摘要
目的:探讨心理干预对经皮脊柱内镜术后患者生活质量的影响。方法:纳入2018年1月16日至2019年4月23日在北京大学第三医院疼痛科行经皮脊柱内镜术的患者96例,年龄≥18岁,病程≥3个月,保守治疗>6周无效。根据入院心理评估结果和是否给予额外心理干预,分为3组:无焦虑抑郁组、有焦虑抑郁无额外心理干预组(常规干预组)和有焦虑抑郁有额外心理干预组(心理干预组),各组分别34、31、31例。无焦虑抑郁组和常规干预组给予常规围术期干预措施,心理干预组除给予常规围术期干预措施之外,还增加关于"疼痛认知"的患者教育,并给予共情支持。入院时记录患者的一般资料、广泛性焦虑障碍量表(GAD-7)评分、患者健康问卷抑郁量表(PHQ-9)评分、Oswestry功能障碍指数(ODI)和数字等级评分(NRS);术后1、3、6个月时进行随访,记录SF-36条目简明量表(SF-36)评分、ODI评分、NRS评分。结果:所有患者均完成了随访。3组患者的一般资料和临床资料进行比较,差异均无统计学意义( P均>0.05)。3组患者术后1、3、6个月NRS评分和ODI评分差异均无统计学意义( P均>0.05);无焦虑抑郁组患者术后1个月时生活质量的情感职能(RE)维度优于常规干预组患者( P<0.05);心理干预组患者术后1个月时生活质量的RE维度优于常规干预组患者( P<0.05);无焦虑抑郁组患者和心理干预组患者术后1个月时生活质量的RE维度的差异无统计学意义( P>0.05);常规干预组患者和心理干预组患者术后3、6个月时生活质量各维度的差异均无统计学意义( P均>0.05)。 结论:认知干预和共情支持的心理干预有助于改善经皮脊柱内镜术后患者早期的生活质量。
Objective To explore the effects of perioperative psychological intervention on quality of life in patients after percutaneous spinal endoscopy.Methods sNinety-six patients received percutaneous spinal endoscopy were included from January 16,2018 to April 23,2019 in the Department of Pain Medicine,Peking University Third Hospital.Inclusive criteria were as following:aged≥18 years,preoperative course≥3 months,conservative treatment invalid>6 weeks.Patients were divided into three groups according to the results of admission psychological assessment and whether additional psychological intervention was given:without anxiety and depression group,with anxiety and depression but no additional psychological intervention(conventional intervention group),and with anxiety and depression and additional psychological intervention(psychological intervention group).Patients were received routine perioperative nursing intervention in the without anxiety and depression group and conventional intervention group,while patients were given routine perioperative nursing intervention and additional cognitive-based psychological intervention and empathy support in the psychological intervention group.Demographic information,generalized anxiety disorder 7-item scale(GAD-7),patient health questionnaire-9(PHQ-9),Oswestry disability index(ODI),numerical rating scale(NRS)were recorded at admission.The Mos 36-item short-form health survey(SF-36),ODI and NRS were collected at 1,3 and 6 months follow-up after the surgery.Results All patients completed the follow-up.The demographic information and clinical data were not statistically significant in the 3 groups(all P>0.05).There were no statistically significant differences in NRS scores and ODI scores at 1,3 and 6 months follow-up after the surgery among 3 groups(all P>0.05).The RE dimension of quality of life was better at 1 month follow-up in the without anxiety and depression group than that in the conventional intervention group(P<0.05).The RE dimension of quality of life was better at 1 month follow-up in the psychological intervention group than that in the conventional intervention group(P<0.05).There was no significant difference between the without anxiety and depression group and the psychological intervention group in the RE dimension of life quality at 1 month follow-up(P>0.05).There was no significant difference between the conventional intervention group and the psychological intervention group in all the dimensions of life quality at 3 months follow-up and 6 months follow-up(all P>0.05).Conclusionn Cognitive-based psychological intervention and empathy support can improve the early quality of life of patients after percutaneous spinal endoscopy.
作者
朱薇
李水清
贾东林
Zhu Wei;Li Shuiqing;Jia Donglin(Department of Pain Medicine,Peking University Third Hospital,Beijing City 100191,China)
出处
《中华疼痛学杂志》
2022年第6期757-762,共6页
Chinese Journal Of Painology
关键词
认知干预
共情支持
生活质量
内窥镜
Cognitive behavioral therapy
Empathy support
Quality of life
Endoscopes
作者简介
朱薇,女,1977年10月出生,医学科学、护理学双硕士学位,国家二级心理咨询师,主管护师,工作单位:北京大学第三医院疼痛科,专业特长:脊柱源性疼痛护理和疼痛护理管理,研究方向:疼痛心理护理、疼痛护理管理;通信作者:贾东林,Email:jiadlin@126.com。
