怜悯团体护理干预对双相抑郁患者情感症状及自我怜悯能力影响
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摘要
目的双相障碍患者在发病期易出现危害公共安全、伤害自身或危害他人人身安全的行为,长期患病会严重损害患者的社会功能。双相障碍的治疗护理和康复既是医学问题也是社会康复问题,双相障碍目前仍以药物治疗和临床护理为主。怜悯护理对双相障碍患者是否有帮助未见专题报道,怜悯团体护理干预应用于双相障碍患者是临床康复护理的有益尝试。本研究探讨怜悯团体护理干预对双相抑郁患者情感症状及自我怜悯能力的影响。方法选择2017-04-01-2018-04-30汕头市第四人民医院收治的76例双相抑郁患者作为研究对象,按照住院号的单双分成对照组与研究组,对照组根据病情采用情感稳定剂药物治疗及相应临床护理干预,研究组在有效药物治疗和相应临床护理干预基础上,结合怜悯团体护理干预。在干预前和完成18次团体怜悯护理干预6周末各测1次汉密顿抑郁量表(hamilton depression scale,HAMD)和自我怜悯量表(self-compassion scale,SCS-C);观察情感症状的变化和自我怜悯能力的变化。结果干预后,研究组HAMD评分为(9.82±6.48)分,低于对照组的(16.14±5.65)分,差异有统计学意义,t=4.53,P<0.05;研究组自我怜悯评分为(96.05±12.52)分,高于对照组的(80.60±5.33)分,差异有统计学意义,t=7.00,P<0.05;研究组临床有效率为89.47%,高于对照组的63.16%,差异有统计学意义,χ~2=7.28,P<0.05。结论怜悯团体护理干预对双相抑郁患者的情感症状有改善作用,能提高患者的自我怜悯能力,有利于促使患者早日康复。
OBJECTIVE Bipolar disorder patients are prone to harm public safety,harm themselves or the personal safety of others during the onset of the disease.Long-term illness will seriously damage the social function of patients.The treatment and rehabilitation of bipolar disorder is not only a medical problem but also a social rehabilitation problem.There is no special report on whether compassion nursing can help bipolar disorder patients.It is a beneficial attempt of clinical rehabilitation nursing to apply compassionate group nursing intervention to bipolar disorder patients.The objective of study is to explore the effect of compassion group nursing intervention on emotional symptoms and self-compassion ability of bipolar depression patients.METHODS Totally 76 patients with bipolar depression admitted to Shantou Fourth People's Hospital from April 1,2017 to April 30,2018 were selected as study subjects.These patients were divided into control group and study group according to single or double number of hospitalization serial code.The control group was treated with mood stabilizer and the corresponding clinical nursing intervention according to the condition.The study group was treated with compassion nursing intervention at the basis of effective drug treatment and corresponding clinical nursing intervention.The hamilton depression scale(HAMD)and self-compassion scale(SCS-C)were measured before and after 18 times' group compassion nursing interventions at the end of 6 weeks,to observe the changes of emotional symptoms and self-compassion ability.RESULTS After intervention,the HAMD score of the study group was(9.82±6.48),significantly lower than that of the control group(16.14±5.65),with statistical significance,t=4.53,P<0.05.The selfcompassion score of the study group was(96.05±12.52),higher than that of the control group(80.60±5.33),with statistical significance,t=7.00,P<0.05.The clinical effective rate of the study group was 89.47%,higher than that of the control group(63.16%).The difference was significant,χ~2=7.28,P<0.05.CONCLUSIONS Compassionate group nursing intervention can improve the emotional symptoms of bipolar depression patients,can improve the ability of selfcompassion,and promote the early recovery of patients.
OBJECTIVE Bipolar disorder patients are prone to harm public safety,harm themselves or the personal safety of others during the onset of the disease.Long-term illness will seriously damage the social function of patients.The treatment and rehabilitation of bipolar disorder is not only a medical problem but also a social rehabilitation problem.There is no special report on whether compassion nursing can help bipolar disorder patients.It is a beneficial attempt of clinical rehabilitation nursing to apply compassionate group nursing intervention to bipolar disorder patients.The objective of study is to explore the effect of compassion group nursing intervention on emotional symptoms and self-compassion ability of bipolar depression patients.METHODS Totally 76 patients with bipolar depression admitted to Shantou Fourth People's Hospital from April 1,2017 to April 30,2018 were selected as study subjects.These patients were divided into control group and study group according to single or double number of hospitalization serial code.The control group was treated with mood stabilizer and the corresponding clinical nursing intervention according to the condition.The study group was treated with compassion nursing intervention at the basis of effective drug treatment and corresponding clinical nursing intervention.The hamilton depression scale(HAMD)and self-compassion scale(SCS-C)were measured before and after 18 times' group compassion nursing interventions at the end of 6 weeks,to observe the changes of emotional symptoms and self-compassion ability.RESULTS After intervention,the HAMD score of the study group was(9.82±6.48),significantly lower than that of the control group(16.14±5.65),with statistical significance,t=4.53,P<0.05.The selfcompassion score of the study group was(96.05±12.52),higher than that of the control group(80.60±5.33),with statistical significance,t=7.00,P<0.05.The clinical effective rate of the study group was 89.47%,higher than that of the control group(63.16%).The difference was significant,χ~2=7.28,P<0.05.CONCLUSIONS Compassionate group nursing intervention can improve the emotional symptoms of bipolar depression patients,can improve the ability of selfcompassion,and promote the early recovery of patients.
