聚焦解决模式在溃疡性结肠炎患者中的应用及其效果评价

Application and efficacy of solution focused brief therapy in patients with ulcerative colitis

目的探讨聚焦解决模式在溃疡性结肠炎（UC）患者护理干预中的应用价值。方法采用随机数字表法将180例UC患者分为观察组和对照组各90例。2组患者均给予延续护理，同时对观察组患者应用聚焦解决模式进行干预。比较干预前后2组患者简明健康调查量表（SF-36）、焦虑自评量表（SAS）、抑郁自评量表（SDS）及治疗总有效率。采用单因素分析，筛选UC治疗显效／有效的影响因素。结果干预前，2组SF-36的8个维度方面得分比较差异均无统计学意义（P〉0．05）；干预后，观察组8个维度得分即生理机能（70．0±20．9）分、生理职能（72．2±16．3）分、躯体疼痛（71．9±21．7）分、生活能力（68．7±18．2）分、总体健康状况（70．4±19．3）分、社会功能（69．5±20．4）分、情感职能（68．9±19．3）分、精神健康（72．6±19．7）分，均显著高于对照组相应维度得分的（62．2±18．7）、（66．3±18．8）、（65．7±15．2）、（62．6±17．4）、（62．9±14．9）、（63．5±14．6）、（61．9±15．2）、（64．1±14．5）分，差异有统计学意义（t=2．220～3．291，P〈0．01或0．05）。干预前，2组间SAS和SDS得分比较差异无统计学意义（P〉0．05）；干预后，观察组SAS（37．3±10．8）分，SDS（36．8±10．6）分，均显著低于对照组的（41．0±11．6）、（41．3±12．7）分，差异有统计学意义（t=2．215、2．581，P〈0．05）。观察组治疗总有效率为88．9％（80／90），显著高于对照组的73．3％（66／90），差异有统计学意义（χ^2=7．420，P=0．024）。聚焦解决模式是UC治疗显效侑效的影响因素（χ^2=7．107，P=0．008）。结论聚焦解决模式能明显改善UC患者生命质量，有效缓解其焦虑抑郁情绪，显著提高治疗疗效，临床应用价值高。

Objective To investigate the application value of solution focused brief therapy in the caring of patients with ulcerative colitis （UC）. Methods A total of 180 active UC patients were assigned into control group （90 cases） and observation group （90 cases） using random number table. The two groups were given continuous nursing. For the observation group, the patients received the intervention of solution- focused brief therapy. SF-36 Health Survey （SF-36）, Self-rating Anxiety Scale （SAS）, Self-rating Depression Scale （SDS） and treatment efficacy rate before and after the interventions were compared between the two groups. Univariate analysis was used to determine the related factors of effective treatment of UC. Results Before the intervention, there was no significant difference in the eight scales of SF-36 between the two groups （P 〉 0.05）. After the intervention, the eight scales of SF-36, ie, physical functioning, role limitations due to physical health problems, bodily pain, vitality, general health, social functioning, role limitations due to emotional health problems, and mental health were （70.0±20.9）, （72.2± 16.3）, （71.9± 21.7）, （68.7 ± 18.2）, （70.4±19.3）, （69.5±20.4）, （68.9± 19.3）, （72.6 ± 19.7） points in the observation group, and （62.2 ±18.7）, （66.3±18.8）, （65.7 ±15.2）, （62.6±17.4）, （62.9 ± 14.9）, （63.5 ± 14.6）,（61.9± 15.2）, （64.1 ± 14.5） points in the control group, and there was significant difference between the two groups （t=2.220-3.291, P〈0.01）. Before the intervention, there was no significant difference in SAS and SDS between the two groups（P 〉 0.05）. After the intervention, SASand SDS was （37.3±10.8）, （36.8±10.6） points in the observation group and （41.0± 11.6）, （41.3±12.7） points in the control group, and there was significant difference between the two groups （t=2.215, 2.581, P〈0.05） . The efficacy rate was 88.9% （80/ 90） in the observation group, and 73.3%（66/90） in the control group, and there was significant difference between the two groups 0（2=7.420, P=0.024）. Solution focused brief therapy was the related factor of effective treatment in UC patients （X2=7.107, P=0.008）. Conclusions Solution focused brief therapy could improve the quality of life, reduce anxiety and depression, and increase the treatment efficacy in patients with UC, which was an effective intervention method with clinical application value.