认知-行为疗法对有意性急性农药中毒患者的干预效果评价
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摘要
目的评价认知-行为疗法对有意性急性农药中毒患者的干预效果。方法采用类实验性研究,2016年1月至12月在甘肃某三甲综合医院选取了40名有意性急性农药中毒患者作为研究对象,随机分为干预组和对照组各20例。干预组实施认知-行为疗法,对照组实施常规农药中毒健康教育,实施前后应用症状自评量表(symptom check list 90,SCL-90)进行评估。结果干预后两组患者在躯体化、人际关系、焦虑、偏执、其他、强迫症状、抑郁和总分等维度的得分差异均有统计学差异(均P<0.05);与干预前比较,干预组在总分和各分量表维度的得分差异均有统计学差异(均P<0.05),对照组在焦虑、躯体化、人际关系、强迫症状和总分5个维度上差异均有统计学差异(均P<0.05),但偏执、其他和抑郁维度得分差异无统计学意义(均P>0.05)。结论认知-行为疗法可以改变有意性急性农药中毒患者的不良认知,改善其生理不适感,减轻强迫和抑郁症状,提高应对能力,避免二次伤害行为的发生。
Objective To evaluate the effect of cognitive-behavioral therapy for patients with intentional acute pesticide poisoning.Methods The quasi-experimental study was used.Forty patients with intentional acute pesticide poisoning from January to December 2016 were selected and randomly divided into the intervention group and the control group,with 20 cases in each group,respectively.The intervention group received the cognitive-behavioral therapy and the control group received routine pesticide poisoning health education.The symptom checklist 90 was evaluated before and after implementation.Results After intervention,there were significant differences in scores of somatization,interpersonal relationship,anxiety,paranoia,obsessive-compulsive symptoms,depression and total scores between the two groups(all P<0.05).There were significant differences in total scores and subscale dimensions in the intervention group after interventions(all P<0.05).There were statistical differences in anxiety,somatization,interpersonal relationship and total score in the control group after intervention(all P<0.05).However,there was no statistical differences in paranoia,other factors and depression in the control group after intervention(P>0.05).Conclusions Cognitive-behavioral therapy can change the negative cognition of patients with intentional acute pesticide poisoning,improve their physiological discomfort,alleviate obsessive-compulsive and depressive symptoms,improve coping ability,thus avoid the occurrence of secondary injuries.
Objective To evaluate the effect of cognitive-behavioral therapy for patients with intentional acute pesticide poisoning.Methods The quasi-experimental study was used.Forty patients with intentional acute pesticide poisoning from January to December 2016 were selected and randomly divided into the intervention group and the control group,with 20 cases in each group,respectively.The intervention group received the cognitive-behavioral therapy and the control group received routine pesticide poisoning health education.The symptom checklist 90 was evaluated before and after implementation.Results After intervention,there were significant differences in scores of somatization,interpersonal relationship,anxiety,paranoia,obsessive-compulsive symptoms,depression and total scores between the two groups(all P<0.05).There were significant differences in total scores and subscale dimensions in the intervention group after interventions(all P<0.05).There were statistical differences in anxiety,somatization,interpersonal relationship and total score in the control group after intervention(all P<0.05).However,there was no statistical differences in paranoia,other factors and depression in the control group after intervention(P>0.05).Conclusions Cognitive-behavioral therapy can change the negative cognition of patients with intentional acute pesticide poisoning,improve their physiological discomfort,alleviate obsessive-compulsive and depressive symptoms,improve coping ability,thus avoid the occurrence of secondary injuries.
引文
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[15]王霞,杨敏.基于认知行为疗法的自助干预在抑郁患者中的应用[J].中华行为医学与脑科学杂志,2016,25(5):404-409.
[16]陈树林,李凌江.SCL-90信度效度检验和常模的再比较[J].中国神经精神疾病杂志,2003,29(5):323-327.
[17]高欣,段蕾蕾,杨超,等.2006-2013年全国伤害监测系统中自残/自杀病例特征分析[J].中华流行病学杂志,2015,36(1):17-19.
[18]孔媛媛,张杰.农村青年男女自杀死亡者心理状态和心理特征的心理解剖研究[J].中国心理卫生杂志,2011,25(4):302-307.
[19]徐东,张学立,李献云,等.社会心理干预对自杀未遂者的效果[J].中国心理卫生杂志,2012,26(1):24-29.
[20]HUANG J,MEYER J S,ZHANG Z,et al.Non-steroidal anti-inflammatory drug(NSAID)use and Alzheimer disease in community-dwelling elderly Chinese[J].Carr Alzheimer Res,2005,2(5):571-578.
[21]李献云,费立鹏,张艳萍.负性生活事件与自杀行为研究[J].中国神经精神疾病杂志,2008,34:156-160.
[22]王琳琳,贾存显,徐爱强,等.山东省农村地区自杀死亡的危险因素研究[C].江西省科协学术年会暨华东地区流行病学学术交流会议,2012.
