基于跨理论模型动机访谈对脑卒中患者创伤后应激障碍及健康行为改变阶段效果研究

Effect of Motivational Interviewing based on Trans-theoretical Model on Post-traumatic Stress Disorder and Health Behavior Changing of Stroke Survivors

目的评价基于跨理论模型(trans-theoretical model,TTM)的动机访谈(motivational interviewing,MI)在改善脑卒中患者创伤后应激障碍以及健康行为改变阶段的效果。方法选取60例住院脑卒中患者随机分为基于跨理论模型动机访谈组(TTM-MI)和对照组。针对其行为改变阶段实施不同心理干预策略,对照组给予常规住院教育,干预前后分别测评两组患者健康行为改变阶段以及创伤后应激障碍得分。结果干预后TTM-MI组行为改变阶段、健康行为评估得分与干预前比较差异有统计学意义(P<0.05)。干预后TTM-MI组患者的行为改变阶段明显改善,前意向阶段由43.33%降至3.33%,其健康行为和创伤后应激障碍得分均有显著下降,分别由34.96±10.91分降至23.23±9.68分,26.16±4.41分降至16.66±2.65分,较对照组改善明显(χ~2=-2.24,P<0.05)。结论基于TTM的动机访谈技术是一种有效的认知、行为改变方法,是促进脑卒中患者健康行为改变和积极应对疾病的有效措施。

Objective To evaluate the effectiveness the trans-theoretical model(TTM)with motivational interviewing(MI)method changing the stroke patients in healthy behaviors and post-traumatic stress disorder.Methods Sixty stroke patients in Zhengzhou were divided into TTM-MI and routine group randomly.TTM-MI group received the motivational interviewing based TTM model which implement different psychological intervention strategies according to their behavioral changes.The routine group was given normal education.The patients were evaluated by behavior stage and mental health phase.Results After intervention,the behavior changing and behavior scores in the experimental group were significantly improved than before and the control group(P﹤0.05).Conclusion The trans-theoretical model(TTM)with motivational interviewing(MI)method is a kind of effective technical to change cognition and behavior change stage in stroke patients.