情志护理对肝硬化患者焦虑抑郁心理状态影响的研究

Study on the effects of emotional care on the anxious and depressive state of patients with cirrhosis

目的探讨中医情志护理对肝硬化患者心理状态的影响。方法经患者知情同意及医院伦理委员会批准,将100例肝硬化患者分为实验组和对照组,每组50例。实验组给予中医情志护理,对照组给予常规护理和心理指导,疗程共10 d。采用焦虑自评量表(SAS),抑郁自评量表(SDS)对2组患者护理前后的心理状态进行评价,并记录护理前后的睡眠时间;同时应用卡方检验对不同类型患者情志护理的效果进行分析。结果实验组进行中医情志护理后,SAS、SDS评分较护理前明显降低,睡眠时间延长[(6.29±0.77)h,(6.70±0.66)h](P<0.01);同时,比较2组患者护理干预后的SAS、SDS评分,实验组也低于对照组(P<0.05)。此外,经卡方检验,医保的患者进行中医情志护理后,焦虑的发生率较低(P<0.01),而文化程度较高、年龄较大的患者抑郁的发生率较低(P<0.05,P<0.01)。结论中医情志护理能明显降低肝硬化患者的焦虑抑郁评分,缓解患者的负性心理状态,同时医疗费用的来源,年龄和文化程度可能会对情志护理的效果产生影响。

Objective To explore the effects of emotional care on the physiological states of patients with cirrhosis. Methods One hundred patients with cirrhosis were randomly divided into the experimental group and the control group,each consisting of 50 patients. The patients in the experimental group were treated with emotional care of traditional Chinese medicine（ TCM）,while the patients in the control group were given conventional nursing and psychological intervention,all with a treatment course of 10 days. Selfrating anxiety scale（ SAS） and self-rating depression scale（ SDS） were used to evaluate the psychological state of the patients both before and after nursing,and in the meantime the sleeping time of patients in both groups was also recorded. Chi-square test was used to analyze the effect of emotional care on different types of patients with cirrhosis. Results for the patients in the experimental group,the scores of SAS and SDS were significantly decreased following emotional care and sleeping time [（ 6. 29 ± 0. 77） h,（ 6. 70 ± 0. 66） h]was extended,as compared with that before care（ P 0. 01）. At the same time,scores of SAS and SDS for the patients in the experimental group were also lower than those of the control group,when comparisons were made between them（ P 0. 05）. Furthermore,chi-square test indicated that the incidence of anxiety was also decreased in the patients of the experimental group,following emotional care（ P 0. 01）,and at the same time,the incidence of anxiety in the patients with higher education background and more senior age was also lower（ P 0. 01）. Conclusion The emotional care of TCM could significantly decrease the scores of SAS and SDS in the patients with cirrhosis and relieve their negative psychological state. At the same time,source of medical expenses,age and educational background all had some impact on the effects of emotional care.