合理情绪疗法在乙型肝炎肝硬化代偿期患者心理干预中的应用效果
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摘要
目的探讨合理情绪疗法(REBT)在乙型肝炎肝硬化代偿期患者心理干预中的应用效果。方法选择2015年1月～2017年12月新疆医科大学第一附属医院住院治疗的乙型肝炎肝硬化代偿期患者92例为研究对象,按照随机数字表法分为观察组和对照组,每组各46例。对照组实施常规护理,观察组在对照组基础上联合REBT。采用相应量表评价并比较患者的心理健康、自我效能和自我管理行为的情况。结果观察组心身症状自评量表(SCL-90)中的人际关系敏感、抑郁、焦虑维度评分明显低于对照组(P <0.05),慢性病自我效能量表(CDSES)和自我管理行为的各维度评分及总分均明显高于对照组(P <0.05)。结论合理情绪疗法可明显缓解乙型肝炎肝硬化代偿期患者的负性情绪,进而提高自我效能,促进自我管理行为的养成,对改善患者生存质量具有重要意义。
Objective To explore the effect of rational emotional behavior therapy(REBT) on psychological intervention in patients with hepatitis B cirrhosis in compensatory phase. Methods A total of 92 patients with compensatory hepatitis B cirrhosis admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2015 to December2017 were selected as the study subjects. According to random number table method, they were randomly divided into observation group and control group, with 46 cases in each group. The control group received routine nursing, while the observation group on the basis of control group combined with REBT. The mental health, self-efficacy and self-management behaviors of the patients were evaluated and compared with the corresponding scale. Results The scores of interpersonal sensitivity, depression and anxiety in the psychosomatic symptom checklist 90(SCL-90) in the observation group were significantly lower than those in the control group(P < 0.05). The scores and total scores of chronic self-efficacy scale(CDSES) and self-management behavior were significantly higher than those of the control group(P <0.05). Conclusion Reasonable emotional therapy can obviously alleviate the negative emotions of patients with hepatitis B cirrhosis in the compensatory period, and then improve self-efficacy, promote the development of self-management behavior, which is of great significance to improve the quality of life of patients.
Objective To explore the effect of rational emotional behavior therapy(REBT) on psychological intervention in patients with hepatitis B cirrhosis in compensatory phase. Methods A total of 92 patients with compensatory hepatitis B cirrhosis admitted to the First Affiliated Hospital of Xinjiang Medical University from January 2015 to December2017 were selected as the study subjects. According to random number table method, they were randomly divided into observation group and control group, with 46 cases in each group. The control group received routine nursing, while the observation group on the basis of control group combined with REBT. The mental health, self-efficacy and self-management behaviors of the patients were evaluated and compared with the corresponding scale. Results The scores of interpersonal sensitivity, depression and anxiety in the psychosomatic symptom checklist 90(SCL-90) in the observation group were significantly lower than those in the control group(P < 0.05). The scores and total scores of chronic self-efficacy scale(CDSES) and self-management behavior were significantly higher than those of the control group(P <0.05). Conclusion Reasonable emotional therapy can obviously alleviate the negative emotions of patients with hepatitis B cirrhosis in the compensatory period, and then improve self-efficacy, promote the development of self-management behavior, which is of great significance to improve the quality of life of patients.
引文
[1]周丽,孙健.慢性传染性肝病患者的抑郁心理研究进展[J].山西医药杂志,2016,45(17):2019-2021.
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[4]任宏飞,刘常清,王瑞.肝硬化患者自我护理能力与自我效能感的相关性分析[J].华西医学,2018,33(5):3027-3030.
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[7]郝翠英,温玉萍,柳美欣.合理情绪疗法联合疾病管理护理教育对尘肺患者自护能力的影响[J].海南医学,2017,28(17):2918-2920.
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[12]甄英丽,李晓云,张萧谊,等.不同肝功能分级的乙型肝炎肝硬化患者心理及精神状况调查分析[J].肝脏,2017,22(4):348-350.
[13]许萌.住院乙型肝炎肝硬化患者发生抑郁的危险因素及心理护理干预的效果研究[J].中华全科医学,2017,15(4):715-717.
[14]尚丽,秦维,李荣宽,等.慢性肝脏病患者的心理状态分析[J].中华肝脏病杂志,2017,25(8):623-625.
