Intervention Of Guided Music Imagination Training On Patients With Chronic Obstructive Pulmonary Disease Complicated With Anxiety

Background:Chronic Obstructive Pulmonary Diseases(COPD)is a common disease that seriously endangers human health.It is characterized by persistent airflow restriction and corresponding respiratory symptoms.It seriously affects the quality of life of patients and is an important cause of human death.It is known that COPD is not a simple lung disease,but also can lead to cardiovascular system,nervous system,skeletal muscle,mental and endocrine system damage.Anxiety is the first common bad mood in COPD patients,mainly manifested as avoidance.fear,irritability,irritability,attention loss,sleep disorders and psychomotor agitation or block.Anxiety is a very important factor leading to the decline of quality of life and prognosis of COPD patients.Some studies suggest that COPD with anxiety may be a chronic low-level inflammatory reaction involving neuro immune endocrine.With the change of modern medical model,clinical treatment should not only treat physical diseases,but also preserve social functions.The psychological and mental health level and quality of life of patients are more and more concerned.Many COPD patients have transient anxiety during the progress or deterioration.Generally speaking,with the remission of symptoms,this anxiety can be eliminated.However,when the development of anxiety affects COPD patients’ own feelings and treatment effect,positive intervention is needed.In traditional Chinese medicine,COPD belongs to the concept of "lung distension",while anxiety belongs to the category of "depression syndrome".Music therapy is a kind of complementary and alternative therapy based on the theory and method of psychotherapy,which belongs to the category of "psychosomatic medicine".It uses the unique physiological and psychological effects of music to achieve the functions of sedation,analgesia,blood pressure reduction and elimination of psychological obstacles,which is conducive to the recovery or improvement of mental and physical health.Music is "situational" and "infectious".Our brain can integrate and recognize these characteristics of music.stimulate the body’s parasympathetic nervous system and enhance its excitability.so as to weaken the patient’s tension,strengthen positive emotions and weaken negative emotions.On the basis of music therapy,western scholar Dr.Helen bonny invented guided music imagination training,which takes music as the background and achieves consciousness transformation through music to regulate patients’ emotions.This intervention method can achieve satisfactory results in patients with stroke,heart failure and intensive care,but its application in COPD patients with anxiety has not been reported.Objective:To observe the intervention effect of guided music imagination training on COPD patients with anxiety,and to provide the basis for the development of non drug intervention methods for COPD patients with anxiety.Method:80 cases of patients with stable COPD complicated with anxiety in our hospital from April 2020 to November 2020 were randomly divided into control group and experimental group with 40 cases in each group.The control group was given routine treatment and nursing,including health education,medication guidance,diet guidance,respiratory exercise exercise,exercise guidance,etc.The experimental group conducted guided music imagination training on the basis of the control group.Both groups were intervened for 3 months.Before and after the intervention,SAS,TCMSSS,cat,MMRC and SSC were used to evaluate the intervention effect.Result:1.80 patients were included,including 40 cases in the experimental group(5 cases of abscission)and 40 cases in the control group(2 cases of abscission).Before intervention,in addition to the typical symptoms of COPD,such as dyspnea,chronic cough,chest tightness,expectoration,wheezing and so on,they showed irritability,irritability,decreased attention,sleep disorder and so on.Before the intervention,the SAS scores of the two groups were 53.63±3.34 in the experimental group and 53.89±2.97 in the control group.The patients in the two groups had varying degrees of anxiety.2.After intervention,the SAS scores of the two groups decreased in varying degrees,but the SAS score of the observation group was lower than that of the control group after intervention,and the difference was statistically significant(P<0.05).3.After the intervention,the TCM symptom score of both groups decreased significantly(P<0.05),and the TCM symptom score of the experimental group was lower than that of the control group,with statistical significance(P<0.05).4.After the intervention,the total effective rate of the experimental group was 97.1%,and that of the control group was 81.6%.The comparison between the two groups showed that the treatment effect of the experimental group was significantly better than that of the control group,and the difference was statistically significant(P<0.05).5.The cat scores of the two groups decreased in varying degrees after the intervention,but the cat score of the observation group was lower than that of the control group(P<0.05).6.After the intervention,the MMRC scores of both groups decreased to varying degrees,but the MMRC score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).7.After the intervention,The difference of two self-efficacy scores before and after the intervention in the observation group was statistically significant(P<0.05),the two self-efficacy scores of the two groups were increased,but there was no significant difference between the two groups(P>0.05).Conclusion1.The anxiety of COPD patients may come from bad emotional experience,and the incidence of sleep disorder,irritability,irritability and attention loss is high.2.Guided music imagination training can significantly alleviate the anxiety of patients,and can improve the degree of dyspnea and disease state of patients,improve the self-efficacy of patients.help to enhance the psychological reserve of disease resistance,and the effect is better than routine nursing.3.The guided music imagination training is simple and safe,which will not significantly increase the economic burden of patients,and is not limited by time and place.It is a convenient and scientific non drug intervention method for patients with COPD complicated with anxiety,which is conducive to broaden clinical thinking and form a more effective way of anxiety management.