认知疗法对创伤性截瘫患者自杀意念和行为的干预效果

Cognitive Therapy for Traumatic Paraplegia Suicidal Ideation and Behavior Iintervention by Orthopedic Nurse

目的：探讨认知疗法对创伤性截瘫患者自杀意念和行为的干预效果。方法：选取100例创伤性截瘫患者,按随机数字表顺序分为观察组和对照组各50例。对照组给予常规的护理干预,观察组在常规护理干预基础上给予认知疗法。分别与干预前后比较两组患者焦虑自评量表（Self-Rating Anxiety Scale,SAS）评分、抑郁自评量表（Self-Rating Depression Scale,SDS）评分、自杀评分量表（QSA）、Derogatis编制的症状自评量表（SCL-90）、简明健康调查量表（The MOS36-item Short Form Health Survey,SF-36）评分以了解认知疗法对创伤性截瘫患者自杀意念和行为的干预效果。结果：干预前,两组患者SDS评分、SAS评分、SF-36各维度评分、QSA各维度评分比较差异无统计学意义（P〉0.05）;干预后,观察组QSA各维度评分高于对照组（t=3.273,3.706,2.644,3.861）;SCL-90总评分低于对照组（t=-3.333）;SF-36各维度评分高于对照组（t=14.136,16.392,11.015,10.205,19.647,15.337,13.092,16.903）;SDS评分（t=-11.518）和SAS评分（t=-11.576）低于对照组,差异均有统计学意义（P〈0.05或0.01）。结论：急诊科护士通过认知疗法干预创伤性截瘫患者,可显著改善患者焦虑及抑郁症状,降低自杀意念,提高生活质量,其效果优于单纯常规的护理干预治疗。

Objective：TO explore the effect of coynitive therapy on traumatic paraplegia suicidal ideation and behavior by nurse.Methods：A total of 100 cases of traumatic paraplegia patients were randomly divided into observation group and the sequence of the control group,50 cases in each.The control group received routine nursing intervention,observation group received cognitive therapy intervention on the basis of the control group.Respectively Checklist Self-Rating Anxiety Scale（Self-Rating Anxiety Scale,SAS）score,（Self-Rating Depression Scale,SDS）score,Suicide Rating Scale（QSA）,The symptom Checklist（SCL-90）,concise health survey（the MOS36-item Short Form health survey,SF-36）scores were used to evaluate the effect of cognitive therapy for traumatic paraplegia suicidal ideation and behavior.Results：Before the intervention,there was not statistical significant difference between two groups in SDS score,SAS scoret〉-0.05）,the score of each dimension of SF-36 and QSA score of each dimension（P〉0.05）;After intervention,the score of each dimensions of QSA in observation group was higher than those in control group（t=3.273,3.706,2.644,3.861,P〈0.01）,the total score of SCL-90 in observation group was lower than that in control group（t=-3.333,P〈0.01）,SF-36 score of each dimension in observation group was higher than those in control group（t=14.136,16.392,11.015,10.205,19.647,15.337,13.092,16.903,P〈0.001）;SDS score and SAS score in observation group was lower than those in control group,the differences were statistically significant（P=-11.518,-11.576,P〈0.001）.Conclusion：Orthopedic nurse through cognitive therapy in patients with traumatic paraplegia,can significantly improve symptoms of depression and anxiety,reduce suicidal ideation,improve quality of life;The effect is better than conventional care intervention.