Influence Of Group Sandplay Therapy On Perioperative Patients With Acute Angle-Closure Glaucoma

Objective:Acute angle-closure glaucoma(AACG)is a serious irreversible blindness ocular disease.It is also considered a typical psychosomatic diseases.Its occurrence,development and prognosis are closely related to psychosocial factors.The study is to investigate:1 The characteristics of psychological personality and situation of mental health among AACG patients;2 The variety of the psychological characteristic and cortisol level comparing pre-operative time with post-operative time of the patients with AACG;3 The influence of group sandplay therapy on perioperative AACG patients.Methods:Patients which diagnosed as AACG in the Second Affiliated Hospital of Dalian Medical University from August 2016 to February 2017 were randomized divided to 2 groups,psychological intervention group and control group。Detect the level of cortisol,fill out the SCL-90 and EPQ questionnaire。In the case group,four members form a group,the group was given one time treatment of sandplay therapy by the same psychologist.The surgery(rabeculoplasty)were conducted by the same doctor.The treatment of group sandplay therapy are given 1week、2weeks、3weeks and 4 weeks after surgery.Test the level of cortisol and fill the SCL-90 questionnaire of all AACG patients once again 4 weeks latter。Results:1 The differences between two groups in age,gender,marital status,educational level,visual acuity have no significance(P>0.05).2 EPQ:the score of AACG group in E,P are higher than national norm significantly(P<0.01),the score in N of AACG group are higher than national norm(P<0.05),the score in L of AACG group are lower than national norm significantly(P<0.01).3 SCL-90:In postoperation,the score in somzatization,obsessive disorder,interpersonal sensitivity,depression,anxiety,hostility,horror,stubborn,psychoticism,total average,total of case group is lower than pre-operation significantly(P<0.05),and all lower than control group significantly(P<0.0 1).In control group,expect scores of obsessive disorder is not significant(P>0.05),the other aspects are higher than pre-operation significantly(P<0.05).(4)Cortisol:The horizontal comparison shows the level of cortisol in case group changes significantly less than those in control group(P<0.01),The longitudinal comparison shows the level of cortisol changes significantly less than those of pre-operation in case group(P<0.01),the level of cortisol changes significantly more than those of pre-operation in control group(P>0.05).(5)Intraocular pressure(IOP): 4 weeks after surgery,IOP of case group constantly lower than control group(P<0.05),and fluctuates significantly lower than control group(P<0.05).Conclusion:(1)AACG patients lack emotional and psychological stability,with mental illness,neurotic of personality characteristics;(3)After anti-glaucoma surgery,the emotional disorder is aggravated,the level of cortisol rises,the system of immune disorders;(3)Group sandplay therapy can help to improve the psychological states,immune disorders,reduce IOP,and contribute to maintain equability of IOP during perioperative period.