择期手术病人术前心理干预的临床研究

Clinical Study of Psychological Intervention in the Selective Patients during Preoperative Period

目的:探讨择期手术病人术前心理干预的必要性与可行性,为术前实施心理干预提供依据。方法:对60例择期手术病人术前进行心理应激调查,并针对调查出的心理问题进行心理干预,评估心理干预前后的心理状态;与60例未实施心理干预的病人对照研究患者进入手术室前后的生命体征变化。结果:调查显示择期手术病人术前SCL-90中躯体化、抑郁、焦虑、恐惧及精神病性等因子与国内常模比较有明显升高,而人际关系因子与国内常模比较有明显降低;心理干预后病人的焦虑、抑郁、疑虑等不良心理反应有显著性降低(P<0.05或P<0.01);经过心理干预的患者入手术室前后的生命体征更趋平稳。结论:术前心理干预能有效地降低术前焦虑、抑郁、恐惧等不良心理情绪的水平,可使病人处于最佳心理状态来完成手术,表明对择期手术病人术前进行心理干预(认知治疗与支持治疗)是切实可行、行之有效的。

Objective: To investigate the necessity and practicability of preoperative psychological intervention in the selective patients. Methods: Patients were divided into two groups: control( n = 60) and psychological intervention group( n = 60) in which the psychological stress investigation was carried out and preoperative psychological intervention was performed individually to e-valuate the psychological condition and life signs before and after the intervention. Results: The indices of SCL-90 including so-matical change,depression, anxiety, fear and psychological diseases were significantly higher than that of the domestical routine model, and the index of inter personal relationship was significantly lower than that of the domestical routine model. And adverse reactions including anxiety,depression and suspicion was dramatically lower after psychological intervention than before the inter-vention( P<0.05,P<0.01). The patient's life signs were more stable before patients enter the operative room because of psychological intervention. Conclusion:The preoperative psychological intervention can effectively lower the level of adverse psychological conditions including anxiety and depression and fear, and make the patients in the best condition for operation. It is indicated that preoperative psychological intervention (cognitive therapy and supportive psychotherapy) is an effective and practicable method.