治疗性沟通配合心理干预对行鼻内镜治疗慢性鼻-鼻窦炎患者心理状态、治疗依从性及生活质量的影响
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摘要
目的:分析治疗性沟通配合心理干预对行鼻内镜治疗慢性鼻-鼻窦炎(CRS)患者心理状态、治疗依从性及生活质量的影响。方法:选取2016年6月至2017年6月我院收治的CRS患者200例为研究对象,采用随机数字表法将其分为观察组、对照组各100例,对照组实施常规干预,观察组在此基础上予以治疗性沟通配合心理干预,比较两组干预前后症状[鼻腔鼻窦结局测试量表-20(SNOT-20)]、心理状态[医院焦虑抑郁量表(HADS)、简明心境量表(BPOMS)]、治疗依从性及生活质量(生活质量评定量表SF-36)、术后并发症。结果:观察组干预后3d、1周SNOT-20评分低于对照组(t=-16.977,-11.073;P<0.01);干预后观察组HAD-A、HAD-D、BPOMS评分均明显低于对照组(t=-14.951,-9.873,-7.516;P<0.01);干预后观察组治疗依从性优于对照组(Z=6.710,P<0.05);两组术后1周、1个月SF-36评分均高于同组干预前(F=298.939,126.655;P<0.01),且观察组术后1周、1个月SF-36评分均明显高于对照组(t=5.249,7.595;P<0.01);观察组并发症发生率(5.00%)低于对照组(14.00%)(χ~2=4.711,P<0.05)。结论:治疗性沟通配合心理干预可明显改善鼻内镜治疗慢性鼻-鼻窦炎患者相关症状、心理状态,提高其治疗依从性与生活质量,减少术后并发症,值得在临床推广实践。
Objective:To analyze the effect of therapeutic communication combined with psychological intervention on the mental status,treatment compliance and quality of life of patients with chronic rhinosinusitis(CRS)undergoing nasal endoscopic treatment.Methods:A total of 200 patients with CRS admitted to the hospital from June 2016 to June 2017 were selected as the study subjects.They were divided into the observation group and the control group by the random number table method,100 cases in each group.The control group was given routine intervention,while the observation group was given therapeutic communication combined with psychological intervention on the basis of routine nursing.The symptoms[the Sino-Nasal Outcome Test 20(SNOT-20)],mental status[Hospital Anxiety and Depression Scale(HADS),Brief Profile Of Mood State(BPOMS)],treatment compliance,quality of life(Quality of Life Assessment Scale SF-36)before and after the intervention and postoperative complications were compared between the two groups.Results:The SNOT-20 scores of the observation group at 3 days and 1 week after the intervention were lower than those of the control group(t=-16.977,-11.073;P<0.01).The scores of HAD-A,HAD-D and BPOMS of the observation group were significantly lower than those of the control group after the intervention(t=-14.951,-9.873,-7.516;P<0.01).After the intervention,the treatment compliance of the observation group was better than that of the control group(Z=6.710,P<0.05).The SF-36 scores of observation group at 1 week and 1 month after the intervention were higher than those in the same group before the intervention(F=298.939,126.655;P<0.01),and those of the control group(t=5.249,7.595;P<0.01).The incidence rate of complications in the observation group was lower than that in the control group(5.00% vs 14.00%)(χ~2=4.711,P<0.05).Conclusion:Therapeutic communication combined with psychological intervention can significantly relieve the related symptoms,improve the mental status,treatment compliance and quality of life of patients with CRS undergoing nasal endoscopic treatment,and reduce postoperative complications.
Objective:To analyze the effect of therapeutic communication combined with psychological intervention on the mental status,treatment compliance and quality of life of patients with chronic rhinosinusitis(CRS)undergoing nasal endoscopic treatment.Methods:A total of 200 patients with CRS admitted to the hospital from June 2016 to June 2017 were selected as the study subjects.They were divided into the observation group and the control group by the random number table method,100 cases in each group.The control group was given routine intervention,while the observation group was given therapeutic communication combined with psychological intervention on the basis of routine nursing.The symptoms[the Sino-Nasal Outcome Test 20(SNOT-20)],mental status[Hospital Anxiety and Depression Scale(HADS),Brief Profile Of Mood State(BPOMS)],treatment compliance,quality of life(Quality of Life Assessment Scale SF-36)before and after the intervention and postoperative complications were compared between the two groups.Results:The SNOT-20 scores of the observation group at 3 days and 1 week after the intervention were lower than those of the control group(t=-16.977,-11.073;P<0.01).The scores of HAD-A,HAD-D and BPOMS of the observation group were significantly lower than those of the control group after the intervention(t=-14.951,-9.873,-7.516;P<0.01).After the intervention,the treatment compliance of the observation group was better than that of the control group(Z=6.710,P<0.05).The SF-36 scores of observation group at 1 week and 1 month after the intervention were higher than those in the same group before the intervention(F=298.939,126.655;P<0.01),and those of the control group(t=5.249,7.595;P<0.01).The incidence rate of complications in the observation group was lower than that in the control group(5.00% vs 14.00%)(χ~2=4.711,P<0.05).Conclusion:Therapeutic communication combined with psychological intervention can significantly relieve the related symptoms,improve the mental status,treatment compliance and quality of life of patients with CRS undergoing nasal endoscopic treatment,and reduce postoperative complications.
