高血压老人情绪健康状况与基于注意和音乐的干预
文献类型：学位论文
| 作者 | 王佳舟
|
| 答辩日期 | 2024-06 |
| 文献子类 | 博士 |
| 授予单位 | 中国科学院大学 |
| 授予地点 | 中国科学院心理研究所 |
| 其他责任者 | 韩布新 |
| 关键词 | 高血压老人 情绪健康 注意训练技术 音乐治疗 干预 |
| 学位名称 | 理学博士 |
| 学位专业 | 健康心理学 |
| 其他题名 | Emotional Health in Hypertensive Older People and Intervention Based on Attention and Music Therapy |
| 中文摘要 | The older people are history and drama for reference of our lives, healthy older people are valuable wealth of society. However, most older people are faced with serious health challenge by hypertension. As the most common chronic disease as well as the most common disease in the old population, hypertension impedes the healthy aging. The hypertensive older people have more sadness and worries compared with the healthy older people. Improving emotional wellbeing in hypertensive older people is essential for elegant and composed aging. Which is worth more researchers’ thinking and exploration. Thus, this research includes 3 studies. Study 1 including two sub-studies to examine the emotional status of the hypertensive older people by macro and micro perspectives. Study 1a investigated the current status of depression in hypertensive older people and its differences across sociodemographic factors and hypertension control/treatment using the Center for Epidemiological Studies Depression Scale (CES-D) and used logistic regression to analyze the factors influencing depression in hypertensive older people. Study 1b adopted semi-structured interview to investigate the factors (especially psychological factors) that influencing emotional health of the hypertensive older people. Study 2 used physiological polygraph to test respiratory and heart rate variability as emotional indicators to investigate the effect of attention training technique (ATT) on improving the emotional health of hypertensive older people. Study 2a mainly examines the model of attention selection and switching, 2b mainly examines the model of attention selection and division. In study 3, we designed and implemented a set of emotional improvement intervention program for hypertensive older people and evaluated its process and effect. Study 3a designed a set of intervention plan with high-ecological validity and feasibility and implemented in the communiversity for the older people by combining the ATT with the music therapy. Study 3b tested the immediate effect of intervention by questionnaire, and then conducted subgroup analysis and analyzed intervention paths by a mediation model. Study 3c used interview method to evaluate the effect and precise process of intervention, and further explored the specific details of intervention. On the basis of previous studies, it is assumed that the emotional health level of the hypertensive older people is poor, and the attention bias to negative information and social support are the main psychological factors affecting their emotional health. ATT and Attention division can effectively improve the emotions of hypertensive older people. And the intervention based on ATT and music therapy can also efficiently improve the emotional health of hypertensive older people. The results showed that the depression score and depression prevalence of the hypertensive older people in study 1 were significantly higher than that of the healthy older people. In terms of influencing factors, demographic factors including gender, educational level and marital status; social factors including body, age, income, family and living conditions; and attention bias to negative information and social support were the main psychological factors influencing their emotional health. In study 2, attention selection and switching mode and attention selection and division in ATT can effectively change the respiratory and heart rate variability of hypertensive older people and further improve emotion wellbeing. The intervention program designed in study 3 is well and easy applicable in intervention for the hypertensive older people. It has excellent immediate effect