脑心健康管理师介入干预对老年急性缺血性脑卒中患者应对方式和希望水平的影响

Effect of Interventions by Brain and Heart Health Managers on Coping Style and Hope Level of the Elderly with Acute Ischemic Stroke

目的探讨脑心健康管理师介入干预对老年急性缺血性脑卒中(acute ischemic stroke,AIS)患者的应对方式和希望水平的影响,为防治AIS提供方法。方法选取2018年12月-2019年5月在绵阳市第三人民医院诊治的老年AIS患者194例,按照入院建档顺序分为对照组(n=97)与观察组(n=97)。对照组施行神经内科常规干预,观察组在与对照组相同干预的基础上增设脑心健康管理师介入干预,2组均干预至患者出院后1个月。在干预前后对2组分别采取SAS评分、SDS评分、CSQ评分、HHI评分和NIHSS评分评估并比较焦虑程度、抑郁程度、应对方式、希望水平和预后情况,同时比较2组治疗及随访依从性。结果(1)干预后观察组SAS和SDS分值均明显低于对照组(P<0.05)。(2)干预后2组合理化分值差异无统计学意义(P>0.05),但观察组解决问题和求助分值均明显高于对照组,幻想、回避和自责分值均低于对照组(P<0.05)。(3)干预后观察组看待现实及未来的积极态度、采取的积极行动和同他人维系的亲密关系分值均明显高于对照组(P<0.05)。(4)干预期间观察组治疗及随访依从性优于对照组(P<0.05)。(5)观察组预后情况优于对照组(P<0.05)。结论脑心健康管理师介入干预能显著缓解老年AIS患者焦虑和抑郁情绪,提高积极应对方式,减少消极应对方式,且能有效增强患者希望水平,提高治疗及随访依从性,改善预后效果,具有一定的临床应用价值。

Objective To discuss the effect of interventions by brain and heart health managers on the coping style and hope level of the elderly with acute ischemic stroke(AIS).Methods 194 elderly patients with AIS hospitalized during the period from Dec.,2018 to May,2019 were selected and divided,according to the sequence of admission,into 2 groups:control group(n=97) and research group(n=97);routine intervention of neurology was provided to the elderly in both groups while interventions by brain and heart managers was added to the elderly in research group;interventions lasted till 1 month after discharge;before and after intervention,SAS,SDS,CSQ,HHI and NIHSS were applied to all the elderly and a comparative study was made in anxiety,depression,coping style,hope level,prognosis and the treatment and follow-up compliance between the 2 groups.Results After intervention,the SAS and SDS scores of the elderly in research group were lower than those in control group(P<0.05);no statistical difference was found in rationalization scores between the 2 groups(P>0.05),the scores of problem-solving and help-seeking were higher while the scores of fantasy,avoidance and self-blame were lower in research group than those in control group(P<0.05);the scores of positive attitude towards reality and future,positive action and intimate relationship with others were higher in observation group than those in control group(P<0.05);during the intervention,the treatment and follow-up compliance of the elderly in observation group was superior to that in control group(P<0.05);the prognosis of the elderly in observation group was better than that of the elderly in control group(P<0.05).Conclusions Brain and heart health administrator intervention can significantly alleviate anxiety and depression in elderly patients with AIS,improve positive coping style and hope level,reduce negative coping style,and effectively enhance the level of hope of patients,improve treatment and follow-up compliance,and promote the prognosis.