心理干预对骨折患者焦虑抑郁情绪效果的临床对照研究
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摘要
目的探讨心理干预对骨折患者焦虑抑郁情绪的效果及其对预后的影响,为骨折患者的心理康复提供参考。方法将2016年9月-12月某医院骨科收治的各种骨折需手术患者100例随机分为干预组和对照组各50例。两组患者均接受手术治疗和常规护理;在此基础上,干预组在术前及术后接受心理干预(包括手术室音乐治疗、认知心理治疗、支持性心理治疗、呼吸放松训练),共3个月。在基线期及治疗3个月后采用抑郁自评量表(SDS)、焦虑自评量表(SAS)评定患者的抑郁、焦虑症状;治疗3个月后,采用肌肉骨骼功能评分简表(SMFA)评定患者整体健康状况和功能。结果两组性别、年龄及基线期SDS、SAS评分差异均无统计学意义(P均>0.05)。治疗3个月后,干预组SDS及SAS评分均低于基线期(t=17.673、13.431,P均<0.01),且低于对照组(P均<0.01);干预组与对照组SMFA功能指数及烦恼指数评分差异均有统计学意义(t=3.721、40.837,P均<0.01)。结论与单纯手术治疗相比,手术联合心理干预不仅有助于改善骨折患者的焦虑抑郁情绪,还可促进患者躯体的康复和骨骼功能恢复。
Objective To explore the efficacy for anxiety and depression emotion and the influence of prognosis of psychological intervention to fracture patients,and to provide references for psychological rehabilitation of patients with fracture. Methods All kinds of fracture patients in a hospital who were needed to have surgery from September to December,2016 were included. A total of 100 patients were randomly divided into intervention group and control group,50 cases in each group. All patients underwent surgery treatment and conventional nursing. On this basis,the intervention group accepted psychological intervention therapy before and after operation,including music therapy in operation room,cognitive psychotherapy,supportive psychotherapy and breathing relaxation and meditation training. They were treated for 3 months. All patients were evaluated with Self-rating Depression Scale( SDS) and Self-rating Anxiety Scale( SAS) at the baseline and 3 months after intervention. Overall health status and function of all patients were evaluated with Short Musculoskeletal Function Assessments( SMFA) 3 months after intervention. Results The difference of gender,age and score of SDS,SAS at baseline between two groups was not statistically significant( all P > 0. 05). After intervention for 3 months,the SDS and SAS scores of intervention group were lower than baseline( t = 17. 673,13. 431,all P < 0. 01) and control group( all P < 0. 01); the difference of Functional index and Annoyance index score of SMFA was statistically significant between two groups( t = 3. 721,40. 837,all P < 0. 01). Conclusion Compared with the simple surgery,surgery with psychological intervention therapy not only helped to improve the anxiety and depression emotion of fracture patients,but also could promote the recovery of patients 'body and bone function.
Objective To explore the efficacy for anxiety and depression emotion and the influence of prognosis of psychological intervention to fracture patients,and to provide references for psychological rehabilitation of patients with fracture. Methods All kinds of fracture patients in a hospital who were needed to have surgery from September to December,2016 were included. A total of 100 patients were randomly divided into intervention group and control group,50 cases in each group. All patients underwent surgery treatment and conventional nursing. On this basis,the intervention group accepted psychological intervention therapy before and after operation,including music therapy in operation room,cognitive psychotherapy,supportive psychotherapy and breathing relaxation and meditation training. They were treated for 3 months. All patients were evaluated with Self-rating Depression Scale( SDS) and Self-rating Anxiety Scale( SAS) at the baseline and 3 months after intervention. Overall health status and function of all patients were evaluated with Short Musculoskeletal Function Assessments( SMFA) 3 months after intervention. Results The difference of gender,age and score of SDS,SAS at baseline between two groups was not statistically significant( all P > 0. 05). After intervention for 3 months,the SDS and SAS scores of intervention group were lower than baseline( t = 17. 673,13. 431,all P < 0. 01) and control group( all P < 0. 01); the difference of Functional index and Annoyance index score of SMFA was statistically significant between two groups( t = 3. 721,40. 837,all P < 0. 01). Conclusion Compared with the simple surgery,surgery with psychological intervention therapy not only helped to improve the anxiety and depression emotion of fracture patients,but also could promote the recovery of patients 'body and bone function.
