汶川地震外伤患者康复期心理状况及护理
|
摘要
目的了解地震外伤患者康复期的心理状况,并观察护理干预的效果。方法对32例处于康复期的汶川地震外伤患者,采用精神症状自评量表(Symptom Checklist 90,SCL-90)、焦虑自评量表(Self-rating Anxiety Scale,SAS)及抑郁自评量表(Self-rating Depression Scale,SDS)进行评定,针对存在的心理问题进行心理干预,观察干预前后患者的心理状况并与国内常模比较。结果干预前,本组对象SCL-90总分为(152.93±32.56)分,SAS评分为(33.15±5.65)分,SDS评分为(39.85±7.19)分,均高于国内常模(P<0.05);经过6周干预后,本组的SCL-90总分及6个因子分(除恐怖、偏执、精神病性外)、SAS及SDS评分均较干预前降低(P<0.05),但与国内常模相比,SCL-90各因子中,除人际关系、敌对2个因子外,其余7个因子分、总分、SAS及SDS评分仍高于国内常模(P<0.05)。结论经历地震灾难的外伤患者在康复期仍存在不同程度的心理问题,心理护理对患者心理康复有一定的作用,但短期内不能完全消除其负性心理反应,需要制定长期的心理治疗计划,实施远期跟踪随诊。
Objective To explore the psychological status of the wounded in the convalescence stage in Wenchuan earthquake and the effects of the nursing interventions. Methods Thirty-two patients in convalescence stage were appraised with Symptom Checklist 90 (SCL-90), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). Then psychological interventions directed at the existing mental problems were offered and an observation was made of the patient's psychology before and after the interventions, which was also compared against the domestic norm. Results The scores of SCL-90, SAS, and SDS before the intervention were (152.93±32.56), (33.15±5.65) and (39.85±7.19), respectively, significantly higher than Chinese norm (P<0.05). After six weeks' nursing interventions, the scores of SCL-90 and items (except for the scores of terror, paranoid and psychosis), SAS and SDS were lower than those before the interventions (P<0.05). Compared with Chinese norm, the other scores of SCL-90 factors showed statistically significant difference (P<0.05) except the two factors of interpersonal relationship and hostility. The total score, SAS and SDS grading still showed statistically significant differences (P<0.05). Conclusion Those wounded in the earthquake still have psychological problems to various degrees in the convalescence stage. Psychological nursing interventions can improve the patient's psychological status effectively, but it cannot eliminate patient's negative mood completely in the short-term. Long-term psychological treatment plan and follow-up treatment are called for.
Objective To explore the psychological status of the wounded in the convalescence stage in Wenchuan earthquake and the effects of the nursing interventions. Methods Thirty-two patients in convalescence stage were appraised with Symptom Checklist 90 (SCL-90), Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS). Then psychological interventions directed at the existing mental problems were offered and an observation was made of the patient's psychology before and after the interventions, which was also compared against the domestic norm. Results The scores of SCL-90, SAS, and SDS before the intervention were (152.93±32.56), (33.15±5.65) and (39.85±7.19), respectively, significantly higher than Chinese norm (P<0.05). After six weeks' nursing interventions, the scores of SCL-90 and items (except for the scores of terror, paranoid and psychosis), SAS and SDS were lower than those before the interventions (P<0.05). Compared with Chinese norm, the other scores of SCL-90 factors showed statistically significant difference (P<0.05) except the two factors of interpersonal relationship and hostility. The total score, SAS and SDS grading still showed statistically significant differences (P<0.05). Conclusion Those wounded in the earthquake still have psychological problems to various degrees in the convalescence stage. Psychological nursing interventions can improve the patient's psychological status effectively, but it cannot eliminate patient's negative mood completely in the short-term. Long-term psychological treatment plan and follow-up treatment are called for.
引文
[1]Calea S,Nandi A,Vlahov D.The Epidemiology of Post-traumatic Stress Disorder after Disasters[J].Epidemiol Rev,2005,27(1):78-91.
[2]张继红,杨晓媛,崔渝敏,等.200例地震致骨折伤员身心状况分析[J].护理学报,2008,15(10):89-90.
[3]刘丽.地震区灾民的心理救治体会[J].护理学报,2008,15(9):88-89.
[4]周宏珍,周春兰,陈建辉,等.地震后受灾伤员及其陪护家属的心理及干预[J].护理学报,2008,15(11):87-88.
[5]汪向东.心理卫生评定手册[J].中国心理卫生杂志,1993,7(增刊):31-161.
[6]李瑞锋,徐丽华.首发精神分裂症患者父母心理状况分析[J].中国临床康复,2004,8(24):5033.
[7]俞子彬.医学心理学[M].北京:高等教育出版社,2006:158-160.
[8]李雪英.PTSD的认知理论及认知行为治疗[J].中国心理临床学杂志,1999,7(2):128-125.
[9]张本,王雪义,孙贺祥,等.唐山大地震心理创伤后应激障碍的抽样调查研究[J].中华精神科杂志,1999,32(2):106-108.
[2]张继红,杨晓媛,崔渝敏,等.200例地震致骨折伤员身心状况分析[J].护理学报,2008,15(10):89-90.
[3]刘丽.地震区灾民的心理救治体会[J].护理学报,2008,15(9):88-89.
[4]周宏珍,周春兰,陈建辉,等.地震后受灾伤员及其陪护家属的心理及干预[J].护理学报,2008,15(11):87-88.
[5]汪向东.心理卫生评定手册[J].中国心理卫生杂志,1993,7(增刊):31-161.
[6]李瑞锋,徐丽华.首发精神分裂症患者父母心理状况分析[J].中国临床康复,2004,8(24):5033.
[7]俞子彬.医学心理学[M].北京:高等教育出版社,2006:158-160.
[8]李雪英.PTSD的认知理论及认知行为治疗[J].中国心理临床学杂志,1999,7(2):128-125.
[9]张本,王雪义,孙贺祥,等.唐山大地震心理创伤后应激障碍的抽样调查研究[J].中华精神科杂志,1999,32(2):106-108.
版权所有：© 2023 中国地质图书馆 中国地质调查局地学文献中心