中青年急性心肌梗死患者家属负性心理状况分析及护理

Negative psychological state analysis and nursing of young and middle aged families of acute myocardial infarction patient

目的 探讨中青年急性心肌梗死（AMI）患者家属的心理状况.方法 选择2011—2013年南京医科大学附属无锡市第二人民医院收治的120例中青年AMI患者的家属分为对照组和试验组,对其进行焦虑自评量表（SAS）、抑郁自评量表（SDS）、汉密尔顿焦虑量表（HAMA）、汉密尔顿抑郁量表（HAMD）的问卷调查;分析令患者家属焦虑、抑郁的因素,比较两组经不同干预后的SAS、SDS、HAMA、HAMD评分.结果 组内比较：对照组和试验组患者入院第3天各指标值均显著低于入院时（P〈0.05）,同时入院第7天各指标值也显著低于入院第3天（P〈0.05）;组间比较：两组入院时各指标值均差异无统计学意义（P〉0.05）.两组患者入院第3天和第7天的各指标值差异有统计学意义（P〈0.05）.试验组入院第3天和第7天的各指标值均显著低于对照组（P〈0.05）.令患者家属焦虑的因素主要有担心患者健康状况、家庭经济困难、家属工作受到影响、体力精力上无法承受、急于了解患者病情、治疗、预后、想时刻守护患者、急于了解疾病相关知识、危急情况下救助知识、交通不便等.结论 应重视对患者家属进行心理护理,采用四维度创新服务模型指导护理服务,减少医患纠纷,间接鼓励支持患者,促进患者早日康复.

Objective To explore the young and middle-aged families psychological status of patients with acute myocardial infarction. Methods A total of 120 families of patients with acute myocardial infarction （AMI） who admitted in our hospital from 2011 to 2013, and the families were divided into experimental group and control group. All patients of two groups were used the self-evaluation of anxiety scale （ SAS） , depression self rating scale （ SDS ） questionnaire after different interventions in two groups. We analyzed the families′anxiety and depression influencing factors and compared the SAS, SDS, HAMS and HAMD scores in two groups. Results Within group comparison：in both groups, each index of the third day of admission were significantly lower than those on admission day （P〈0. 05）; at the same time, each index value seventh days after admission was significantly lower than that of the third day of admission （P〈0. 05）; comparison between two groups：the index difference of two groups was no indexes had no statistically significant on admission （ P〉0. 05）; but the difference had statistical significance at third days and seventh days in each index value of two groups （P ＆lt;0. 05）. Each index of third days and seventh days in experimental group were significantly lower than those in control group （P ＆lt; 0. 05）. Factors that cause anxiety in patients′ families included concerning about the health of patients, family economic difficulties, families′ work affected, unbearable physical strength and energy, to understand patient′s condition, treatment and prognosis, eager to know disease-associated knowledge, first aid knowledge under emergency situation, traffic inconvenience and so on.Conclusions The psychological nursing should be paid attention on patients′ relatives by four-dimensional innovation service model to guide nursing service, so as to reduce medical dispute, indirectly encourage patients and promote patients recovery early.