[23]宫艳芳.认知行为疗法治疗广泛性焦虑症的疗效观察[J].中国健康心理学杂志,2007,15(2):151-153.
[24]刘媛媛,张晓燕,张澜.认知行为集体心理咨询对老年高血压患者焦虑情绪的干预效果[J].中国心理卫生杂志,2017,31(1):13-18.
[25]涂阳军,郭永玉.生活事件对负性情绪的影响:社会支持的调节效应与应对方式的中介效应[J].中国临床心理学杂志,2011,19(5):652-655.
[26]王霞,杨敏.基于认知行为疗法的自助干预在抑郁患者中的应用[J].中华行为医学与脑科学杂志,2016,25(5):404-409.
[2]MEW E J,PADMANATHAN P,KONRADSEN F,et al.The global burden of fatal self-poisoning with pesticides 2006-15:Systematic review[J].J Affect Disord,2017,219:93-104.
[3]LEKEI E,NGOWI A V,LONDON L.Acute pesticide poisoning in children:hospital review in selected hospitals of Tanzania[J].J Toxicol,2017:4208405.
[4]蒋炜,吴春眉,邓晓,等.2006-2008年全国伤害监测中毒病例分布特种分析[J].中华流行病学杂志,2010,31(9):1009-1012.
[5]王冠梅,杨文海,孙伟,等.宁夏2007-2011年农药中毒病例流行病学分析[J].宁夏医科大学学报,2013,35(10):1124-1126.
[6]金蕾,王龙义,王毓深.2006-2014年海南省农药中毒流行病学特征分析[J].中国工业医学杂志,2015,28(4):298-300.
[7]刘庆东,潘丽萍,丁璐,等.2006-2014年江苏省三城市APP状况分析[J].环境与职业医学,2016,33,(3):259-262.
[8]金若刚,黄霜.2006-2014年长沙市农药中毒报告情况分析[J].实用预防医学杂志,2016,25(3):363-365.
[9]黄荣峥,郑玉玲,巫丰宏.2010-2014年南宁市农药中毒流行病学分析[J].医学动物防制,2016,32(2):141-144.
[10]施忠文,胡月娇,王淑媛.2010-2014年玉溪市红塔区农药中毒分析[J].现代预防医学,2016,43(7):1179-1181.
[11]ZHANG J,SUN L,LIU Y,et al.The change in suicide rates between 2002and 2011in China[J].Sui Life Threat Behav,2014,44(5):560-568.
[12]PAGE A,LIU S,GUNNELL D,et al.Suicide by pesticide poisoning remains a priority for suicide prevention in China:analysis of national mortality trends 2006-2013[J].J Affect Disord,2017,208:418-423.
[13]PHILLIPS M R,LI X,ZHANG Y.Suicide rates in China,1995-99[J].Lancet,2002,359:835-840.
[14]李善峰,张璐.中国北方农村自杀行为的特点、类型和影响因素---基于一个农业县的田野调查[J].山东社会科学,2015,11(3):85-91.
[15]王霞,杨敏.基于认知行为疗法的自助干预在抑郁患者中的应用[J].中华行为医学与脑科学杂志,2016,25(5):404-409.
[16]陈树林,李凌江.SCL-90信度效度检验和常模的再比较[J].中国神经精神疾病杂志,2003,29(5):323-327.
[17]高欣,段蕾蕾,杨超,等.2006-2013年全国伤害监测系统中自残/自杀病例特征分析[J].中华流行病学杂志,2015,36(1):17-19.
[18]孔媛媛,张杰.农村青年男女自杀死亡者心理状态和心理特征的心理解剖研究[J].中国心理卫生杂志,2011,25(4):302-307.
[19]徐东,张学立,李献云,等.社会心理干预对自杀未遂者的效果[J].中国心理卫生杂志,2012,26(1):24-29.
[20]HUANG J,MEYER J S,ZHANG Z,et al.Non-steroidal anti-inflammatory drug(NSAID)use and Alzheimer disease in community-dwelling elderly Chinese[J].Carr Alzheimer Res,2005,2(5):571-578.
[21]李献云,费立鹏,张艳萍.负性生活事件与自杀行为研究[J].中国神经精神疾病杂志,2008,34:156-160.
[22]王琳琳,贾存显,徐爱强,等.山东省农村地区自杀死亡的危险因素研究[C].江西省科协学术年会暨华东地区流行病学学术交流会议,2012.
[23]宫艳芳.认知行为疗法治疗广泛性焦虑症的疗效观察[J].中国健康心理学杂志,2007,15(2):151-153.
[24]刘媛媛,张晓燕,张澜.认知行为集体心理咨询对老年高血压患者焦虑情绪的干预效果[J].中国心理卫生杂志,2017,31(1):13-18.
[25]涂阳军,郭永玉.生活事件对负性情绪的影响:社会支持的调节效应与应对方式的中介效应[J].中国临床心理学杂志,2011,19(5):652-655.
[26]王霞,杨敏.基于认知行为疗法的自助干预在抑郁患者中的应用[J].中华行为医学与脑科学杂志,2016,25(5):404-409.