个性化心理支持在COPD患者中的应用效果

Effects of individualized psychological support in patients with chronic obst：＇uctive pulmonary disease

目的 探讨个性化心理支持对呼吸科与重症医学科COPD患者睡眠情况、心理状态及生活质量的影响.方法 采用方便抽样法,选取2014年7月—2016年10月商丘市第一人民医院呼吸科与重症医学科收治的68例COPD患者为研究对象,根据随机数字表分为对照组与观察组,每组各34例.对照组予以常规护理,观察组在对照组基础上实施个性化心理支持护理,直至患者出院或转科.干预前后采用匹兹堡睡眠质量指数问卷（PSQI）评估患者睡眠情况,自我感受负担量表（SPBS）及纽芬兰纪念大学幸福度量表（MUNSH）评估患者心理状态,采用成人慢性阻塞性肺疾病生活质量量表评估干预前后两组生活质量,比较两组睡眠情况、心理状态及生活质量.结果 干预前,两组睡眠情况、自我感受负担、主观幸福感、生活质量评分差异无统计学意义（P〉0.05）.干预后观察组睡眠质量和睡眠情况总分较对照组低;自我感受负担各维度得分及总分均低于对照组;主观幸福感正性评分、总评分均高于对照组,负性评分低于对照组;观察组患者生活能力、心理状态及生活质量总分均高于对照组;差异均有统计学意义（P〈0.05）.结论 个性化心理支持可显著改善呼吸科和重症医学科COPD患者睡眠质量,并减轻患者自我感受负担,促使患者采取健康、积极的应对方式,从而提高生活质量.

Objective To explore the effects of individualized psychological support on sleep condition, psychological status and quality of life in patients with chronic obstructive pulmonary disease （COPD） in Respiratory Department and ICU. Methods A total of 68 patients with COPD administrated in the respiratory department and ICU of Shangqiu First People＇s Hospital from July 2014 to October 2016 were selected by convenience sampling method and divided into control group and observation group by random number table method, with 34 cases in each group. The patients in the control group were given routine nursing care, while the patients in the observation group were given individualized psychological nursing support on the basis of routine care till discharged or transferred. Pittsburgh Sleep Quality Index （PSQI） was applied to evaluate patients＇ sleep condition; Self-Perceived Burden Scale （SPBS） and Memorial University of Newfoundland Scale of Happiness （MUNSH） were used to assess patients＇ psychological status; and the Quality of Life Scale for Adult Patient with Chronic Obstructive Pulmonary Disease （COPD-QOL） was applied to compare the patients＇ quality of life between the two groups before and after the intervention. The sleep condition, psychological status and quality of life were compared between the two groups. Results Before the intervention, there were no statistical differences in sleep condition, self-perceived burden, subjective happiness and quality of life between the two groups （P〉0.05）. After the intervention, the scores of sleep quality and sleep condition of the observation group was significantly lower than those of the control group; the total score and the score of each dimension in the self-perceived burden scale of the observation group were all lower than those of the control group; the positive score of subjective happiness and its total score of the observation group were higher than those of the control group, while the negative score was lower than that of the control group; in addition, the total scores of patients＇ living ability, psychological status and quality of life of the observation group were all higher than those of the control group;the differences were all statistically significant （P〈0.05）. Conclusions Individualized psychological support can significantly improve the sleep quality of patients with COPD in respiratory department and ICU,relieve their self-perceived burden, encourage patients to adopt healthy and positive coping style, so as to improve the quality of life.