结构式心理干预对急性心肌梗死患者心理状态及应激水平的影响
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摘要
目的探讨结构式心理干预对急性心肌梗死患者心理状态及应激水平的影响。方法选取2017年3月—2019年1月在湖州市中心医院急诊科收治的急性心肌梗死患者96例作为研究对象,根据随机数字表法将其分为观察组和对照组,各48例。对照组应用常规急诊护理,观察组在对照组的基础上应用结构式心理护理干预。根据焦虑自评量表(SAS)、抑郁自评量表(SDS)比较2组患者护理干预前后心理状态,比较2组患者护理前后应激指标水平变化包括:收缩压(SBP)、舒张压(DBP)、心率(HR)及肾上腺素(E),统计2组患者护理满意度。结果护理干预前,2组患者心理状态评分及应激水平比较差异无统计学意义(均P>0.05);护理干预后,观察组患者SAS、SDS评分均低于对照组(均P<0.05);护理干预后观察组患者SBP、DBP、HP及E水平均明显低于对照组,差异有统计学意义(均P<0.05);观察组患者护理满意度为100.0%(48/48),高于对照组的85.4%(41/48),差异有统计学意义(P<0.05)。结论结构式心理干预可明显改善急诊急性心肌梗死患者抑郁、焦虑等负性情绪,可有效降低患者应激水平,同时提高患者及家属的护理满意度,推动和谐护患关系的建立,值得临床应用推广。
Objective To explore the effect of structural psychological intervention on psychological status and stress level in patients with acute myocardial infarction. Methods A total of 96 patients with acute myocardial infarction admitted to the emergency department of our hospital from March 2017 to January 2019 were selected as the research objects. According to the random number table method, they were divided into observation group and control group with 48 cases each. The control group was given routine emergency nursing, while the observation group was given structured psychological nursing intervention on the basis of the control group. According to the Self-rating Anxiety Scale(SAS) and self-rating depression scale(SDS), the psychological status of the two groups before and after nursing intervention was compared. The changes of stress indicators before and after nursing in the two groups were compared, including systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR) and epinephrine(E), and the nursing satisfaction of the two groups was counted. Results Before nursing intervention, there was no significant difference in mental state score and stress level between the two groups(all P>0.05); after nursing intervention, SAS and SDS scores of the observation group were lower than those of the control group(all P<0.05); after nursing intervention, the levels of SBP, DBP, HP and E of the observation group were significantly lower than those of the control group(all P<0.05); the nursing satisfaction of the observation group was 100.0%(48/48), which was far higher than 85.4%(41/48) of the control group(P<0.05). Conclusion Structural psychological intervention can significantly improve the negative emotions such as depression and anxiety in patients with acute myocardial infarction, effectively reduce the stress level of patients, improve the satisfaction of patients and their families, and promote the establishment of harmonious nurse-patient relationship, which is worthy of clinical application and promotion.
Objective To explore the effect of structural psychological intervention on psychological status and stress level in patients with acute myocardial infarction. Methods A total of 96 patients with acute myocardial infarction admitted to the emergency department of our hospital from March 2017 to January 2019 were selected as the research objects. According to the random number table method, they were divided into observation group and control group with 48 cases each. The control group was given routine emergency nursing, while the observation group was given structured psychological nursing intervention on the basis of the control group. According to the Self-rating Anxiety Scale(SAS) and self-rating depression scale(SDS), the psychological status of the two groups before and after nursing intervention was compared. The changes of stress indicators before and after nursing in the two groups were compared, including systolic blood pressure(SBP), diastolic blood pressure(DBP), heart rate(HR) and epinephrine(E), and the nursing satisfaction of the two groups was counted. Results Before nursing intervention, there was no significant difference in mental state score and stress level between the two groups(all P>0.05); after nursing intervention, SAS and SDS scores of the observation group were lower than those of the control group(all P<0.05); after nursing intervention, the levels of SBP, DBP, HP and E of the observation group were significantly lower than those of the control group(all P<0.05); the nursing satisfaction of the observation group was 100.0%(48/48), which was far higher than 85.4%(41/48) of the control group(P<0.05). Conclusion Structural psychological intervention can significantly improve the negative emotions such as depression and anxiety in patients with acute myocardial infarction, effectively reduce the stress level of patients, improve the satisfaction of patients and their families, and promote the establishment of harmonious nurse-patient relationship, which is worthy of clinical application and promotion.
引文
[1] 余红艳.急诊护理优化流程对急性心肌梗死患者救治效果的影响[J].实用临床护理学电子杂志,2018,3(24):45-46.
[2] 董海,荆全民,徐凯,等.胸痛中心的成立对急性ST段抬高型心肌梗死患者救治的影响[J].解放军医学杂志,2016,41(6):452-455.
