| Backgroud: Lung cancer is one of the highest incidence in malignant tumors,mortality keeping high. Due to the onset of more hidden, often not associated with obvious symptoms in early stage, most of the patients are diagnosed in medium and advanced lung cancer.When a patient knows he has cancer,he will have a negative and restless mood plus strong adverse reactions and intolerable cancer pain leading to serious hopelessness mood.Therefore, how to improve the negative emotions,assisit clinical treatment, improve quality of life, physical and mental state in medium and advanced lung cancer patients,becomes a hotspot nowadays.Objective: By using the modified version of Individual Computer Game-version Magnanimous Therapy(ICGMT) in medium and advanced lung cancer patients, discuss the clinical efficacy of ICGMT in terms of psychological, physiological and social aspects,so as to provide a theoretical basis and empirical evidence for medium and advanced lung cancer patients in physical and psychological rehabilitation.Methods: 1. Make the modified version of Individual Computer Game-version Magnanimous Therapy(ICGMT). Refit 8 philosophical stories into flash animations respectively,in order to make it forming a more standard, vivid, practical, effective intervention.2. According to the matching grouping principle, 6O medium and advanced lung cancer patients were divided into control group and ICGMT group evenly. The individual computer Game-version magnanimous therapy(ICGMT) was applied in ICGMT grouppatients in one to one treatment for two weeks, 4 times a week, once for about 40 minutes.But the control group only has conventional treatment, not giving magnanimous therapy.Two groups of patients accomplish a series of questionnaires and measurements including Cancer Psychosomatic Status Questionnaire, Tumour Psychological Scale,Psychological Adjustment Scale for Cancer Patients, Cancer Coping Modes Questionnaire,Enterprising and Magnanimous Questionnaire, Functional Living Index-Cancer, Hospital Anxiety Depression and House-Tree-Person Subconscious Painting Test before and after their treatments for measuring their psychological and social indexes. Through using biofeedback instrument valued recording brain waves, blood pressure, heart rate and breathing as well as venous blood examination of immune cells Ig A, Ig G, Ig M, NK value,for measuring their physiological indexes. Through Observing the physical condition,psychological coping, adjustment, quality of life and physiological indicators beween the two groups before and after the experiment, assesses the efficacy.Results: 1. Developed modified Individual Computer Game-version Magnanimous Therapy(ICGMT).2. Psychological and social indicators of patients(1). The score of Cancer Psychosomatic Status Questionnaire:In the ICGMT group, th total score, “psychological”, “body”, “social function”, “psychological behavior plasticity”dimensions(30.70±3.98、8.10±1.63、7.20±1.21、8.2±1.45、7.00±1.01)were lower compared to two weeks ago(35.90±4.91、10.03±2.11、8.60±1.75、9.2±1.87、8.07±1.33), which has a significant difference(p<0.05); In the control group, the total score, “psychological”,“body”, “social function” dimensions after treatment(40.08±1.11 、 11.94±4.38 、10.22±2.13、14.01±3.78)were higher compared to two weeks ago(35.33±1.37、10.83±4.28、7.71±2.41、9.89±4.23), which has a significant difference(p<0.05),while, “psychological behavior plasticity” dimensions after two weeks(9.01±3.54)was compared to 2 weeks ago(8.78±1.09), which not has a significant difference.(2). The score of Tumour Psychological Scale:In the ICGMT group and the control group,there was no signicant differences in four dimensions including "personality", "" cognitive habit ", “emotional expression " and "unconscious" dimensions and the total score(p>0.05).(3). The score of Psychological Adjustment Scale for Cancer Patients:In the ICGMT group, the total score,five dimensions including "emotional", "subjective feelings", "relationships", "daily life" and "other" after treatment(3.40±0.33、3.65±0.54、3.53±0.41、3.53±0.34、2.89±0.45、3.37±0.59)were higher compared to before treatment(3.35±0.52、3.57±0.43、3.41±0.51、2.77±0.48、3.51±0.33、3.29±0.51),the differences were significant(p<0.01); In the control group, the total score,five dimensions including "emotional", "subjective feelings", "relationships", "daily life" and "other" s after 2 weeks(3.29±0.49 、 3.72±0.74 、3.38±0.64 、 2.69±0.21 、 3.87±0.24 、 3.45±0.81)were lower compared to 2 weeks ago(3.31±0.64、3.73±1.49、3.27±0.52、2.71±0.42、3.87±0.32、3.47±0.49), the difference was not statistically significant(p>0.05).(4). The score of Cancer Coping Modes Questionnaire:In the ICGMT group, the total score and "face " dimension(2.34±0.14 、 2.77±0.55)were higher compared to before treatment(2.29±0.23 、 2.48±0.52), "avoidance and suppression" and "surrender" dimensions(1.73±0.69、2.10±0.55)were lower compared to before treatment(2.00±0.51、1.73±0.69), the differences were statistically significant(p<0.05); "fantasy" and "vent" dimensions(2.17±1.46 、 3.35±5.67)were compared to before treatment(2.04±0.61 、1.55±0.41), the difference were not statistically significant(p>0.05). In the control group, "face " dimension(2.41±0.39)were lower compared to before treatment(2.56±0.41), the difference were statistically significant.Total score, four dimensions including "avoidance and suppression", "surrender" dimensions, "fantasy" and "vent" dimensions after 2weeks(2.01±1.45、2.14±0.29、2.43±0.58、2.12±0.11、1.42±0.56)were compared to 2 weeks ago(1.99±1.08、2.13±0.63、2.46±0.44、2.01±0.22、1.43±0.58), the difference were not statistically significant(p>0.05).