结构式心理干预对面肌痉挛显微血管减压术患者疾病不确定感和围术期心理状态的影响
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摘要
目的:探讨结构式心理干预对面肌痉挛显微血管减压术患者疾病不确定感和围术期心理状态的影响。方法:回顾性分析我院在2017年1-12月期间接受面肌痉挛显微血管减压术治疗的86例患者的临床资料,根据干预方式将患者分为两组,每组43例,对照组给予常规干预,观察组在对照组基础上加结构式心理干预。比较两组患者手术前后的不确定感、围手术期心理状态及术后并发症情况。结果:①观察组术后复杂性、不确定感评分及疾病不确定感总分均低于对照组(t=6.149,7.276,5.311;P<0.001);②干预后,观察组在混乱、紧张、抑郁、愤怒评分均低于对照组,自尊感高于对照组(t=7.436,7.652,14.951,14.183,-8.229;P<0.01)。③观察组患者的术后并发症少于对照组,但是组间差异无统计学意义(P>0.05)。结论:对面肌痉挛显微血管减压术治疗患者常规干预基础上加用结构式心理干预,可明显降低患者的不确定感,改善患者围手术期心理状态。
Objective:To investigate the effect of structural psychological intervention on the disease uncertainty and perioperative mental state during microvascular decompression for hemifacial spasm.Methods:The clinical data of 86 patients undergoing microvascular decompression in our hospital from January to December in 2017 were retrospectively analyzed.Patients were divided into two groups,each with 43 cases.The control group was given conventional intervention,based on this,the observation group was given structural psychological intervention.The uncertainty,the perioperative psychological status and postoperative complications of the two groups before and after surgery were compared.Results:① The postoperative complexity,uncertainty score,and disease uncertainty score were all lower in the observation group than in the control group(t=6.149,7.276,5.311;P<0.001);② After the intervention,the scores of confusion,nervousness,depression and anger in the observation group were lower than those in the control group,and the self-esteem score was higher in the observation group than that in the control group((t=7.436,7.652,14.951,14.183,-8.229;P<0.01));③ Postoperative complications were not different in the observation group than that in the control group(P>0.05).Conclusion:The conventional intervention combined with the structural psychological intervention can effectively reduce the patient's uncertainty and ameliorate the patient's perioperative psychological state for patients undergoing Microvascular decompression.
Objective:To investigate the effect of structural psychological intervention on the disease uncertainty and perioperative mental state during microvascular decompression for hemifacial spasm.Methods:The clinical data of 86 patients undergoing microvascular decompression in our hospital from January to December in 2017 were retrospectively analyzed.Patients were divided into two groups,each with 43 cases.The control group was given conventional intervention,based on this,the observation group was given structural psychological intervention.The uncertainty,the perioperative psychological status and postoperative complications of the two groups before and after surgery were compared.Results:① The postoperative complexity,uncertainty score,and disease uncertainty score were all lower in the observation group than in the control group(t=6.149,7.276,5.311;P<0.001);② After the intervention,the scores of confusion,nervousness,depression and anger in the observation group were lower than those in the control group,and the self-esteem score was higher in the observation group than that in the control group((t=7.436,7.652,14.951,14.183,-8.229;P<0.01));③ Postoperative complications were not different in the observation group than that in the control group(P>0.05).Conclusion:The conventional intervention combined with the structural psychological intervention can effectively reduce the patient's uncertainty and ameliorate the patient's perioperative psychological state for patients undergoing Microvascular decompression.