引文
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[11]孙霞,苑成梅.双相障碍的团体心理治疗[J].上海交通大学学报(医学版),2015,35(10):1575-1580.
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[13]董妍,周浩,俞国良.应对消极学业评价:自我同情的作用[J].中国临床心理学杂志,2011,19(6):810-813.
[14]刘英洁,张华,牛琪惠,等.团体社交技能训练对已婚双相情感障碍患者婚姻质量的影响[J].中华现代护理杂志,2016,22(8):1107-1109.
[15]Neff KD.The development and validation of a scale to mea-sure self-compassion[J].Self Identity,2003,2(3):223-250.
[16]岳君思,耿峰,董毅,等.抑郁症患者自我怜悯与快感缺失间的关系[J].安徽医科大学学报,2016,51(7):1058-1061.
[17]Collett N,Pugh K,Waite F,et al.Negative cognitions about the self in patients with persecutory delusions:An empirical study of self-compassion,self-stigma,schematic beliefs,self-esteem,fear of madness,and suicidal ideation[J].Psychiatry Res,2016,239(1):79-84.
[18]高艳平,董毅,耿峰,等.精神分裂症患者自我怜悯水平及其与快感缺失间的关系[J].中国临床心理学杂志,2016,24(5):819-822.
[2]中华医学会精神科分会.中国精神障碍分类与诊断标准(CCMD-3)[M].第3版.济南:山东科技出版社,2001,86-87.
[3]张明园.精神科评定量表手册[M].第2版.长沙:湖南科学技术出版社,1998:123-126.
[4]Neff KD.Self-compassion:An alternative conceptualization of a healthy attitude toward oneself[J].Self Identity,2003,2(2):85-101.
[5]赵靖平,方怡儒.双相障碍的早期识别[J].中华精神科杂志,2011,44(4):240-241.
[6]任志斌,马永春,金卫东,等.首发、复发和双相抑郁患者精神症状的比较[J].临床精神医学杂志,2013,23(4):238-240.
[7]赵靖平.双相障碍的治疗原则[J].中华精神科杂志,2012,45(5):307.
[8]Citrome L.Olanzapine-fluoxetine combination for the treatment of bipolar depression[J].Expert Opin Pharmacother,2011,12(17):2751-2758.
[9]覃金荣,陆沈艳,杨带兰.医护一体化模式在双相障碍患者中的应用[J].齐鲁护理杂志,2017,23(10):46-47.
[10]吴丹萍,苑成梅.双相障碍的团体心理教育[J].临床精神医学杂志,2018,28(2):140-142.
[11]孙霞,苑成梅.双相障碍的团体心理治疗[J].上海交通大学学报(医学版),2015,35(10):1575-1580.
[12]吴庆,王莹,费龙才.双相障碍缓解期自我和谐与应对方式[J].中国健康心理学杂志,2017,25(3):327-330.
[13]董妍,周浩,俞国良.应对消极学业评价:自我同情的作用[J].中国临床心理学杂志,2011,19(6):810-813.
[14]刘英洁,张华,牛琪惠,等.团体社交技能训练对已婚双相情感障碍患者婚姻质量的影响[J].中华现代护理杂志,2016,22(8):1107-1109.
[15]Neff KD.The development and validation of a scale to mea-sure self-compassion[J].Self Identity,2003,2(3):223-250.
[16]岳君思,耿峰,董毅,等.抑郁症患者自我怜悯与快感缺失间的关系[J].安徽医科大学学报,2016,51(7):1058-1061.
[17]Collett N,Pugh K,Waite F,et al.Negative cognitions about the self in patients with persecutory delusions:An empirical study of self-compassion,self-stigma,schematic beliefs,self-esteem,fear of madness,and suicidal ideation[J].Psychiatry Res,2016,239(1):79-84.
[18]高艳平,董毅,耿峰,等.精神分裂症患者自我怜悯水平及其与快感缺失间的关系[J].中国临床心理学杂志,2016,24(5):819-822.