Article(id=1322925068849918075, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924976893993108, articleNumber=null, orderNo=null, doi=10.12102/j.issn.1009-6493.2026.16.026, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1759766400000, receivedDateStr=2025-10-07, revisedDate=1785168000000, revisedDateStr=2026-07-28, acceptedDate=null, acceptedDateStr=null, onlineDate=1793339515173, onlineDateStr=2026-10-30, pubDate=1787587200000, pubDateStr=2026-08-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1793339515173, onlineIssueDateStr=2026-10-30, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1793339515173, creator=13701087609, updateTime=1793339515173, updator=13701087609, issue=Issue{id=1322924976893993108, tenantId=1146029695717560320, journalId=1220038315760373764, year='2026', volume='40', issue='16', pageStart='2769', pageEnd='2960', issueExtLink='null', onlineDate='null', pubDate='1787587200000', pubDateStr='2026-08-25', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1793339493249, creator='13701087609', updateTime=1793343103544, updator='13701087609', preIssue=null, nextIssue=null, articleTotal=null, ext={EN=IssueExt(id=1322940119640047671, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924976893993108, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1322940119640047672, tenantId=1146029695717560320, journalId=1220038315760373764, issueId=1322924976893993108, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null, downloadFileDto=null}, startPage=2949, endPage=2954, ext={EN=ArticleExt(id=1322925069235794044, articleId=1322925068849918075, tenantId=1146029695717560320, journalId=1220038315760373764, language=EN, title=Application progress of soundscapes therapy in palliative care for cancer patients, columnId=1220689485315101342, journalTitle=Chinese Nursing Research, columnName=Review Articles, runingTitle=null, highlight=null, articleAbstract=

This paper reviewed the concept,mechanism of action,intervention methods,and application effects of soundscapes therapy,so as to provide theoretical support for the application and development of soundscapes therapy in the field of palliative care for cancer patients.Future research should focus on interdisciplinary integration and the construction of an auxiliary intelligent system with multi-sensory synergy,in order to promote the development of soundscapes therapy in the field of palliative care for cancer patients.

, authors=Yue XIE, Lijuan WU, Fang WANG, authorsList=Yue XIE, Lijuan WU, Fang WANG, authorCompany=null, correspAuthors=Fang WANG, authorNote=null, correspAuthorsNote=null, copyrightStatement=null, copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, fund=null), CN=ArticleExt(id=1322925071001596030, articleId=1322925068849918075, tenantId=1146029695717560320, journalId=1220038315760373764, language=CN, title=声景疗愈在癌症病人安宁疗护中的应用进展, columnId=1220689485482873504, journalTitle=护理研究, columnName=科研综述, runingTitle=null, highlight=null, articleAbstract=

对声景疗愈的概念、作用机制、干预方式及应用效果进行综述,以期为声景疗愈在癌症病人安宁疗护领域的应用和发展提供理论支持。未来研究应着重于多学科交叉融合,构建多感官协同作用的辅助智能系统,以推动声景疗愈在癌症病人安宁疗护领域的发展。

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谢玥,护师,硕士研究生

, correspAuthorsNote=
王芳,E-mail:
WANG Fang, E-mail:
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声景疗愈在癌症病人安宁疗护中的应用进展
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谢玥 , 吴丽娟 , 王芳 *, *
护理研究 | 科研综述 2026,40(16): 2949-2954
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护理研究 |科研综述 2026 , 40 (16) : 2949 -2954
声景疗愈在癌症病人安宁疗护中的应用进展
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谢玥, 吴丽娟, 王芳*, *
作者信息
  • 1南通市第一人民医院,江苏 226000
通讯作者:
王芳,E-mail:
WANG Fang, E-mail:
作者简介:

谢玥,护师,硕士研究生

Application progress of soundscapes therapy in palliative care for cancer patients
Yue XIE, Lijuan WU, Fang WANG
Affiliations
  • 1Nantong First People's Hospital, Jiangsu 226000 China
出版时间: 2026-08-25 doi: 10.12102/j.issn.1009-6493.2026.16.026
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对声景疗愈的概念、作用机制、干预方式及应用效果进行综述,以期为声景疗愈在癌症病人安宁疗护领域的应用和发展提供理论支持。未来研究应着重于多学科交叉融合,构建多感官协同作用的辅助智能系统,以推动声景疗愈在癌症病人安宁疗护领域的发展。