引文
[1]刘睿,李钦涛,齐平建.A型肉毒毒素对比面神经显微血管减压术治疗面肌痉挛的疗效观察研究[J].重庆医学,2016,45(3):417-419
[2]Jiang C,Xu W,Dai Y,et al.Failed microvascular decompression surgery for hemifacial spasm:A retrospective clinical study of reoperations[J].Acta Neurochirurgica,2017,159(2):259-263
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[4]田琳琳,马丽莉,李艳萍.结构式团体心理干预对改良根治术后年轻乳腺癌病人创伤后成长的影响[J].护理研究,2016,30(27):3384-3386
[5]张芳,李翠香,宋向芹,等.结构式心理护理对经皮冠脉介入治疗患者疾病不确定感及心血管不良事件的影响[J].中华现代护理杂志,2017,23(20):394-396
[6]陈静,张玉珍.信息及情感支持对支气管哮喘儿童父母疾病不确定感的影响[J].中国健康心理学杂志,2018,26(2):200-203
[7]呼伟霞,刘昶.心理弹性训练对腹腔镜胃癌根治术后患者生活质量和负性情绪的影响[J].中国健康心理学杂志,2018,26(1):38-41
[8]Lee M H,Jee T K,Lee J A,et al.Postoperative complications of microvascular decompression for hemifacial spasm:Lessons from experience of 2040cases[J].Neurosurgical Review,2016,39(1):151-158
[9]胡胜利,汪超甲,张宇强,等.微血管减压术治疗原发性面肌痉挛57例疗效分析[J].中华全科医学,2016,14(11):1854-1856
[10]樊文,余小祥,樊成,等.微血管减压术治疗原发性面肌痉挛的手术效果及并发症分析[J].实用临床医药杂志,2016,20(17):98-99
[11]任琳,郎黎薇,殷志雯,等.专项干预降低唤醒麻醉下颅脑手术患者焦虑及疾病不确定感[J].护理学杂志,2017,32(20):84-87
[12]李蓉蓉,杨静容,胡娜.颅内动脉瘤病人自我感受负担与疾病不确定感的相关性研究[J].护理研究,2016,30(8):934-937
[13]程敏,王新燕,张诚.心理护理干预对中青年缺血性脑卒中患者负性情绪及依从性的影响[J].中国医药导报,2018,39(1):167-170
[14]陆美芹,张玲,陆勤美,等.结构式心理干预对中青年肝癌病人自我感受负担的影响[J].护理研究,2015,29(15):1847-1849
[15]邱春芸.结构式心理疏导对围术期乳腺癌患者的影响[J].中国医药导报,2016,37(31):178-180
[16]曾冉,王飞红,袁邦清,等.微血管减压术治疗面肌痉挛疗效分析[J].中国临床神经外科杂志,2016,21(3):175-176
[2]Jiang C,Xu W,Dai Y,et al.Failed microvascular decompression surgery for hemifacial spasm:A retrospective clinical study of reoperations[J].Acta Neurochirurgica,2017,159(2):259-263
[3]彭彬,申起,董红娟,等.A型肉毒毒素对偏侧面肌痉挛和良性特发性眼睑痉挛患者焦虑/抑郁状态的影响[J].中国神经精神疾病杂志,2017,43(10):603-607
[4]田琳琳,马丽莉,李艳萍.结构式团体心理干预对改良根治术后年轻乳腺癌病人创伤后成长的影响[J].护理研究,2016,30(27):3384-3386
[5]张芳,李翠香,宋向芹,等.结构式心理护理对经皮冠脉介入治疗患者疾病不确定感及心血管不良事件的影响[J].中华现代护理杂志,2017,23(20):394-396
[6]陈静,张玉珍.信息及情感支持对支气管哮喘儿童父母疾病不确定感的影响[J].中国健康心理学杂志,2018,26(2):200-203
[7]呼伟霞,刘昶.心理弹性训练对腹腔镜胃癌根治术后患者生活质量和负性情绪的影响[J].中国健康心理学杂志,2018,26(1):38-41
[8]Lee M H,Jee T K,Lee J A,et al.Postoperative complications of microvascular decompression for hemifacial spasm:Lessons from experience of 2040cases[J].Neurosurgical Review,2016,39(1):151-158
[9]胡胜利,汪超甲,张宇强,等.微血管减压术治疗原发性面肌痉挛57例疗效分析[J].中华全科医学,2016,14(11):1854-1856
[10]樊文,余小祥,樊成,等.微血管减压术治疗原发性面肌痉挛的手术效果及并发症分析[J].实用临床医药杂志,2016,20(17):98-99
[11]任琳,郎黎薇,殷志雯,等.专项干预降低唤醒麻醉下颅脑手术患者焦虑及疾病不确定感[J].护理学杂志,2017,32(20):84-87
[12]李蓉蓉,杨静容,胡娜.颅内动脉瘤病人自我感受负担与疾病不确定感的相关性研究[J].护理研究,2016,30(8):934-937
[13]程敏,王新燕,张诚.心理护理干预对中青年缺血性脑卒中患者负性情绪及依从性的影响[J].中国医药导报,2018,39(1):167-170
[14]陆美芹,张玲,陆勤美,等.结构式心理干预对中青年肝癌病人自我感受负担的影响[J].护理研究,2015,29(15):1847-1849
[15]邱春芸.结构式心理疏导对围术期乳腺癌患者的影响[J].中国医药导报,2016,37(31):178-180
[16]曾冉,王飞红,袁邦清,等.微血管减压术治疗面肌痉挛疗效分析[J].中国临床神经外科杂志,2016,21(3):175-176