运动引导想象训练对脑卒中后病人焦虑、抑郁和疼痛的影响

Effect of moter-guided imagery training on anxiety,depression and pain in patients after stroke

[目的]探讨运动引导想象训练对脑卒中后病人焦虑、抑郁和疼痛的影响。[方法]选取2017年8月—2018年6月神经内科收治的脑卒中后存在焦虑、抑郁情绪和疼痛感的病人100例,采用随机数字表法将其分为对照组(n=50)和观察组(n=50)。对照组在常规护理基础上倾听《Spring》混合《海浪的声音》音频,观察组在对照组基础上进行运动引导想象训练。干预前、干预2周后、干预6周后采用医院焦虑抑郁量表(HADS)测评病人情绪状态,采用视觉模拟评分法(VAS)测评病人疼痛情况。[结果]干预2周后和干预6周后,观察组病人HADS总分分别为(12.92±2.58)分、(7.26±4.49)分;对照组病人HADS总分分别为(18.44±2.94)分、(12.24±5.34)分,两组比较差异均有统计学意义(P<0.001),重复测量方差分析结果显示时间效应、组间效应及交互效应均有统计学意义(P<0.001);干预2周后和干预6周后,两组焦虑评分、抑郁评分和VAS评分比较,差异均有统计学意义(P<0.01或P<0.001),重复测量方差分析结果显示时间效应、组间效应及交互效应均有统计学意义(P<0.05或P<0.001)。[结论]运动引导想象训练有助于改善脑卒中后病人的焦虑、抑郁情绪,减轻病人的疼痛程度。

Objective:To probe into effects of moter-guided imagery training on anxiety,depression and pain in patients after stroke.Methods:Total of 100 patients with anxiety,depression and pain after stroke,who were admitted to the department of neurology from August 2017 to June 2018,were randomly divided into the control group and the experimental group by using the random number table method,with 50 patients in each group.The control group received routine nursing and listened to the music,for example Spring and Sound of the Waves.While the experimental group received moter-guided imagery training therapy on the basis of control group.The Hospital Anxiety and Depression Scale(HADS)were used to evaluate emotional state.The Visual Analogue Scale(VAS)were used to evaluate pain degree before intervention,2 weeks after intervention and 6 weeks after intervention.Results:After 2 weeks and 6 weeks of intervention,total scores of HADS in observation group were 12.92±2.58 and 7.26±4.49,respectively.While total scores of HADS in control group were 18.44±2.94 and 12.24±5.34,respectively.Differences between two groups were statistically significant(P<0.001).Results of repeated measurement ANOVA showed that time effect,intergroup effect and interaction effect were statistically significant(P<0.001).The scores of HADS,anxiety,depression and VAS in the two groups were all different significantly(P<0.01 or P<0.001).Repeated ANOVA indicated that there were stastical differences among time effect,intergroup effect and interaction effect of above scores(P<0.05 or P<0.001).Conclusion:Moter-guided imagery training therapy can effectively improve the emotional state and relieve the the pain degree in patients after stroke.