(5). The score of Enterprising and Magnanimous Questionnaire:In the ICGMT group,the total score, “enterprising” dimensions(72.35±6.76、36.71±4.09)were higher compared to before treatment(70.56±7.89、35.45±4.54),the differences were statistically significant(p<0.01); “magnanimous” dimensions(36.27±3.55)were compared to beforetreatment(36.01±4.06), the difference were not statistically significant(p>0.05). In the control group, total score, “magnanimous” dimensions after 2 weeks(70.81±6.21 、35.20±1.89)were compared to two weeks ago(71.11±8.30 、 35.09±1.21), the difference were not statistically significant(p>0.05). The“enterprising” dimensions(30.07±1.89)lower compared to before treatment(34.11±2.11), the difference were statistically significant(p<0.05).(6). The score of Functional Living Index-Cancer:In the ICGMT group,the total score, "Body Good", "psychological well", "social good" after treatment(4.38±1.21、4.63±1.03、4.93±0.37、5.80±1.24)were higher compared to before treatment(4.13±0.67、4.34±1.31、4.86±0.88、5.67±1.15),and "hardship due to cancer " 、 "nausea" dimensions(3.23±1.28、4.03±1.52)were lower compared to before treatment(3.72±1.54、4.78±1.82),the differences were significant(p<0.01); In the control group, "Body Good", "psychological well" after2 weeks(3.56±1.23 、 4.15±1.09)were lower compared to two weeks ago(4.11±0.98 、4.77±1.22), "nausea" and "hardship due to cancer " dimensions(4.47±2.01、3.33±1.29)was higher compared to two weeks ago(4.46±3.21、3.21±1.04), the total score, "social good" dimensions(3.87±0.37、5.49±1.11)were lower compared to before treatment(3.88±0.52、5.55±1.09)the difference were not statistically significant(p>0.05).(7). The score of Hospital Anxiety Depression:In the ICGMT group, the total score, "anxiety", "depression" score(13.23±3.12、5.99±2.13、7.87±2.24)were lower compared to before treatment(16.12±3.67、 6.67±2.31、9.45±2.78),the differences were significant(p<0.01); In the control group, the total score, "anxiety", "depression" score(19.23±3.16、8.99±4.13、10.87±2.24)were higher compared to before treatment(17.13±4.57、6.98±2.39、9.85±2.18),the differences were significant(p<0.01).(8). House-Tree-Person Test:In the ICGMT group,through two weeks intervening, each part of the layout are complete without missing, moderate proportion, clear picture,continuous thread, decisive stroke,as well as,there was no repeatedly revised trace.The meaning are more active and more sunny,while,negative projection points dramatically reduced compared to before.3. Physiological indexes of patients(1). The value of "SBP、DBP、HR、R" :In the ICGMT group, SBP、DBP、HR、R after treatment(129.55±7.23、80.31±8.09、84.55±4.38、17.47±1.35)were lower compared to before treatment(134.78±7.57、85.77±9.23、87.11±8.22、19.56±2.11),the differences were significant( p<0.05); In the control group,there was no statistically significant between the after two weeks with the before treatment.(2). The value of "Brain waves" 、 "SC/GSR" 、 "Temp" : In the ICGMT group, "α wave"( 35.94±0.98) were higher compared to before treatment(34.85±1.69), "θwave"(3.69±1.61)lower to before treatment(4.68±1.78), the differences were significant(p<0.01). In the control group, "θ wave" after 2 weeks(28.71±4.56)was higher compared to2 weeks ago(24.51±8.21), "α wave"(9.39±3.52)lower compared to before treatment(11.65±4.94),the differences were significant(p<0.01). In the ICGMT group and the control group,there was no statistically significant in "SC/GSR", "Temp", "β wave", "SMR wave".(3). Comparison of the values of Ig A, Ig G, Ig M and NK in immune cells: In the ICGMT group, Ig A、Ig G、Ig M、NK cell after treatment(2.55±3.23、14.87+4.27、1.48±0.13、0.35±0.47)were higher compared two weeks ago(2.29±2.10、10.43+3.14、1.01±0.88、0.21±0.23)the difference was statistically significant(p<0.05); In the control group, Ig A、Ig G、 Ig M、NK cell after 2 weeks(1.55±1.19、9.57±5.19、1.35±0.61、0.21±0.21)were lower compared to 2 weeks ago(2.18±1.10、10.92±3.91、1.61±0.88、0.35±0.13),the differences were significant(p<0.05).4. Clinical qualitative evaluationMost medium and advanced lung cancer patients think the Computer Game-Version Magnanimous Therapy is lively and interesting, close to life, reproducing the patients’ s tangled heart usually; philosophical, through transmitting truth so as to correct their cognitive distortions and negative thoughts; simple operation, suitable for different age levels. The patients in physical condition, coping, adjustment, quality of life and physiological indicators have improved.So the therapy praised by the almost patients.Conclusion: Individual Computer Game-Version Magnanimous Therapy is a Psychological intervention with specification, vivid description,utility, effectiveness,to helppatients develop a positive and optimistic attitudes towards life, in order to achieve the open-minded life. The therapy plays active roles in psychosomatic state,coping, the way of adjustment, social function and quality of life; As well as plays active roles in the physiological index of patients especially immune function. As an effective way of psychological intervention, improves the quality of life with the medium and advanced lung cancer patients, providing a strong empirical evidence for clinical work in the future. |
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