癌症  /  安宁疗护  /  声景疗愈  /  护理  /  综述

This paper reviewed the concept,mechanism of action,intervention methods,and application effects of soundscapes therapy,so as to provide theoretical support for the application and development of soundscapes therapy in the field of palliative care for cancer patients.Future research should focus on interdisciplinary integration and the construction of an auxiliary intelligent system with multi-sensory synergy,in order to promote the development of soundscapes therapy in the field of palliative care for cancer patients.

cancer  /  palliative care  /  soundscapes therapy  /  nursing  /  review
谢玥, 吴丽娟, 王芳. 声景疗愈在癌症病人安宁疗护中的应用进展. 护理研究, 2026 , 40 (16) : 2949 -2954 . DOI: 10.12102/j.issn.1009-6493.2026.16.026
Yue XIE, Lijuan WU, Fang WANG. Application progress of soundscapes therapy in palliative care for cancer patients[J]. Chinese Nursing Research, 2026 , 40 (16) : 2949 -2954 . DOI: 10.12102/j.issn.1009-6493.2026.16.026
癌症是全球主要的致死原因之一。国家癌症中心统计数据显示,2022年我国癌症新发病例数达到482.47万例,死亡人数达到257.42万例[1]。受环境污染、人口老龄化加剧、生活方式改变等多种因素的影响,癌症的发病率和死亡率仍在持续攀升,给个人、家庭乃至整个社会带来了沉重的负担,已成为亟待解决的公共卫生问题[2]。研究表明,处于终末期的癌症病人,不仅需要承受生理上的极度不适感,还时刻经历着死亡恐惧、抑郁等心理痛苦体验,导致其尊严丧失、生存质量下降,甚至会产生自杀意念[3-5]。安宁疗护作为一种以全人照护为核心的医疗服务模式,已成为医疗体系中不可或缺的一部分[6]。在安宁疗护实践中,构建支持性的疗愈环境是提升照护质量的关键。声景干预作为一种非药物、低侵入性的辅助手段,通过引入自然声景等积极声学元素,重塑病人的听觉环境,正日益获得关注[7]。目前,关于声景干预在癌症病人安宁疗护中应用的实证研究尚不充分,其在临床实践中的适用性及有效性仍需深入探讨。因此,本研究就声景疗愈的概念、作用机制、干预方式以及应用效果进行概述,以期为声景疗愈在癌症病人安宁疗护领域的应用和发展提供理论支持。
声景作为一门新兴的跨学科研究领域,其定义一直在不断地更新与完善。1969年,美国学者Southworth[8]首次提出声景的概念,强调声音在塑造人类对环境整体感知过程中所发挥的关键作用。随后,加拿大音乐学家Schafer[9]在进行噪声研究时,观察到自然环境中也存在诸多令人感到舒适和愉悦的声音,进而将声景研究拓展为声音生态学(acoustic ecology)。在我国,声音景观的概念最早由李国棋[10]引入,并进一步深化了声音生态学与人居环境之间关系的研究。随着理论框架日益成熟,声景的定义逐渐标准化。2014年,国际标准化组织将其明确定义为在特定场景中,个体或群体所感知、体验或理解的声环境[11]。在实际应用中,声景理论逐渐拓展出以疗愈为目标的应用领域,通过构建积极的声环境以促进身心健康。需要明确的是,声景疗愈在理念和实践上与传统音乐疗法存在差异。传统音乐疗法通常要求个体作为主动参与者在演奏或聆听中进行有目标的治疗互动。相比之下,声景疗愈更侧重于个体作为环境“感知者”被动沉浸于声环境中,借助“声-人-环境”的动态交互,实现身心调节与压力缓解[12]。目前,声景疗愈的应用范围已经扩展至医疗、养老、教育、城市规划等多个领域。实证研究表明,疗愈性声环境对人们的身心健康具有正面影响[13-15]。声景疗愈作为一种疗愈环境模式,近年来逐渐融入癌症病人的安宁疗护实践中[16-17]。
