结构式心理干预对急性心肌梗死介入治疗患者疾病不确定感、心理状态及预后的影响

Effect of structural psychological intervention on disease uncertainty,psychological status and prognosis of patients with acute myocardial infarction after interventional therapy

目的:探讨结构式心理干预对急性心肌梗死介入治疗患者疾病不确定感、心理状态及预后的影响。方法:选取本院收治急性心肌梗死的患者120例,按随机表达法将患者分成对照组(60例)和研究组(60例)。患者均行冠脉介入术,对照组采用常规干预,研究组行结构式心理干预。对两组患者疾病不确定感、心理状态及预后情况进行分析。结果:冠脉手术前研究组患者与对照组患者的不明确性评分、复杂性评分和疾病不确定感差异均无统计学意义(P>0.05);术后研究组患者疾病不确定感总分、复杂性评分和不明确性评分均低于对照组,差异显著(t=-7.420,-5.195,-4.444;P<0.001),同组患者术前与术后的复杂性评分、不明确性评分及疾病不确定感评分差异比较有统计学意义(t=-9.347,-14.417,-4.492,-8.548,-7.543,-14.342;P<0.001);对干预前后两组患者的心理状态情况进行观察,干预后,研究组的抑郁及焦虑状态改善情况明显优于对照组,有统计学差异(t=-9.008,-7.032;P<0.001);研究组手术成功率高于对照组,其再发恶性心律失常、心绞痛、再发心梗等心脏事件总发生率研究组低于对照组(8.33%VS30.00%),以研究组改善更为显著,比较有统计学意义(χ^2=7.500,P<0.01)。结论:对急性心肌梗死介入治疗患者行结构式心理干预,可显著降低术后再发心梗、心力衰竭等心脏事件的发生,增加患者对疾病和治疗的了解,降低患者对疾病的不确定感,缓解压抑、恐惧等不良情绪。

Objective:To investigate effect of structural psychological intervention on disease uncertainty,psychological status and prognosis of patients with acute myocardial infarction after interventional therapy.Methods:A total of 120 patients with acute myocardial infarction were selected and randomly divided into two groups,each with 60 cases.All patients underwent coronary intervention.The control group received routine intervention,while the study group received structured psychological intervention.Then the disease uncertainty,psychological status and prognosis of patients were analyzed between groups.Results:The ambiguity score,complexity score and disease uncertainty had no difference between groups before operation(P>0.05),which were lower in the study group than that in the control group after operation(t=-7.420,-5.195,-4.444;P<0.001).There were significant differences in the complexity score,ambiguity score and disease uncertainty score between the two groups before and after operation(t=-9.347,-14.417,-4.492,-8.548,-7.543,-14.342;P<0.001).The amelioration of the depression and anxiety symptoms in the study group were significantly better than that in the control group after operation(t=-9.008,-7.032;P<0.001).The success rate of operation in the study group was higher than that in the control group.The total incidence of recurrent malignant arrhythmia,angina pectoris and recurrent myocardial infarction in the study group was lower than that in the control group(8.33% VS 30.00%;χ^2=7.500,P<0.01).Conclusion:The application of structural psychological intervention can effectively reduce the occurrence of cardiac events such as recurrent myocardial infarction and heart failure,increase awareness rate of disease and treatment,reduce patients’ disease uncertainty,alleviate depression,fear and other adverse emotions for patients with acute myocardial infarction after interventional therapy.