分级心理护理对心胸外科手术患者术后焦虑、抑郁及睡眠质量的影响

Influence of hierarchical psychological nursing on anxiety, depression and sleep quality of thoracic surgery patients

目的：探讨分级心理护理对心胸外科手术患者术后焦虑、抑郁及睡眠质量的影响。方法选择82例接受心胸外科手术治疗的患者，按照随机数字表法随机分为对照组与研究组各41例，两组患者均给予常规护理，对照组在常规护理的基础上给予常规心理护理，研究组在常规护理的基础上给予分级心理护理。采用焦虑自评量表（ SAS）、抑郁自评量表（ SDS）评价两组患者手术前后的心理状况；同时用匹兹堡睡眠质量指数量表（PSQI）评价两组患者手术前后的睡眠质量。结果术后15 d，研究组SAS评分和SDS评分分别为（37．68±3．41）、（38．12±3．17）分，分别低于对照组的（41．23±3．07）、（41．82±2．64）分，差异有统计学意义（t值分别为4．954，8．847；P＜0．05）。术后15 d，研究组PSQI总分为（6．99±0．86）分，对照组为（9．02±1．21）分，差异有统计学意义（t＝8．756，P＜0．05）；PSQI睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍、催眠药物及日间功能障碍各维度评分研究组均显著低于对照组，差异均有统计学意义（ P＜0．05）。结论分级心理护理能够改善心胸外科手术患者术后焦虑和抑郁心理，同时能提高患者术后睡眠质量，值得临床推广和普及。

Objective To study the influence of hierarchical psychological nursing on anxiety , depression and sleep quality of thoracic surgery patients .Methods Totals of 82 thoracic surgery patients were randomly divided into two groups .The control group （ 41 cases ） was given routine care including conventional psychological nursing .Based on this , the research group （ 41 cases ） was given hierarchical psychological nursing.Self-Rating Anxiety Scale （ SAS） and Self-Rating Depression Scale （ SDS） were used to evaluate psychological status of two groups before and after surgery .Pittsburgh Sleep Quality Index （ PSQI） was used to evaluate the quality of sleep before and after operation .Results Fifteen days after the operation , SAS and SDS scores of the research group were （37.68 ±3.41） and （38.12 ±3.17）, respectively.Those scores of the control group were （41.23 ±3.07） and （41.82 ±2.64）.The differences were significant （t=4.954, 8.847, respectively;P〈0.05）.Fifteen days after the operation , the total score of PSQI was （6.99 ±0.86） in the research group and （9.02 ±1.21） in the control group.There was a significant difference between two groups （t=8.756, P〈0.05）.The scores of sleep quality, time to fall asleep, sleep time, sleep efficiency, sleep disturbance , hypnotic drugs and daytime dysfunction in the research group were significantly lower than those in the control group （ P〈0.05 ）.Conclusions Hierarchical psychological nursing can decrease anxiety , depression and improve sleep quality of thoracic surgery patients . It is worthy of clinical promotion and popularization .