该方法主要用于测量声音的能量属性,是量化物理声环境的基础[18]。通过采用倍频程或三分之一倍频程带进行频谱分析、使用经过校准的声级计(sound level meters,SLMs)精确测定声压级(sound pressure level,SPL),进一步可利用科学软件计算心理声学参数,以实现对物理声环境的全面评估[19-20]。该方法的优势在于其提供的测量数据具有高度的精确性和可靠性。
量表及问卷用来完善和改进现有的声景评估方法。语义差异量表(Semantic Differential Scales)通过将一系列预设的双极形容词(如平静与混乱、愉悦与烦恼)供参与者选择,以此衡量参与者对声景的态度和感受[21]。此量表信效度较好,是测量自我感知水平的有效工具。声景感知恢复量表(Perceived Restorativeness Soundscape Scale,PRSS)用于测量声景环境对心理恢复的促进作用,Payne等[22]通过心理语言学分析验证了其具备良好的内部一致性信度。自我情绪评定量表用以评定个体情绪状态,通过图形化的表情人偶帮助病人表达情绪,包括愉悦度、唤醒度、支配度3个维度。该量表具有较高的表面效度与操作便利性,适用于现场、线上及实验室等多种测评场景[23]。
该方法是评估声景对个体生理恢复效应的关键指标。通过测量心率(HR)、心率变异性(HRV)、皮肤电导(EDA),以及运用脑电图(EEG)或面部情绪识别的人工智能等技术,可以动态地掌握不同声景环境刺激对个体生理指标的影响[24-25]。
20世纪80年代,学者Kaplan和Ulrich分别提出了注意力恢复理论(attention restoration theory,ART)和减压理论(stress reduction theory,SRT)。这两个理论作为环境心理学的核心理论,可相互作用并转化,极大地丰富了疗愈环境的机制与应用。
该理论指出个体若长时间专注于特定的刺激或目标,可能会引发定向注意力疲劳,进而对认知、情感和行为产生负面影响[26]。自然环境具有距离感、丰富性、吸引力和兼容性特征。个体置身于自然环境之中,可促进大脑的高效运作,有效缓解疲劳感并恢复注意力。个体与自然环境的互动程度愈高,其对个体产生的疗愈效果愈为显著[27]。
该理论认为在压力环境的影响下,个体会出现自主神经系统唤醒水平升高,副交感神经系统活动减弱等表现,久而久之对其造成不可逆的损害[28]。相比之下,自然环境能够迅速引导病人的注意力聚焦于自然元素,从而有效缓解焦虑情绪,提升感知能力,并促进生理机能的恢复[29]。
在当前声景学研究中,被普遍应用的模型是由Axelsson等所开发的愉悦感-事件感圆周模型(pleasantness-eventfulness circumplex model)[19]。该模型将大量潜在感知属性整合到少数基本维度中,并分析这些维度与声景物理属性的关系。在模型中,声音感知的基本维度被细分为愉悦性、事件性和熟悉性3个主要要素。当令人愉悦的声音(即愉悦感知维度)成为主导音时,能显著提升个体对环境声景的感知质量,帮助其缓解压力以及改善情绪。
基于经典恢复理论,国内学者张圆[28]融合声景恢复性研究的实证经验,构建了声景恢复性表现理论模型。该模型揭示了城市开放空间声景对个体具有显著的恢复性效应,效应主要分为直接恢复效应(心理、生理和认知恢复)和间接恢复效应(视听交互恢复)。
声景疗愈的神经生理调节机制是一个复杂的生理过程,涉及听觉通路、脑区活动、自主神经系统以及神经递质等多个层次和方面的协同作用。通过调节人体神经生理功能,能够有效地改善情绪状态、促进睡眠质量并缓解疼痛症状。多项科学研究已经证实了声景在情绪调节方面的作用,声景疗法能够降低交感神经的活性,并增强副交感神经的活性,进而降低心率、血压及皮质醇等压力激素的水平;同时,声景还能通过增强前额叶背外侧皮层(DLPFC)与杏仁核的功能连接,提升情绪调节能力[30-31]。在提高睡眠质量方面,声景也发挥着积极的作用,通过抑制杏仁核的过度激活、促进γ-氨基丁酸(GABA)的释放,进而缩短入睡潜伏期,增加深度睡眠的比例[32]。此外,有研究表明,特定频率的声景具有刺激中脑导水管周围灰质(PAG)释放内啡肽的效应,通过激活μ-阿片受体,抑制脊髓背角的疼痛信号传导,从而促进生理放松,缓解慢性疼痛[33]。
