叙事疗法对老年冠心病患者负性情绪的影响

Effect of Narrative Therapy on Negative Emotion in Elderly Patients with Coronary Heart Disease

目的调查老年冠心病患者负性情绪的发生状况,探讨叙事疗法对老年冠心病患者负性情绪的影响。方法采用随机抽样的原则,选取符合纳入标准和排除标准,2020年1月至2020年12月锦州医科大学附属第一医院心内科冠心病伴有焦虑抑郁的患者280例。其中,试验组138例,采用常规护理和叙事疗法;对照组142例,采用常规护理。通过成立叙事干预小组,分别对两组患者焦虑抑郁情况、自我效能、患者满意度进行效果评价。结果两组患者焦虑抑郁情况比较,入院时焦虑抑郁情况比较差异无统计学意义(P>0.05),干预2 w、4 w后试验组焦虑抑郁情况与入院时对比均降低,差异存在统计学意义(P<0.05),干预4 w后对照组焦虑抑郁评分对比降低,差异存在统计学意义(P<0.05);两组患者自我效能评分比较,试验组各条目评分均优于对照组,有统计学意义(P<0.05);两组患者满意度,对照组低于试验组,差异存在统计学意义(P<0.05)。结论老年冠心病患者容易产生负性情绪,加重疾病的发生发展,叙事疗法能够让患者改变对疾病的认知,提高自我效能,重新树立信心,战胜疾病,从而提高生活质量。同时,提高患者满意度。

Objective To investigate the occurrence of negative emotions in elderly patients with coronary heart disease and to explore the influence of narrative therapy on their negative emotions.Methods 280 patients with coronary heart disease and anxiety depression treated in the Department of Cardiology of the First Affiliated Hospital of Jinzhou Medical University who met inclusion and exclusion criteria were chosen by random sampling.Among them,138 cases in the experimental group were treated with routine nursing and narrative therapy,while 142 cases in the control group were treated with routine nursing alone.Narrative intervention group was set up to evaluate the results of the two groups in terms of anxiety and depression,self-efficacy and patient satisfaction.Results There was no significant difference in anxiety and depression between the two groups on admission(P>0.05).After 2 and 4 weeks of intervention,the anxiety and depression of the experimental group decreased compared with that on admission,with statistically significant difference(P<0.05);after intervention for 4 weeks,the score difference in terms of the anxiety and depression in the control group decreased,with statistically significant difference(P<0.05);comparison of self-efficacy scores between the two groups showed that scores of each item in the experimental group were better than those in the control group,and the difference was statistically significant(P<0.05);the satisfaction of patients was lower in the control group than that in the experimental group,and the difference was statistically significant(P<0.05).Conclusion The elderly patients with coronary heart disease are prone to negative emotions,which will aggravate the occurrence and development of the disease.Narrative therapy can help patients change their perception of the disease,improve self-efficacy,regain confidence and overcome the disease,thereby improving the patients quality of life and their satisfaction as well.