个人中心疗法对首次脑卒中患者康复效果的探讨

Rehabilitation Effect of Personal-centered Therapy on the Patients with Initial Stroke

目的探讨个人中心疗法对首次脑卒中康复期患者的影响。方法将首次脑卒中的本院住院患者和社区非住 院患者共120例随机分为心理治疗(观察组)和一般治疗(对照组)各60例,两组均予常规临床治疗与护理,观察组 在此基础上采用个人中心疗法对患者实施治疗,包括主动倾听、无条件积极关注、准确共情、对峙、建立合理认知、 满足患者需要及建立良好支持系统等。并采用自我和谐量表及应付方式问卷于治疗前及治疗3个月后评价两组 效果。结果观察组自我与经验不和谐、退避、自责分值较治疗前明显降低(均P<0.01),自我灵活性、求助、解决问 题评分较治疗前显著提高(P<0.05,P<0.01);自我刻板、幻想、合理化较稳定(均P>0.05)。对照组则仅在自我 灵活性及解决问题上分值稍有升高(均P<0.05),其余变化不大(均P>0.05)。观察组自我不和谐、自责、解决问 题评分与对照组比较,差异有显著性意义(均P<0.01);求助评分与对照组比较,差异有显著性意义(均P<0.05)。 结论脑卒中患者普遍伴有抑郁、焦虑,缺乏对社会支持的认识和利用,应付方式易走极端等心理障碍。个人中心疗 法在脑卒中后康复期可以很好地帮助患者摆脱负性情绪,形成积极向上的应付方式。

Objective To investigate the influence of personal-centered therapy on the patients with initial stroke.Methods The 120 stroke patients were analyzed with Self Consistency and Congruence Scale(sccs) and the Way of Coping Questionnaire, and they were divided into intervention group (60 cases) and control group (60 cases). They were all treated with regular clinical therapy and nursing. In addition, the patients in the intervention group were subjected to the treatment of the psychological intervention of Roger, personal-centered therapy. Two groups were tested at beginning and 3 months later. Sixty healthy subjects were assessed, too.Results The scores of “self-harmonious, avoidance and self-blame” were significantly decreased (P<0.01) and “problem-solving, seek help and self-flexible” increased remarkably (P<0.01) as compared with the healthy subjects who tended to psychological recovering, but not attend. For control group, only the scores of self-flexible, problem-solving were increased, while the others remained no change (P>0.05). There were significant difference in self-harmonious, self-blame, problem-solving, seek help, and self-flexible between intervention group and control group (P<0.05). Conclusion Anxiety, major-expression, less understanding and utilization of social supporting are common complications after stroke. The psychological intervention of personal-centered therapy can help them to get rid of those negative emotion, establish active ways of coping question and cooperate with doctors actively in rehabilitation treatment and develop their living quality.