心理护理对创伤后应激障碍患者的影响

The effect of psychological care for patients with post-traumatic stressdisorder

目的探讨心理护理对创伤后应激障碍患者的影响。方法选取我院2011年8月~2013年8月收治的创伤后应激障碍患者116例,按随机数字表法分为观察组和对照组,对应随机数字为奇数者为观察组,偶数者为对照组,每组为58例。两组患者均予以药物治疗和常规护理,观察组予以综合心理护理干预,分别于入院时、治疗后采用焦虑自评量表（Self-Rating Anxiety Scale SAS）以及创伤后应激障碍症状清单平民版（PTSD Checklist Civilian Version PCLC）对创伤后应激障碍患者进行评估,同时比较两组患者对护理的满意度。结果观察组患者总有效率为100%（58/58）,对照组患者的总有效率为86.21%（50/58）,其差异具有统计学意义（χ^2=8.59,P〈0.05）;两组患者治疗后的SAS评分较入院时明显降低,（Pa〈0.05,Pb〈0.05）;入院时,两组患者无明显差异,（Pc〉0.05）,治疗后,观察组的SAS评分明显低于对照组,（Pd〈0.05）;对照组患者的PCL-C评分为（29.84±10.28）明显低于对照组为（34.87±13.26）,其差异具有统计学意义（P〈0.05）;根据所得的PCL-C评分,若PCL-C评分〉50分,或者各项症状的评分〉3分时,即为PTSD阳性,观察组的PTSD的阳性率3.45%（2/58）明显低于对照组13.79%（8/58）,且其差异具有统计学意义（P〈0.05）。结论研究表明,在常规治疗的基础上采用心理护理,不仅能提高患者对于治疗与护理的满意度,而且能明显的降低患者的SAS、PCL-C评分,降低其PTSD的阳性率,有助于患者康复,值得在临床上推广。

Objective To explore the effect of psychological care for post- traumatic stress disorder. Methods choosing 116 patients with post- traumatic stress disorder in August 2011 ~ August 2013 in our hospital,then the patients were randomly divided into observation group and control group,corresponding to the random number is odd for the observation group,even for the control group,and each group had 58 cases. All patients were given drug treatment and routine care,and the observation group were given psychological nursing intervention at the same time.After treatment,Self- Rating Anxiety Scale（ SA- S） and PTSD Checklist- Civilian Version（ PCL- C） were used to evaluate patients and compared the satisfaction with care and treatment of patients. Results The satisfaction with care and treatment of the observation group is 100%（ 58 /58） which is much higher than the control group 86. 21%（ 50 /58）,and the difference was significant（ χ^2= 8. 59,P〈0. 05）; the SAS of after treatment is much lower than observation,and the differences were significant（ P〈0. 05,P〈0. 05）; The difference of two groups when patients were admitted is not significant（ P〉0. 05）,; and the SAS of the observation group is much lower than the control group after treatment,the difference is significant（ P〈0. 05）; the PCL- C of the control group（ 29. 84 ± 10. 28）is significantly lower than the control group（ 34. 87 ± 13. 26）,the difference is significant（ P〈0. 05）; According to the PCL- C scores obtained,if the PCL- C scores 50 points,or the scores of symptom 3 points,the patient is positive for PTSD. The positive rate of PTSD of the observation group 3. 45%（ 2 /58） is significantly lower than the control group 13. 79%（ 8 /58）,and the difference is significant（ P〈0. 05）. Conclusion T- his study showed that psychological care on the basis of conventional treatment,not only can improve patients satisfaction for care an- d treatment,but also can significantly reduce patients SAS,PCL- C scores and the positive rate of PTSD patients,and help cure patients,so it should be promoted in clinical practice.