression and other negative emotions had significant correlation with exercise habit in women with heroin dependence to predict the mental health. To construct beneficial exercise habit could improve the mental health.4. On the completion of the exercise program, two exercise groups had better mental health than control group. The exercise intervention improved mental health in detoxification women with heroin dependence.5. Aerobic exercise intervention had faster effect on the improvement of mental health than yoga intervention over the three months. Yoga intervention had slower effect on the improvement of mental health over the six months.Conclusions1. The total scores and each dimension of SCL-90, the scores of SDS and SAS in detoxification women with heroin dependence were significantly higher than domestic norm to reveal the poor mental health, significant anxiety and depression in women with heroin dependence.2. The total scores and each dimension of SCL-90, the scores of SDS and SAS in detoxification women with heroin dependence had significant correlation with age, marriage status, employment status, duration of using heroin, times of abstinence, daily dose of heroin use, hobby of smoking and alcohol and exercise habit. Education level and month income had correlation with mental health indexes except paranoid factor and SAS. Major method of heroin use had correlation with the total scores, physical and force factors.3. During the nursing intervention, the women with heroin dependence who were elder or divorced, had enterprise employment, longer time of using heroin, more times of abstinence, mixture heroin use, higher daily dose of heroin use, hobby of smoking and alcohol and no exercise habit should be paid more attention and provided more guidance to improve the mental health.4. The study found that the aerobic exercise and yoga could significantly improve the mental health in detoxification women with heroin dependence so that the exercise intervention had beneficial effect on the mental health in detoxification women with heroin dependence. The exercise intervention was an effective measure used in female detoxification treatment to supply help for improving the mental health and eliminating negative emotion.更多还原