[3] 徐小华,占亚平,王平,等.选择性血栓抽吸在急性ST段抬高型心肌梗死介入治疗中的临床价值[J].当代医学,2018,24(36):105-107.
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[5] 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(5):1847-1849.
[6] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会,《中国循环杂志》编辑委员会,等.急性心肌梗死诊断和治疗指南[J].中华心血管病杂志,2001,29(12):710-725.
[7] 段泉泉,胜利.焦虑及抑郁自评量表的临床效度[J].中国心理卫生杂志,2012,26(9):676-679.
[8] 郑娟如,吴丹燕,黄旭华,等.舒适护理在泌尿外科老年后腹腔镜手术中的应用效果观察[J].齐鲁护理杂志,2017,23(4):7-8.
[9] 李臣凤.延续性护理对急性心肌梗死患者PCI术后心理状态与服药依从性的影响[J].护理实践与研究,2019,16(1):59-60.
[10] 毛洪艳,李玫,赵秀民.优质护理在急性心肌梗死患者中的应用[J].齐鲁护理杂志,2018,24(24):61-63.
[11] 程梅,张芳.结构式心理护理对经皮冠状动脉介入治疗患者负性情绪的影响[J].解放军护理杂志,2014,31(15):46-48.
[12] 苏家琼,敖卫,谭心.结构式心理干预对急诊急性心肌梗死病人负性情绪及应激水平的影响[J].全科护理,2018,16(31):3879-3881.
[13] 卢晓恋.心理干预对急性心肌梗死患者恢复期负性情绪和生活质量的影响[J].中国医药,2014,9(5):754-756.
[14] 杨杰,谷寅煜,宋秀岩,等.结构式心理干预对肺癌患者术前自我效能感的影响[J].中华现代护理杂志,2014,20(20):2518-2520.
[15] 廉莹,熊瑛.不同心理干预方法对开放式急诊环境下初诊患者应激指标的影响[J].中国实用护理杂志,2014,30(14):7-9.
[16] 杨静.结构式心理护理对冠脉介入术患者心理应激的干预作用[J].当代护士(上旬刊),2018,25(5):33-36.
[2] 董海,荆全民,徐凯,等.胸痛中心的成立对急性ST段抬高型心肌梗死患者救治的影响[J].解放军医学杂志,2016,41(6):452-455.
[3] 徐小华,占亚平,王平,等.选择性血栓抽吸在急性ST段抬高型心肌梗死介入治疗中的临床价值[J].当代医学,2018,24(36):105-107.
[4] 韩葵葵,胡卫平,王碧梅.国际科学教学心理的研究进展与趋势[J].华东师范大学学报(教育科学版),2014,32(4):63-70.
[5] 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(5):1847-1849.
[6] 中华医学会心血管病学分会,中华心血管病杂志编辑委员会,《中国循环杂志》编辑委员会,等.急性心肌梗死诊断和治疗指南[J].中华心血管病杂志,2001,29(12):710-725.
[7] 段泉泉,胜利.焦虑及抑郁自评量表的临床效度[J].中国心理卫生杂志,2012,26(9):676-679.
[8] 郑娟如,吴丹燕,黄旭华,等.舒适护理在泌尿外科老年后腹腔镜手术中的应用效果观察[J].齐鲁护理杂志,2017,23(4):7-8.
[9] 李臣凤.延续性护理对急性心肌梗死患者PCI术后心理状态与服药依从性的影响[J].护理实践与研究,2019,16(1):59-60.
[10] 毛洪艳,李玫,赵秀民.优质护理在急性心肌梗死患者中的应用[J].齐鲁护理杂志,2018,24(24):61-63.
[11] 程梅,张芳.结构式心理护理对经皮冠状动脉介入治疗患者负性情绪的影响[J].解放军护理杂志,2014,31(15):46-48.
[12] 苏家琼,敖卫,谭心.结构式心理干预对急诊急性心肌梗死病人负性情绪及应激水平的影响[J].全科护理,2018,16(31):3879-3881.
[13] 卢晓恋.心理干预对急性心肌梗死患者恢复期负性情绪和生活质量的影响[J].中国医药,2014,9(5):754-756.
[14] 杨杰,谷寅煜,宋秀岩,等.结构式心理干预对肺癌患者术前自我效能感的影响[J].中华现代护理杂志,2014,20(20):2518-2520.
[15] 廉莹,熊瑛.不同心理干预方法对开放式急诊环境下初诊患者应激指标的影响[J].中国实用护理杂志,2014,30(14):7-9.
[16] 杨静.结构式心理护理对冠脉介入术患者心理应激的干预作用[J].当代护士(上旬刊),2018,25(5):33-36.