综合性心理护理干预对颅脑损伤后综合征患者心理状态及生活质量的影响

Influence of comprehensive mental nursing on mental status and life quality of patients with post-traumatic brain syndrome

目的探讨综合性心理护理干预对颅脑损伤后综合征患者心理状态及生活质量的影响。方法选取颅脑损伤后综合征患者70例,均为2007年1月～2013年12月在杭州市萧山区中医院脑外科的就诊患者,将其分为常规护理组（n=35）和心理护理组（n=35）。两组患者均在神经科药物治疗基础上予以常规护理,心理护理组在此基础上加用综合性心理护理,两组患者均干预8周。两组患者分别于治疗前后进行抑郁、焦虑等症状的评估,并比较其生活质量评分。结果干预8周后,常规护理组和心理护理组患者焦虑自评量表（self-rating anxiety scale,SAS）和抑郁自评量表（self-rating depression scale,SDS）评分[SAS：（45.84±4.87）、（37.52±4.73）分,SDS：（52.84±4.75）、（43.91±4.21）分]均较前[SAS：（53.04±5.12）、（52.82±6.47）分,SDS：[（57.17±5.42）、（57.32±4.65）分]均有不同程度下降（t=2.42、2.14、3.24、2.89,P〈0.05或P〈0.01）,且心理护理组下降值更大（t=2.21、2.19,P〈0.05）;两组患者活动能力、日常生活、健康感觉、家庭及朋友支持和生活前景认识等5项生活质量评分均上升（常规护理组：t=2.32、2.39、2.19、2.45、1.20,P〈0.05,心理护理组：t=3.07、2.94、2.98、2.89、2.86,P〈0.01）,且心理护理组上升值更大（t=2.27、2.11、2.16、2.19、2.16,P〈0.05）。结论综合性心理护理干预对于颅脑损伤后综合征的治疗有较好的效果,对抑郁、焦虑等心理症状具有较好的改善作用,可提高患者生活质量和预后。

Objective To discuss influence of comprehensive mental nursing on mental status and life quality of patients with post-traumatic brain syndrome. Methods 70 cases of patients with post-traumatic brain syndrome, who were given the medical treatment in the Surgical Department of Xiaoshan District Hospital of Traditional Chinese Medicine in Hangzhou during the period from January 2007 to December 2013, were selected and divided into routine nursing group（n = 35） and mental nursing group（n = 35） at random. The patients in two groups were given routine medical treatment and nursing, and the patients in mental nursing group were additionally given comprehensive mental nursing intervention. The intervention time of both groups was 8 weeks. The changes of depression, anxiety and other mental symptom and life quality scores of patients in two groups before and after medical treatment were observed and compared. Results After 8 weeks′intervention, SAS and SDS scores of patients in mental nursing group and routine nursing group [SAS：（45.84 ±4.87）,（37.52 ±4.73） scores, SDS：（52.84 ±4.75）,（43.91 ±4.21） scores] declined than before [SAS：（53.04±5.12）,（52.82±6.47） scores, SDS：（57.17±5.42）,（57.32±4.65） scores] with different degrees（t = 2.42, 2.14, 3.24,2.89, P〈0.05 or P〈0.01）, and the declining rate of patients in mental nursing group was much higher than that in routine nursing group（t = 2.21, 2.19, P〈0.05）. Meanwhile, 5 items of life quality scores of activity ability, daily life,health feelings, supporting of family and friends and consciousness of life prospect of patients in two groups rose with different degrees（routine nursing group： t = 2.32, 2.39, 2.19, 2.45, 1.20, P〈0.05, mental nursing group： t = 3.07,2.94, 2.98, 2.89, 2.86, P〈 0.01）, and the rising rate of patients in mental nursing group was much higher than that in routine nursing group（t = 2.27, 2.11, 2.16, 2.19, 2.16, P〈0.05）. Conclusion Comprehensive mental nursing intervention can obviously improve the depression, anxiety mental attitude of patients with post-traumatic brain syndrome,which can improve the life quality and prognosis.