特定声音环境(如自然声音、结构化声景)的听觉输入干预,能够引导个体注意力从焦虑情绪或消极思维中转移,并减少认知控制机制对负面刺激的认知处理。自然声景中所含的“无威胁性”声学特征(例如流水声、鸟鸣)通过认知评价机制降低环境威胁感知,促进前额叶皮层对情绪的理性调控,其规律性与和谐性有助于建立认知秩序感,缓解由不确定性引起的焦虑[34]。Cai等[25]研究显示,森林声景可降低皮质醇水平,并通过激活前额叶皮层的奖赏通路增强情绪调控能力。此外,声音引发的心理意象(如自然场景联想)能激活积极情绪记忆,抑制杏仁核的过度唤醒,这种效应在非自愿心理意象(例如听自然声音触发的视觉联想)中更为显著[35]。
声学掩蔽系统在传统物理降噪基础上,通过主动引入一种规律、中性的背景声(如白噪声、粉红噪声或自然声景),以提高环境声音的感知阈值,从而有效掩蔽或削弱突发、令人不快的噪声(如谈话声、设备报警声),为病人提供一个更健康、舒适的诊疗环境。Keting等[36]在ICU中于病人床旁播放40~50 dB的白噪声,干预时段为每日21:30至次日06:00,结果显示白噪声能显著减少病人夜间觉醒次数。另一项针对心脏重症监护室病人的研究也表明,连续3个晚上暴露于50~60 dB的白噪声环境中,可有效改善其睡眠质量[37]。然而,当前声学掩蔽系统的干预参数尚未形成统一标准。未来需要更多试验进一步探索不同临床场景下的最佳方案,以实现更安全、个性化的声学干预。
声景疗愈理论将声音重新定义为一种积极的治疗性资源,主张通过引入愉悦的声源以促进身心健康。声景能够产生降低心率、减轻疼痛感知、提升心理恢复力等多维积极效应,从而有效缓解焦虑、抑郁与压力。不同声景元素的恢复效果具有特异性,且受到环境背景的调节。在绿色空间(如城市公园)中,研究发现参与者更偏爱自然声景的均衡组合[38]。Van Renterghem等[39-40]研究指出,树叶沙沙声、水流声与鸟鸣声能促进个体的恢复性体验。从生理机制上看,王鹏等[41]进一步发现,水流声能调节心率和呼吸频率,而鸟鸣与虫鸣则分别更易唤起好奇心与舒适感。此外,多种自然声的协同组合通常比单一元素更能提升愉悦度与修复效果。研究表明,鸟鸣、风声与水声的融合更能模拟宁静且生物多样性丰富的自然声境,从而通过吸引无意识注意、降低交感神经兴奋性等途径发挥疗愈作用[42]。综上所述,声景的恢复效果受声源特性、环境背景以及个人偏好等多种因素影响,特定声景元素的作用机制及其在临床领域的应用仍需进一步探讨。
虚拟现实(virtual reality,VR)技术与增强现实(augmented reality,AR)技术通过构建沉浸式或增强融合的声景环境,为病人提供了真实且可控的个性化疗愈体验。VR技术能够对城市公共空间中的声景感受进行高精度评价。AR技术能够增强室内外环境的声景交互,并通过听觉刺激强化视觉体验。Latini等[43]在VR中搭建办公室场景,并融入自然声景(如鸟鸣),通过非连续29 d、每次35 min的干预,显著改善了参与者的生理指标。在另一项研究中,Hsieh等[44]利用VR呈现融合森林景观与瀑布声的自然环境,通过对比不同强度水声(20 dB与50 dB)发现,自然水声能有效缓解焦虑、促进健康的自主神经活动,且低强度水声的效果更为显著。在此基础上,人工智能(artificial intelligence,AI)正推动声景干预朝着精准化方向发展。Wang等[45]采用经过精细训练的人工智能模型(TPA-AI),对参与者日常生活中的瞬间音频进行情感质量预测,准确率为92.88%,并进一步证实声景的情感质量与压力缓解效果呈正相关。
癌症病人在经历漫长的治疗周期和面对疾病的不确定性时,常会产生强烈的焦虑和抑郁情绪。这些负面情绪不仅影响他们的生活质量,还会加速疾病的恶化。声景疗愈对个体的生理反应和情绪变化具有积极的促进作用。目前,声景相关的研究主要建立在减压理论和注意力恢复理论基础上。多项研究进一步验证了声景干预在临床与日常场景中的应用价值。在医疗环境中,Williamson[46]研究发现,使用海洋声(白噪声)可显著改善冠状动脉搭桥术后病人在ICU转出后的夜间睡眠质量,具体表现为睡眠深度、恢复性睡眠及夜间睡眠得分提高。Evans等[47]对儿科姑息治疗的病人和家庭进行心跳干预后,结果显示心跳干预提高了患儿的生活质量,促进健康和积极情绪。在日常生活场景中,Booi等[48]在一项针对荷兰安静地区的研究显示,自然声音(如鸟鸣和喷泉的混合声)能够帮助个体从交感神经激活的状态中恢复正常,进而降低压力水平。此外,Ascone等[49]对27名参与者进行了一项暴露于虚拟自然的试验,结果发现其可提升参与者的认知表现与感知恢复力,同时降低其感知压力。由此可见,积极的声景干预可以有效促进个体的情绪感知和注意力恢复。
