| ObjectiveThe research discussed its improvement effect for the psychological distress,anxiety and depression,sleep quality and life quality of the advanced lung cancer patients who receive chemotherapy by adopting the intervention on the psychological distress for the advanced lung cancer patients who receive chemotherapy through directed imaginative five-element music therapy and taking the perspective of five-element music therapy Zang-Fu music selection based on strengthening earth to generate metal theory and guiding imagination music playing based on modern music treatment technology.Taking the psychological distress of the lung cancer patients who receive chemotherapy as a carrier,the research discusses the feasibility of the treatment technology combination between five element music and modern music under the theoretical guidance of classic five elements ?strengthening earth to generate metal” to further promote the research on the five-element music treatment effect for clinical application.It provides a clinic practical foundation for further mechanism study and effective non-drug assistant intervention for the psychological distress of the advanced lung cancer patients who receive chemotherapy.MethodsThe research designed reasonable intervention schemes from the selection of five-element music and music playing process by adopting randomized controlled trial before official experiment,which is based on the professional suggestions of clinical experts in traditional Chinese Medicine,psychology experts and clinical oncology specialists and music professionals as well as literature review.It has been consecutively admitted to one of the top three hospitals in Chengdu,Sichuan from December 2016 to August 2017.120 cases of advanced lung cancer patients who receive chemotherapy suffer distress according to the standard.They was divided into control group(five-element music therapy group),experimental group No.1(Five-element music of strengthening earth to generate metal)and experimental group No.2(Five-element music of strengthening earth to generate metal combined with guiding imagination group)with 40 cases for each group.Each group is treated by lung cancer first-line chemotherapy regimen and supportive treatment.The control group adopts the regular differentiation selection of Zang and Fu and the corresponding Shang-tone music therapy of Zang and Fu for intervention.The experimental group No.1 adopts Shang-tone music therapy for Zang and Fu together with Gong-tone music for the mother of lung – Zang and Pi based on strengthening earth to generate metal theory for intervention.The experimental group No.2 is intervened by adopting five-element music of strengthening earth to generate metal combined with guiding imagination technology.Three groups are averagely intervened for once every day with 30 minutes or over 30 minutes each time.They can rest for two days every five days.A course of treatment is two weeks.There are total two intervention treatments.They need to pay regular visits to doctors in the second week after the intervention is completed.The patients' psychological distress degree,anxiety and depression and sleep quality improvement will be evaluated before intervention,the second week after intervention,the fourth week after intervention and the second week after the intervention is completed by adopting Chinese DT,PL,HADS and PSQI.The patients' life quality improvement will be evaluated before intervention,the fourth week after intervention and the second week after the intervention is completed by adopting EORTC QLQ-LC43 of the tissue tumor patients from European cancer study and treatment.ResultsA total of 127 cases were included in the research,and 120 patients completed the data collection,in which 40 cases(2 cases for abscission and 1 case for elimination)for control group,40 cases(2 cases for abscission)for experimental group No.1 and 40 cases(1 case for abscission and 1 case for elimination)for experimental group No.2.The results are as follows: 1.The results of distresse valuation 1.1 the comparison of scores of distress thermometer(1)The result of comparison among groups indicate: when distress thermometer scores are compared among control group,experimental group No.1 and experimental group No.2 in the second week of intervention,fourth week of intervention and the second week after the intervention is completed,the difference is statistically significant(P<0.05).(2)The repetitive measure analysisresults of variance(ANOVA)indicate: the DT score are statistically significant in the group effect,time effect and interaction effect(P<0.05).(3)The further comparison between every two groups indicate: In the second week of intervention,fourth week of intervention and the second week after the intervention is completed,if the score of control group and experimental group No.1 or that of experimental group No.1 and experimental group No.2 are compared,the difference in DT score is not statistically significant(P>0.017).In the second week of intervention,fourth week of intervention and the second week after the intervention is completed,if the score of experimental group No.2 is compared with that of control group,the difference in DT score is statistically significant(P<0.017).