on the emotion, attention and blood pressure related indicators, and has remarkable migration effect in insomnia and social support status. Hypertensive older people with high extraversion and low neuroticism showed better intervention effects. The reduction of negative information attention played a partial mediating role between intervention and improvement of depressive mood in hypertensive older people. In general, in this intervention study, the negative emotions of hypertensive older people have been well alleviated. And the effect and intervention process analysis both show that the alleviation of negative emotions is closely related to the positive effects of music therapy and ATT on emotions. This research conducted a series of systematic studies on the emotional health level, influencing factors, emotional improvement intervention targets, intervention program design, implementation, effect and process evaluation for the hypertensive older people. Which aims to help them improving their mental health level. This is the first attempt to use ATT for the older people in China. This study explores the intervention methods to improve the emotional health of hypertensive older people as well as its feasibility and effect, and further considers how ATT and music therapy can be beneficial to improve the negative emotional symptoms of hypertensive older people. On the basis of the Music-based Emotion Regulation, a theoretical model of attention in music therapy was derived to try to deal with the emotional problems of the hypertensive older people in a more comprehensive way. This study tried to provide a stable and reliable technical carrier for intervention research on emotional health of hypertensive older people, help to improve understanding of their own emotional health status and emotional improvement methods, so as to guide them to treat and deal with negative emotions in a positive and effective way in the local environment. This study provides a theoretical basis for the active aging of hypertensive older people in healthcare-integrated community. With a view to replacing nursing home beds with seats in the older people communiversity in order to provide reference and support for the effective development of the work of healthy and active aging. |
| 英文摘要 | “最美不过夕阳红”，健康老人是社会的宝贵财富。然而，多数老年人都面临一个严峻健康挑战——高血压。高血压作为最常见慢性病及老年人群最易得疾病（刘力生，2011），已然是老年人健康老龄化的绊脚石。相比健康老人，高血压老人更会感伤和忧思“人谁不顾老，老去有谁怜”（刘梅颜，2014）。关注高血压老人情绪健康，如何帮助他们改善自身不良情绪，让高血压老人也能优雅从容地老去，值得我们思考探索。 本研究共分三个部分。研究 1 从宏观和微观角度考察全国范围内 60 岁以上 高血压老人情绪影响因素，包含两个子研究。1a 采用流调中心抑郁问卷（CES-D） 调查高血压老人抑郁现状及其在不同社会人口学因素和高血压控制/治疗情况差 异，并使用 logistic 回归分析高血压老人抑郁影响因素；1b 采用半结构式访谈探究高血压老人情绪健康影响因素（尤其是心理因素）。研究 2 采用生理多导仪作 为研究工具、呼吸和心率变异性作为情绪指标在实验室考察注意训练技术改善 60 岁以上高血压老人心理健康的作用。2a 考察注意选择加转移模式；2b 考察注 意选择加分散模式。研究 3 制定并实施高血压老人情绪改善方案，并检验其效果 和影响因素。3a 结合注意训练技术和音乐治疗，设计一套兼具生态化效度和可 行性的干预方案对高血压老人实施；3b 使用问卷法检验干预的即时效果和亚群体效果，并使用中介模型分析干预路径；3c 使用访谈法评估干预效果和被试的 收获及感受，进一步探索干预细节。 结合以往研究，假设高血压老人情绪健康状况欠佳，负面信息注意偏向和社会支持是其情绪健康主要心理影响因素。注意训练技术及注意分散可有效改善高血压老人情绪。且基于注意训练技术和音乐治疗干预也能有效改善高血压老人情 绪健康。 结果显示：研究 1 高血压老年人抑郁得分和检出率都显著高于普通健康老人，情绪健康人口学影响因素有性别、文化程度和婚姻状况，社会影响因素有身体、年龄、收入、家庭及居住情况，心理影响因素有负面信息注意偏向和社会支 持。研究 2 注意训练技术的注意选择&注意转换模式和注意选择&注意分散模式 均能有效改变高血压老人呼吸和心率变异性，从而改善情绪。研究 3 中高血压老 人情绪改善方案适用性好且干预过程顺利，能即时改善高血压老人情绪、注意以 及血压等相关指标，迁移改善其睡眠、社会支持等方面状况。拥有高外倾性或低 神经质人格特质的高血压老人干预效果更好。消极信息注意减少在干预和高血压老人抑郁情绪改善间发挥部分中介作用。总体来说，本次干预研究中高血压老人负性情绪得到良好缓解，且效果和干预作用过程分析均表明，音乐治疗和注意训 练技术本身对情绪有正性作用。 本论文系统研究了高血压老人情绪健康水平及影响因素、情绪改善干预靶点、干预方案设计、实施、效果和过程评估，帮助其提高心理健康水平，并在国内首次尝试针对老年人使用基于听觉通道注意训练技术。研究探索了高血压老人 情绪健康改善方法并分析了可行性和效果，考虑如何实施注意训练技术和音乐治疗究竟如何实施才能改善高血压老人负性情绪症状，在此基础上衍生出音乐治疗注意作用理论模型用以更全面、综合的应对高血压老人情绪问题。研究为高血压老人情绪健康干预研究提供本土环境下稳定可靠技术载体，有助于高血压老人提 高情绪健康状况自我认知并了解情绪改善方法，从而引导其积极有效地对待和处 理负性情绪。在医养结合社区环境下，为高血压老人积极老龄化提供理论依据，以期用老年大学座位代替疗养院床位，为有效开展“五个老有”工作提供参考。 |
| 语种 | 中文 |
| 源URL | [http://ir.psych.ac.cn/handle/311026/48000]  |
| 专题 | 心理研究所_健康与遗传心理学研究室 |
| 推荐引用方式 GB/T 7714 | 王佳舟. 高血压老人情绪健康状况与基于注意和音乐的干预[D]. 中国科学院心理研究所. 中国科学院大学. 2024. |
入库方式： OAI收割
来源：心理研究所
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