心理护理改善耐多药肺结核患者焦虑抑郁情绪及生存质量的效果观察

Effect of psychological nursing on anxiety and depression and quality of life of patients with multi -drug ;resistant pulmonary tuberculosis

目的：探讨心理护理对耐多药肺结核患者焦虑抑郁情绪及生存质量的影响。方法将58例耐多药肺结核患者应用随机数字表法分为观察组与对照组，每组各29例，对照组采用常规护理，观察组在此基础上增加心理护理，观察两组患者心理护理干预前后焦虑自评量表（SAS）、抑郁自评量表（SDS）、健康调查量表（SF-36）评分变化情况及干预后两组临床疗效、依从性情况。结果心理护理干预后，观察组 SDS 评分、SAS 评分分别为（36．83±7．61）分和（40．07±5．49）分，优于对照组的（44．07±9．16）分和（43．90±7．91）分（t ＝3．27、2．14，均 P ＜0．05）；SF-36评分显示心理护理干预后观察组生理功能（PF）、生理职能（RP）、总体健康（GH）、活力（VT）、社会功能（SF）、情感职能（RE）、精神健康（MH）7个维度的评分均显著高于对照组，差异均有统计学意义（t ＝7．18、10．22、8．85、12．71、12．04、9．68、4．79，均 P ＜0．05）。观察组用药的依从性为93.10％，对照组为72．41％，差异有统计学意义（χ2＝4．35，P ＜0．05），观察组治疗总有效率为86．21％，对照组为62．07％，差异有统计学意义（χ2＝4．41，P ＜0．05）。结论对耐多药肺结核患者进行心理护理干预能够改善患者焦虑抑郁情绪，提高患者生存质量，有利于提高患者治疗依从性，从而提高临床疗效。

Objective To explore the effect of psychological nursing on anxiety and depression and quality of life of patients with multi drug resistant pulmonary tuberculosis.Methods 58 patients with multi -drug resistant pulmonary tuberculosis were randomly divided into observation group and control group,29 cases in each group.The control group received routine nursing care,the observation group received psychological nursing on the basis of the control group.Before and after psychological nursing intervention,the self rating anxiety scale（SAS）and depression self rating scale（SDS）,health survey（SF -36）score were observed,and the clinical curative effect and compliance of the two groups were observed.Results After psychological nursing intervention,the SAS and SDS scores of the observation group[（36.83 ±7.61）points and （40.07 ±5.49）points]were significantly lower than the control group [（44.07 ±9.16）points and （43.90 ±7.91）points],the differences were statistically significant（t =3.27,2.14,all P 〈0.05）.The SF -36 scores showed that after psychological nursing intervention,the physiological function（PF）, physiological functions（RP）,general health（GH）,vitality（VT）,social function（SF）,role emotional（RE）,mental health（MH）,the seven dimensions scores of the observation group were significantly higher than those in the control group,the differences were statistically significant（t =7.18,10.22,8.85,12.71,12.04,9.68,4.79,all P 〈0.05）. The compliance of the observation group was 93.10%,which of the control group was 72.41%,the difference wassignificant（χ2 =4.35,P 〈0.05）.The total effective rate of the observation group was 86.21%,which of the control group was 62.07%,the difference was statistically significant（χ2 =4.41,P 〈0.05）.Conclusion The psychological nursing intervention can improve the anxiety and depression of patients with multi -drug resistant tuberculosis, improve the quality of life of patients,improve the treatment compliance of patients,and improve the clinical efficacy.