(4)when the pairwise comparison of patient's DT scores from three groups is implemented,except that the difference for the second week of intervention and two weeks after intervention is not statistically significant,the DT score of latter time point is always lower than that of previous time point for experimental group No.1 and experimental No.2 after intervention,whose difference is statistically significant(P<0.0083);except that the difference for the second week of intervention and two weeks after intervention is not statistically significant,the DT score of latter time point is always lower than that of previous time point for control group after intervention,whose difference is statistically significant(P<0.0083).1.2 the changing situation of distress questionsIn the research,before the intervention,the top 5 problems affecting patients' pdistrssn mainly include:(1)economic issue(75%)belong to practical problems;(2)fatigue(68.33%)belong to physical problems;(3)anxiousness(66.67%)belong to emotional problems(4)pain(58.33%)belong to physical problems;(5)sleep issue(50%)belong to emotional problems.After the intervention,the top 5 problems influencing patients' distress consist :(1)fatigue(55.83%)belong to physical problems;(2)economic issue(45.83%)belong to practical problems;(3)anxiousness(45.83%)belong to emotional problems(4)take food(30.83%)belong to physical problems;(5)Lack of time and energy to take care of children / old people(27.5%)belong to reality problems.After intervention,the patients' emotional problems and some physical problems were obviously alleviated,and the effect on some practical problems and some related physical symptoms was limited,but the guiding five-element musical imagination therapy could improve the patients' feelings to a certain extent.It's could improve their attitude towards,and thus indirectly have an effect on.2.the results of anxiety-depression evaluation(1)The comparison results among groups indicate: if 2-dimensional scores of HADS for control group,experimental group No.1 and experimental group No.2 in the second week of intervention,fourth week of intervention and the second week after the intervention is completed are compared,the difference is statistically significant(P<0.05).(2)The repetitive measure analysis results of variance(ANOVA)indicate: the HA and DH scores in HADS are statistically significant in the group effect,time effect and interaction effect(P<0.05),whose changes will firstly decrease,then increase.(3)Further pairwise comparison results indicate: The HA and HD dimension in HADS of experimental No.1 and that of experimental No.2 is better than that of control group in the second week of intervention,fourth week of intervention and the second week after the intervention is completed(P<0.017 for both).The difference between experimental group No.1 and experimental group No.2 is not statistically significant.(4)If the pairwise comparison among the HADS scores of three groups at each time point is implemented,the HA and HD score in HADS of the latter time point will always be lower than that of the previous time point for experimental group No.1 and experimental No.2,whose difference is statistically significant(P<0.0083).3.the results of Sleep evaluation(1)The comparison results among groups indicate: The differences in the PSQI sleep time dimension of the patients from three groups in the second week of intervention,their daily functional failure dimension and total score in the second week of intervention and the second week after intervention is completed and sleep quality dimension as well as sleep disorder dimension in the second week after the intervention is completed are statistically significant(P<0.05).(2)The repetitive measure analysis results of variance(ANOVA)indicate: The difference in the daily function failure and total score of PSQI effect for the patients from three groups are in the group effect statistically significant(P<0.05),the differences in the PSQI total score and each dimension are statistically significant in the time effect(P<0.05),and those in the sleep time,daily function failure and total score in the interaction effect are statistically significant(P<0.05),whose changes will firstly decrease,then increase.(3)Further pairwise comparison results indicate:(1)The difference in the scores of the PSQI sleep quality dimension comparison between control group and experimental group No.1 or experimental group No.2 in the second week after intervention is statistically significant(P<0.017).(2)The difference in the scores of the PSQI sleep time dimension comparison between control group and experimental group No.1 or experimental group No.2 in the second week after intervention is statistically significant(P<0.017 for both).(3)The difference in the scores of the PSQI time efficiency dimension comparison between control group and experimental group No.2 in the second week after intervention is statistically significant(P<0.017).(4)The difference in the scores of the PSQI sleep disorder dimension comparison between control group and experimental group No.1 or experimental group No.2 in the second week after intervention is statistically significant(P<0.017 for both).(5)The difference in the scores of the PSQI hypnotic drugs comparison between control group and experimental group No.2 in the second week after intervention is statistically significant(P<0.017).(6)The differences in the scores of the PSQI daily function dimension comparison between control group and experimental group No.1 or experimental group No.2 in the second week after intervention,that between control group and experimental group No.1 in the fourth week after intervention and that between control group and experimental group No.1 or experimental group No.1 and experimental group No.2 after intervention is completed are statistically significant(P<0.017).