引文
[1]常艺琼,徐开伦,李四军,等.功能性鼻窦内窥镜手术对慢性鼻-鼻窦炎患者负面情绪改善的研究[J].四川医学,2017,38(6):643-647
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[11]罗丽敏,王蕾,朱丽萍,等.心理护理干预在维持性血液透析患者护理中的应用[J].中国健康心理学杂志,2017,25(8):1224-1227
[12]池长德.慢性鼻窦炎患者术前心理状况分析及治疗性沟通干预效果[D].太原:山西医科大学,2017
[13]孙刚,薛莲,王努,等.心理评估及干预对提高慢性鼻-鼻窦炎患者鼻内镜手术生存质量的作用[J].重庆医学,2017,46(19):2701-2703
[14]池长德,王斌全.治疗性沟通系统对慢性鼻窦炎鼻内镜术病人的影响[J].护理研究,2017,31(28):3595-3597
[15]詹敏.治疗性沟通及干预对乳腺癌手术患者术后恢复、心理应激及希望水平的影响[J].中国医药导报,2017,14(10):177-180
[16]Annoni M,Miller F G.Placebo effects and the ethics of therapeutic communication:A pragmatic perspective[J].Kennedy Inst Ethics J,20 16,26(1):79-103
[2]刘学军,倪丽艳,高金建,等.微创外科治疗慢性鼻窦炎患者的负性情绪调查[J].中国内镜杂志,2015,21(11):1173-1177
[3]田媛,陈薪羽,王效军,等.成人慢性鼻-鼻窦炎外科治疗的依从性分析[J].临床耳鼻喉头颈外科杂志,2017,31(1):58-61
[4]黄芳,谢磊,徐喆,等.认知干预对慢性鼻窦炎手术患者心理健康及护理措施依从性的影响[J].重庆医学,2017,46(16):2303-2304
[5]肖修兰.治疗性沟通对肝胆手术患者围术期心理及应对方式的影响[J].安徽医药,2015,19(2):406-408
[6]常旭珍,薛云珍,张海波,等.心理干预对慢性疼痛患者负性情绪及失眠的影响[J].中国健康心理学杂志,2017,25(12):1822-1825
[7]中华耳鼻咽喉头颈外科杂志编辑委员会鼻科组,中华医学会耳鼻咽喉头颈外科学分会鼻科学组.慢性鼻-鼻窦炎诊断和治疗指南(2012年,昆明)[J].中华耳鼻咽喉头颈外科杂志,2013,48(2):92-94
[8]Wang T C,Tai C J,Tsou Y A,et al.Absorbable and nonabsorbable packing after functional endoscopic sinus surgery:Systematic review and meta-analysis of outcomes[J].Eur Arch Otolaryngol,2015,272(8):1825-1831
[9]Jurliewicz D,Kamierczak H,Rogowski M,et al.Evaluation of fully biodegradable nasal packings in functional endoscopic sinus surgery-A muiticentre study[J].Otolaryngol Pol,2015,69(1):11-15
[10]申振,王维利,廖贵益,等.治疗性沟通系统对亲属活体肾移植供体术前心理干预的效果[J].中国老年学杂志,2015,35(24):7131-7132
[11]罗丽敏,王蕾,朱丽萍,等.心理护理干预在维持性血液透析患者护理中的应用[J].中国健康心理学杂志,2017,25(8):1224-1227
[12]池长德.慢性鼻窦炎患者术前心理状况分析及治疗性沟通干预效果[D].太原:山西医科大学,2017
[13]孙刚,薛莲,王努,等.心理评估及干预对提高慢性鼻-鼻窦炎患者鼻内镜手术生存质量的作用[J].重庆医学,2017,46(19):2701-2703
[14]池长德,王斌全.治疗性沟通系统对慢性鼻窦炎鼻内镜术病人的影响[J].护理研究,2017,31(28):3595-3597
[15]詹敏.治疗性沟通及干预对乳腺癌手术患者术后恢复、心理应激及希望水平的影响[J].中国医药导报,2017,14(10):177-180
[16]Annoni M,Miller F G.Placebo effects and the ethics of therapeutic communication:A pragmatic perspective[J].Kennedy Inst Ethics J,20 16,26(1):79-103