急性期脑卒中患者心理防御及心理干预策略

Psychological defense and psychological intervention for patients with stroke in acute period

目的:阐述急性期脑卒中患者常用心理防御机制特点以及心理治疗干预技术技巧,增加对脑卒中患者心理干预技术的可操作技巧运用和研究。资料来源:应用计算机检索Medline1995-01/2004-08与脑卒中心理干预相关的文章,检索词“strokepatientspsychologicaldefensepsychotherapy”,并限定文章的种类为English。检索了中文数据库CNKI1995-01/2004-08期间的相关文章,检索词“急性期,脑卒中患者,心理防御,心理干预”。同时用手工检索近期的相关中文期刊和有关书籍。资料选择:对资料进行初审,纳入脑卒中急性期(发病3个月内)患者的现况调查或随机对照临床实验,筛除不明显相关文献及综述,对所选中文献开始查找全文。资料提炼:共收集到脑卒中患者心理防御机制与心理治疗干预文章中文文献3篇,英文4篇。资料综合:结合心理防御的理论,综合提炼的研究资料,综述脑卒中患者的心理防御与干预策略。有7篇文献分别对脑卒中患者的心理防御进行了评价,就心理防御特点以及心理干预具体方式方法进行了研究和经验式交流,总体来看,对脑卒中患者而言是有效果的。结论:脑卒中发病率高,脑卒中所致心身应激对脑卒中恢复有着密切的关系,若对脑卒中后心理应激干预能及时了解,并进行有效的心理干预。

OBJECTIVE:To expound the characteristics of psychological defense mechanism and the skills of psychotherapy intervention,which were used in acute stroke patients,to increase the application and research on psychological intervention in stroke patients.DATA SOURCES:Using the key terms “ stroke patients,psychological defense psychotherapy” ,we searched Medicine for the articles related to psychological intervention in stroke between January 1995 and August 2004 in English.Meanwhile,using the key terms “ acute phase,stroke patients,psychological defense and psychological intervention” ,we searched Chinese database CNKI between January 1995 and August 2004.At the same time,we searched recently correlative journals and books by hand.STUDY SELECTION:All articles were selected firstly,those were relevant to prevalence survey of stroke patients in acute period(in three- month onset) and randomized controlled clinical trials were collected.The articles that were not obviously correlative and overview articles were excluded.DATA EXTRACTION:A total of 3 Chinese and 4 English articles were collected,which were relevant to psychological defense mechanism and psychotherapy intervention in patients with stroke.DATA SYNTHESIS:Totally 7 articles evaluated the psychological defense in stroke patients and investigated and communicated the characteristics of psychological defense and the skills of psychotherapy intervention.From the whole,we found that psychological defense was effective for stroke patients.The author summarized all data on psychological defense and intervention strategy by combining the theory of psychological defense.CONCLUSION:The accidence rate of stroke is high.Psychosomatic stress led by stroke and stroke recoveries have intimate relation.If learning and acting psychological stress intervention after stroke timely, it will be satisfactorily preventive function to reduce the occurrence of emotion disorders and inter- current diseases after stroke.According to the clinical experience,the intervention to psychological defense mechanism in stroke patients has very important practical importance and foundation.The combination of psychological defense mechanism theory and skills of intervention can do psychological debugging to patients' subconsciousness,for reducing, preventing emotion disorders after stroke and improving the survival quality.