(7)The differences in the PSQI total score between control group and experimental group No.1 or experimental group No.2 in the second week after intervention and that between control group and experimental group No.2 in the fourth week after intervention and in the second week after the convention is completed are are statistically significant(P<0.017).(4)If the pairwise comparison among the each PSQI dimension of three groups at each time point is implemented,the score differences in each PSQI dimension of the latter time point will always be lower than that of the previous time point for control group before and after intervention are statistically significant(P<0.0083).The score differences in the PSQI sleep quality,sleep time and total score of the latter time point will always be lower than that of the previous time point for experimental group No.1 before intervention,in the second week after intervention,in the fourth week after intervention and in the second week after the intervention is completed are statistically significant(P<0.0083).The score differences in the sleep efficiency,sleep disorder and daily function failure before intervention,in the fourth week after intervention and in the second week after the intervention is completed are statistically significant(P<0.0083).The score in PSQI sleep quality,sleep time,daily function failure and total score of the latter time point will always be lower than that of the previous time point for experimental group No.2 before intervention,in the second week after intervention,in the fourth week after intervention and in the second week after the intervention is completed,whose difference is statistically significant(P<0.0083).The score in PSQI sleep efficiency and sleep disorder of the latter time point will always be lower than that of the previous time point before intervention,in the fourth week after intervention and in the second week after the intervention is completed,whose difference is statistically significant(P<0.0083).4.the results of life quality evalutation(1)The comparison results among groups indicate: The differences in the function,symptom,overall life quality and lung cancer module dimension of the patients from three groups in the fourth week of intervention and the second week after intervention is completed is completed are statistically significant(P<0.05).(2)The analysis results of repeated measurement variance(ANOVA)indicate: The QLQ-LC43 function dimension,symptom dimension,overall life quality and lung cancer module of the patients from three groups are statistically significant in the group effect,time effect and interaction effect(P<0.05),in which the change in function dimension and overall life quality will firstly increase,then decrease while that in the symptom dimension and lung cancer module will firstly decrease,then increase.(3)Further pairwise comparison results indicate: after the results are classified,the differences in the scores of the function dimension,symptom dimension,overall life quality and lung cancer module of the patients from three groups between control group and experimental group No.1 or experimental group No.2 in the fourth week after intervention and in the second week after intervention are statistically significant(both P<0.017).The difference in that between experimental group No.1 and experimental group No.2 is not statistically significant.(4)If the pairwise comparison among the each QLQ-LC43 dimension of three groups at each time point is implemented,the score differences in each QLQ-LC43 the function dimension and overall life quality of the latter time point will always be lower than that of the previous time point for control group before and after intervention are statistically significant(P<0.017).The score differences in the symptom dimension of the latter time point will always be lower than that of the previous time point before intervention,in the fourth week after intervention and in the second week after the intervention is completed and that in the lung cancer module in the fourth week after intervention and in the second week after the intervention is completed are not statistically significant(P>0.017).The score in function dimension,symptom dimension,overall life quality and lung cancer module of the latter time point will always be lower than that of the previous time point for experimental group No.1 after intervention,whose difference is statistically significant(P<0.017).Except symptom dimension,the score difference in function dimension,overall life quality and lung cancer module of the latter time point will always be lower than that of the previous time point for experimental group No.2 is statistically significant(P<0.017).ConclusionsThe treatment based on strengthening earth to generate metal theory combined with guiding imagination five-element music therapy can reduce the psychological distress of the advanced lung cancer patients who receive chemotherapy,ease their anxiety and depression,improve their sleep quality and life quality.Besides,the treatment effect is better than strengthening earth to generate metal five-element music group and five-element music group.The application of strengthening earth to generate metal theory in the guidance for five-element music therapy will enhance the improvement effect on the psychological distress of the lung cancer patients who receive chemotherapy and promote the development of traditional Chinese medicine nursing and five-element music therapy by playing music through guiding imagination technology.It will be worth promoting and further discussing in the clinics. |
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