在社会环境、心理因素、疾病治疗及其副作用等因素的影响下,癌症病人普遍面临睡眠障碍问题,主要表现为入睡困难、频繁醒来以及睡眠结构的异常,严重损害了病人的身心健康[50]。白噪声与自然声在改善睡眠质量方面展现出积极作用,能够降低个体的皮质醇水平,促进副交感神经的兴奋,并减轻应激反应,从而改善睡眠质量[51]。Yin等[16]对104例接受术前新辅助化疗(NAC)的女性乳腺癌病人进行了白噪声干预研究,结果显示干预组病人的睡眠质量相对于对照组明显提升。有研究采用海浪和发光二极管(LED)星空投影仪进行了一项随机对照试验,研究对象为60例儿科肿瘤病人,干预组的病人每晚在睡前接受30 min的海浪声播放和LED星空投影仪照射,持续1周,结果显示可以提升病人的睡眠质量[52]。综上所述,不同类型的声景能够显著改善病人的睡眠障碍,提升其生活质量和整体幸福感。
疼痛是癌症常见的并发症。声景疗愈作为一种非药物性的干预手段,已被广泛认可能有效缓解病人的疼痛,并为其带来舒适与安全感。Saadatmand等[53]将60例重症病人分成干预组和对照组,干预组病人佩戴耳机聆听自然声音,在干预后的30、60、90 min分别进行疼痛评估,结果表明,在各个时间点,干预组病人的疼痛评分均有所降低。Ruan等[54]同样对ICU中接受气管插管的病人采用了自然声景干预疗法,并运用危重期疼痛观察工具(CPOT)评估疼痛强度,结果显示接受干预的病人疼痛评分相较于接受常规护理的病人有显著下降。Lu等[55]研究发现,白噪声疗法能够减轻参与者的疼痛程度,缓解焦虑情绪,并增强舒适感。上述研究结果表明,声景疗法通过模拟自然环境体验,有助于病人产生积极的情绪状态,进而有效缓解疼痛。
近年来,声景理论基础不断扩展,但相关循证证据主要来源于单中心、小样本的研究,且在探讨声景(无论是积极还是消极)对个体健康的影响时,多局限于短期的横断面试验,其长期的临床效应尚未得到充分验证。需要开展更多高质量、大样本、多中心的干预性及纵向研究,以全面评估声景疗愈在脑卒中病人安宁疗护中的治疗效果。虽然有研究已证实声景疗愈对癌症病人具有积极影响,但其生理机制和神经机制仍需进一步阐明。因此,今后的研究应着重于声景疗愈与心理学、生理学等领域的交叉融合,深入分析声景与个体压力反应、认知功能以及情绪调节之间的互动关系,为声景疗愈在癌症病人安宁疗护中的应用提供坚实的理论支撑。目前,技术整合正成为推动声景研究发展的核心动力,能够为病人提供一个沉浸式的平台,满足其个性化需求和体验。然而,模拟环境与真实世界的体验之间仍存在感知上的差异和不一致性,因此,有必要深入研究,缩小技术与现实应用之间差距,以便更高效地将虚拟信息与现实世界融合。此外,个体对声景的感知受到年龄、性别、性格、文化背景、个人经历等多种因素的影响。在特定环境中,某些主导音(例如人工声)通常被视为不受欢迎的噪声,然而,在其他环境中,它们可能对个体产生正面效应。因此,需要根据个体需求制定个性化干预方案,以评估声景设计策略对不同环境和人群改善健康效果的影响。
在癌症病人病情恶化阶段,传统医学干预措施往往难以提供持续性的支持。通过构建具有治疗性的环境氛围,如声景疗愈环境,能够有效缓解病人的临床症状及心理压力。相较于传统的声音学研究,声景学方法更侧重于个体对声环境质量的主观感受,这一视角为设计促进病人健康、提升生活质量的声环境开辟了新路径。未来研究应着重于声景疗愈与心理学、生理学等学科的交叉融合,深入探讨声景与个体压力反应、认知功能以及情绪调节之间的相互作用。此外,结合人工智能技术,融合芳香疗法、情绪释放技术等,构建多感官协同作用的辅助智能系统,以推动声景疗愈在癌症病人安宁疗护领域的应用和发展。

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doi: 10.12102/j.issn.1009-6493.2026.16.026
  • 接收时间:2025-10-07
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  • 出版时间:2026-08-25
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  • 收稿日期:2025-10-07
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    1南通市第一人民医院,江苏 226000

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genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)
属
Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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