叙事心理疗法对腹腔镜多囊卵巢综合征围手术期心理状态的影响

Effects of Narrative Psychotherapy on Psychological Status of Patients with Laparoscopic Polycystic Ovary Syndrome During Perioperative Period

目的：探讨叙事心理疗法对腹腔镜多囊卵巢综合征患者围手术期心理状态的影响。方法：以我院诊断为多囊卵巢综合征并予以腹腔镜术治疗的120例患者为研究对象,参照随机对照表分为对照组与观察组,每组各60例。患者均予以腹腔镜术治疗,其中对照组采用常规围手术期护理,观察组在对照组护理基础上加用叙事心理疗法护理,内容包括生理、心理及社会全方位心理疗法。干预前后采用Kolcaba舒适状况量表（GCQ）进行舒适度评估,改良症状自评量表（SCL-90）评价其心理变化,并采用抑郁自评量表（SDS）、焦虑自评量表（SAS）评估其负性心理情绪。结果：干预后对照组GCQ评分中生理、心理、精神、社会文化及环境均显著低于观察组（t生理=4.65,P〈0.01;t心理=2.19,P〈0.05;t精神=4.13,P〈0.05;t社会文化及环境=4.96,P〈0.05）;干预后观察组心理状况（t情绪波动=5.34,P〈0.01;t性格变化=6.88,P〈0.01;t角色认知冲突=3.29,P〈0.01）、行为习惯评分显著低于对照组（t睡眠紊乱=2.72,P〈0.01;t饮食不节=4.31,P〈0.01）;干预后对照组SAS、SDS均显著高于观察组（t=3.33,3.53;P〈0.05）。结论：叙事心理疗法可有效改善腹腔镜多囊卵巢法患者悲观、抑郁等负面情绪,通过倾诉、分析、引导等心理治疗,促使患者调节其生活方式,避免情绪波动,有助于手术治疗。

Objective： To explore the effect of narrative psychotherapy on the psychological status of patients with laparoscopic polycystic ovary syndrome during perioperative period. Methods： A total of 120 patients with polycystic ovary syndrome diagnosed by our hospital and treated by laparoscopy were selected for the study and randomly divided into the control group and the observation group,with 60 patients in each group. The patients were given the laparoscopy,and the control group was treated with conventional perioperative nursing and the observation group was given narrative psychotherapy on the basis of the nursing in the control group,including physical,psychological and social all-round psychotherapy. Before and after intervention,the Kolcaba comfort status scale（ GCQ） was used to evaluate the comfort,and the SCL-90（ symptom checklist 90） was used to evaluate the psychological changes and the self-rating depression scale（ SDS） and the self-rating anxiety scale（ SAS） were used to assess the negative emotions.Results： The GCQ scores in physiological,psychological,spiritual,social culture and environment aspects after intervention were（ 24. 9 ± 2. 5） points,（ 21. 8 ± 1. 9） points,（ 22. 4 ± 2. 1）points,（ 21.9± 2. 0） points respectively in the control group,which were significantly lower than those in the observation group with（ 26.9±2.2） points,（ 26.9±2.2） points,（ 20.7±2.4） points,（ 23.9±2.4） points respectively（ t = 4.65,2.19,4.13,4.96; P〈0.05）.After intervention,the scores of psychological status（ t = 5. 34,6. 88,3. 29; P〈0. 01） and behavior habit（ t = 2.72,4.31; P〈0.01） of the two groups were significantly lower than those before intervention,and the decreasing degree of the observation group was significantly higher than that of the control group（ P〈0.05）.After intervention,the scores of SAS,SDS in the control group and SAS（ t = 3.33,P〈0.05） and SDS（ t = 3.53,P〈0.05） in the observation group were significantly lower than those before intervention,and the scores of the observation group were significantly lower than those in the control group（ P〈0.05）.Conclusion： Narrative psychotherapy can effectively improve the pessimistic,depressive and other negative emotions of patients with laparoscopic polycystic ovary syndrome. The talking,analysis,guidance and other psychological treatment can promote patients to adjust their lifestyle and avoid mood fluctuations,which is helpful for surgery.