摘要
目的:观察协同干预模式(CCM)在改善急性缺血性脑卒中(AIS)患者负性情绪、自我感受负担与生活质量中的效果。方法:将医院2016年12月至2018年12月年收治的86例AIS患者纳为研究对象,随机将其分为观察组(n=43)与对照组(n=43),观察两组干预后患者负性情绪、自我感受负担、日常生活能力及生活质量。结果:出院时,观察组患者SAS量表得分显著低于对照组(t=-2.42,P<0.05),两组SDS量表得分无显著性差异(P>0.05),随访半年发现,观察组患者SAS及SDS量表得分均较出院时显著下降(t=10.85,13.77;P<0.05),对照组SAS及SDS量表得分与出院时无显著差异(P>0.05),且观察组出院半年后两量表得分均显著低于对照组(t=-7.94,-7.12;P<0.05);出院时,两组患者身体负担、经济负担得分均无显著性差异(P>0.05),观察组患者情感负担及SPBS量表总得分显著低于对照组(t=-3.24,-2.41;P<0.05),随访半年发现,观察组患者身体、情感负担及SPBS量表总得分均较出院时显著下降(t=8.75,11.20,15.31;P<0.05),经济负担显著上升(t=-3.57,P<0.05),对照组身体、情感负担及SPBS量表总得分均较出院时显著下降(t=6.55,12.06,11.11;P<0.05),经济负担显著上升(t=-2.89,P<0.05),且观察组患者出院半年后,身体、情感及SPBS总得分均显著低于对照组(t=-3.67,-4.86,-5.88;P<0.05);出院时,两组日常生活能力无显著性差异(P>0.05),随访半年发现,观察组日常生活能力较出院时得以显著改善(P<0.05),对照组日常生活能力与出院时无显著性改善(P>0.05),且观察组出院半年后日常生活能力优于对照组,但组间差异不显著(P>0.05);观察组患者主要照护者饮食(t=4.69,P<0.05)、康复训练(t=5.48,P<0.05)、心理干预(t=4.10,P<0.05)、药物干预(t=3.91,P<0.05)及疾病干预能力总得分(t=9.62,P<0.05)均显著高于对照组;随访半年发现,观察组患者SF-36量表中身体功能、生理职能、躯体疼痛、总体健康、活力、社会健康、情感职能、精神健康及总得分均显著高于对照组(t=5.33,9.69,9.53,5.45,6.46,5.00,5.38,5.39,14.84;P<0.05)。结论:CCM能有效提高AIS患者及其主要照护者疾病干预能力,改善患者负面情绪及自我感受负担,提高患者出院后生活质量。
Objective:To observe the effects of collaborative care model(CCM)on improving negative emotions,self-perceived burden and quality of life in patients with acute ischemic stroke(AIS).Methods:A total of 86 patients with AIS admitted to the hospital from December 2016 to December 2018 were enrolled in the study and were randomly divided into observation group(CCM,n=43)and control group(conventional nursing,n=43).The negative emotions,self-perceived burden,daily living ability and quality of life were observed in the two groups after intervention.Results:At discharge,the score of SAS scale in observation group was significantly lower than that in controlgroup(t=-2.42,P<0.05),and there was no significant difference in the SDS score between two groups(P>0.05),and the half-year follow-up found that the scores of SAS and SDS scales in observation group were significantly decreased compared with those at discharge(t=10.85,13.77;P<0.05),and the scores of SAS scale and SDS scale in control group were not significantly different from those at discharge(P>0.05),and the scores of two scales in observation group after half a year of discharge were significantly lower than those in control group(t=-7.94,-7.12;P<0.05).At discharge,there were no significant differences in the scores of physical burden and economic burden between the two groups(P>0.05),and the emotional burden score and total score of SPBS scale in observation group were significantly lower than those in control group(t=-3.24,-2.41;P<0.05),and half-year follow-up found that the scores of physical burden and emotional burden and the total score of SPBS scale in observation group were significantly decreased compared with those at discharge(t=8.75,11.20,15.31;P<0.05)while the score of economic burden was increased significantly(t=-3.57,P<0.05),and the scores of physical burden and emotional burden and the total score of SPBS scale in control group were significantly decreased compared with those at discharge(t=6.55,12.06,11.11;P<0.05)while the score of economic burden was increased significantly(t=-2.89,P<0.05),and the scores of physical burden and emotional burden and the total score of SPBS scale in observation group after half ayear of discharge were significantly lower than those in control group(t=3.67,-4.86,-5.88;P<0.05).At discharge,there was no significant difference in daily living ability between the two groups(P>0.05),and half-year follow-up found that the daily living ability in observation group was significantly improved compared with that at discharge(P<0.05),and there was no significant improvement in daily living ability in control group compared with that at discharge(P>0.05),and the daily living ability in observation group after half a year of discharge was better than that in control group(P>0.05).The scores of diet(t=4.69,P<0.05),rehabilitation training(t=5.48,P<0.05),psychological nursing(t=4.10,P<0.05)and drug intervention(t=3.91,P<0.05)and total score of disease intervention ability(t=9.62,P<0.05)of main caregivers in observation group were significantly higher than those in control group.Half-year follow-up found that the scores of physical function,role physical,physical pain,overall health,vitality,social health,emotional function and mental health and total score of SF-36 in observation group were significantly higher than those in control group(t=5.33,9.69,9.53,5.45,6.46,5.00,5.38,5.39,14.84;P<0.05).Conclusion:CCM can effectively enhance the disease care ability of AIS patients and their main caregivers,improve the negative emotions and self-perceived burden of patients,and promote the quality of life after discharge.
作者
吕红叶
付梦丽
赵贺
LV Hongye;FU Mengli;ZHAO He(Neurological Intervention Department,Nanyang Central Hospital,Nanyang473000,China)
出处
《中国健康心理学杂志》
2020年第4期515-520,共6页
China Journal of Health Psychology
基金
河南省医学科技攻关计划资助项目(编号:2017T02033).