引文
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[19]伍杏容,林婉云.39例胫腓骨骨折病人手术前后的心理观察及护理干预[J].国际医药卫生导报,2006,12(8):111-112.
[20]陈凤仪.护理干预对骨科住院患者功能康复的影响[J].中国医药指南,2012,10(33):634-635.
[21]姜梅,秦贵香.骨科住院患者的心理护理[J].医药前沿,2014(1):317-318.
[22]郭然,付勤.患者领悟社会支持和乐观中介变量与抑郁关系[J].中国公共卫生,2014,30(5):670-671.
[23]刘芹,孔凡贞,黎玮琴,等.认知行为干预护理对抑郁症患者影响的临床对照研究[J].四川精神卫生,2014,27(5):407-409.
[2]宁雪梅,段文娟,黄梅.心理护理对骨科手术患者抗焦虑的效果观察[J].成都医学院学报,2014,9(6):785-786.
[3]周晓慧.心理护理干预对策在创伤性骨科患者术后疼痛及心理状态影响评估中的效果[J].实用临床护理学电子杂志,2017,2(32):76.
[4]乔花.心理护理干预对择期骨科手术患者焦虑、抑郁情绪的影响效果观察[J].河南外科学杂志,2017,23(2):189-190.
[5]黄铭杰,黄泳梅.心理干预在老年股骨颈骨折患者护理应用效果[J].实用临床护理学电子杂志,2016,1(7):85,89.
[6]黄玲辉.心理干预在创伤骨科软组织损伤应用VSD术后患者的应用[J].医学理论与实践,2016,29(18):3280-3281.
[7]佟玲.心理干预对骨科患者疼痛影响的研究[J].内蒙古医学杂志,2015,47(1):102-103.
[8]吴爱玲,叶爱琴,黄丽莎,等.心理干预在骨科截肢术后患者中的临床运用[J].当代护士(下旬刊),2014(6):127-128.
[9]景春华,杨丽.围术期健康教育与心理干预对改善老年骨科患者负性情绪及疼痛的作用[J].中西医结合护理(中英文),2016,2(7):8-10.
[10]王月贵.心理护理对骨科患者术前焦虑情绪的影响分析[J].中国卫生标准管理,2016,7(4):213-214.
[11]夏文静.对行骨科手术的患者进行心理护理干预的效果分析[J].当代医药论丛,2015,13(11):112-113.
[12]张海霞,尹巧燕,安小刚.心理干预对骨科术后患者镇痛效果及负性心理的影响[J].现代中西医结合杂志,2014,23(35):3966-3967.
[13]潘应锋.心理干预联合药物多模式治疗用于骨科镇痛效果与应激反应的研究[J].护士进修杂志,2014,29(18):1694-1696.
[14]王晓玲.术前心理干预对择期骨科手术患者焦虑情绪的影响[J].保健医学研究与实践,2014,11(4):14-16.
[15]蒋协远,王大伟.骨科临床疗效评价标准[M].北京:人民卫生出版社,2005:235-236,315-318.
[16]熊洪莉,陈君辉,王雪.心理护理对介入治疗围手术期肝癌患者焦虑抑郁水平影响的临床对照研究[J].四川精神卫生,2015,28(3):227-229.
[17]刘金亮,筱毅.心理应激状态评定量表手册[M].2版.武汉:湖北科学技术出版社,2009:235-236.
[18]孙明启,郝廷.老年患者肱骨远端关节内骨折切开复位内固定的预后评估[J].实用临床医药杂志,2013,17(11):136-138.
[19]伍杏容,林婉云.39例胫腓骨骨折病人手术前后的心理观察及护理干预[J].国际医药卫生导报,2006,12(8):111-112.
[20]陈凤仪.护理干预对骨科住院患者功能康复的影响[J].中国医药指南,2012,10(33):634-635.
[21]姜梅,秦贵香.骨科住院患者的心理护理[J].医药前沿,2014(1):317-318.
[22]郭然,付勤.患者领悟社会支持和乐观中介变量与抑郁关系[J].中国公共卫生,2014,30(5):670-671.
[23]刘芹,孔凡贞,黎玮琴,等.认知行为干预护理对抑郁症患者影响的临床对照研究[J].四川精神卫生,2014,27(5):407-409.