[15]马起山,梁森,肖和卫,等.中国12个地区乙型肝炎相关疾病住院患者经济负担调查[J].中华流行病学杂志,2017,38(7):868-876.
[16]任沁展,张辉,杨凤池,等.社区居民压力管理技术的自助化研究[J].中国社会医学杂志,2017,34(1):40-43.
[17]刘莉莉,林平,赵振娟.自我效能、社会支持及应对方式对急性心肌梗死患者心理弹性影响的路径分析[J].中华护理杂志,2016,51(1):21-25.
[18]丁彩霞.自我效能与健康教育干预对慢性稳定期心力衰竭患者的影响[J].中国医药导报,2015,12(34):166-168.
[19]赵梅香,蒋维连,农军,等.感恩情绪干预对肝硬化代偿期患者希望水平和自我效能的影响[J].中华现代护理杂志,2017,23(14):1880-1883.
[20]王迪,李星,苗莹,等.肝硬化患者自我护理能力与自我效能感的相关性分析[J].中华现代护理杂志,2016,22(21):3027-3030.
[2]李珺,崔巍.预见性护理干预对慢性乙型肝炎肝衰竭患者护理满意度及负性情绪的影响[J].中国医药导报,2017,14(19):153-156.
[3]栾雯,景淑文.正念减压疗法对肝硬化腹水患者应对方式与生命质量的影响[J].中国实用护理杂志,2015,31(5):338-342.
[4]任宏飞,刘常清,王瑞.肝硬化患者自我护理能力与自我效能感的相关性分析[J].华西医学,2018,33(5):3027-3030.
[5]OItean HR,Hyland P,Vallières F,et al.An Empirical Assessment of REBT Models of Psychopathology and Psychological Health in the Prediction of Anxiety and Depression Symptoms[J].Behav Cogn Psychother,2017,45(6):600-615.
[6]冼美娘,黄小平,黄妙妃.合理情绪疗法对首次抑郁症患者自我效能的影响[J].中华现代护理杂志,2016,22(32):4689-4692.
[7]郝翠英,温玉萍,柳美欣.合理情绪疗法联合疾病管理护理教育对尘肺患者自护能力的影响[J].海南医学,2017,28(17):2918-2920.
[8]中华医学会肝病学分会.慢性乙型肝炎防治指南(2015更新版)[J].肝脏,2015,33(11):321-340.
[9]王向东,王希林,马弘,等.心理卫生评定量表手册[M].北京:中国心理卫生杂志社,1999:31-35.
[10]Lorig KR,Stewart A,Ritter PL,et al.Outcome Measures for Health Education and Other Health Care Intervention[M]Los Angeles:Sage Publication,1996:41-44.
[11]王倩,王燕,高健,等.肝硬化患者自我管理行为量表的研制[J].中华护理杂志,2014,49(12):1515-1520.
[12]甄英丽,李晓云,张萧谊,等.不同肝功能分级的乙型肝炎肝硬化患者心理及精神状况调查分析[J].肝脏,2017,22(4):348-350.
[13]许萌.住院乙型肝炎肝硬化患者发生抑郁的危险因素及心理护理干预的效果研究[J].中华全科医学,2017,15(4):715-717.
[14]尚丽,秦维,李荣宽,等.慢性肝脏病患者的心理状态分析[J].中华肝脏病杂志,2017,25(8):623-625.
[15]马起山,梁森,肖和卫,等.中国12个地区乙型肝炎相关疾病住院患者经济负担调查[J].中华流行病学杂志,2017,38(7):868-876.
[16]任沁展,张辉,杨凤池,等.社区居民压力管理技术的自助化研究[J].中国社会医学杂志,2017,34(1):40-43.
[17]刘莉莉,林平,赵振娟.自我效能、社会支持及应对方式对急性心肌梗死患者心理弹性影响的路径分析[J].中华护理杂志,2016,51(1):21-25.
[18]丁彩霞.自我效能与健康教育干预对慢性稳定期心力衰竭患者的影响[J].中国医药导报,2015,12(34):166-168.
[19]赵梅香,蒋维连,农军,等.感恩情绪干预对肝硬化代偿期患者希望水平和自我效能的影响[J].中华现代护理杂志,2017,23(14):1880-1883.
[20]王迪,李星,苗莹,等.肝硬化患者自我护理能力与自我效能感的相关性分析[J].中华现代护理杂志,2016,22(21):3027-3030.
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