认知行为干预联合肌肉放松训练对IVF-ET病人心理应激及幸福感的影响

Effect of the cognitive behavioral intervention combined with muscle relaxation training on psychological stress level and well-being in patients treated with IVF-ET

目的:观察认知行为干预联合肌肉放松训练对行体外授精-胚胎移植(in-vitro fertilization and embryo transfer,IVF-ET)病人心理应激水平及幸福感的影响。方法:选择2017年5月至2018年7月行IVF-ET治疗的116例病人为研究对象,按照随机表法将病人分为对照组和观察组2组,各58例;对照组入院后给予常规治疗以及护理,观察组在对照组的基础上给予认知行为干预联合肌肉放松训练。在治疗前和治疗后(完成胚胎移植)使用焦虑自评量表(SAS)、抑郁自评量表(SDS)评价病人焦虑抑郁情绪,使用睡眠状况自评量表(SRSS)评估病人睡眠状况,采集病人静脉血使用化学发光法检测病人皮质醇水平;治疗后使用纽芬兰纪念大学幸福度量表(MUNSH)对病人幸福感进行评估,在治疗后1个月行超声检查,确认病人妊娠情况。结果:治疗前,2组SDS和SAS评分差异无统计学意义(P>0.05),治疗后,2组SDS和SAS评分均明显低于治疗前,且观察组SDS和SAS评分明显低于对照组(P<0.01)。治疗前2组睡眠质量比较差异无统计学意义(P>0.05),治疗后观察组睡眠质量明显优于对照组(P<0.01)。治疗前2组皮质醇水平比较差异无统计学意义(P>0.05),治疗后观察组皮质醇水平明显低于对照组(P<0.01)。观察组妊娠率高于对照组(P<0.05)。治疗后观察组MUNSH量表负性评分明显低于对照组,且正性评分以及总分均明显高于对照组(P<0.01)。结论:认知行为干预联合肌肉放松训练可有效减轻IVF-ET病人病人焦虑抑郁情绪,提升病人睡眠质量以及幸福感,有效降低心理应激水平,提高妊娠成功率。

Objective:To observe the effects of the cognitive behavioral intervention and muscle relaxation training on psychological stress level and well-being in patients treated with in-vitro fertilization and embryo transfer(IVF-ET).Methods:One hundred and sixteen patients treated with IVF-ET from May 2017 to July 2018 were were divided into the observation group and control group by random number table method(58 cases in each group).The control group was treated and nursed with routine method after admission.The observation group was treated with cognitive behavioral intervention and muscle relaxation training on the basis of the control group.Before and after treatment(completing embryo transfer),the anxiety and depression,and sleep condition in two groups were evaluated using self-rating anxiety scale(SAS)and self-rating depression scale(SDS),and self-rating scale of sleep(SRSS),respectively.The serum levels of cortisol in two groups were detected using chemiluminescent immunoassay.The well-being in two groups after treatment were assessed using Memorial University of Newfoudland Scale of Happiness(MUNSH),and the pregnancy in two groups after 1 month of treatment were identified using ultrasound examination.Results:Before treatment,the differences of the scores of SDS and SAS were not statistically significant between two groups(P>0.05).After treatment,the scores of SDS and SAS in two groups were significantly lower than those before intervention,and the SDS and SAS scores in observation group were significantly lower than those in control group(P<0.01).Before treatment,the difference of the sleep quality score was not statistically significant between two groups(P>0.05).After treatment,the sleep quality in observation group was significantly better than that in control group(P<0.01).Before treatment,the difference of the cortisol level was not statistically significant between two groups(P>0.05).After treatment,the cortisol level in observation group was significantly lower than that in control group(P<0.01).The pregnancy rate in observation group was higher than that in control group(P<0.05).The negative score of the MUNSH scale in observation group was significantly lower than that in control group,and the positive score and total score in obseravtion group were significantly higher than those in control group(P<0.01).Conclusions:The cognitive behavioral intervention combined with muscle relaxation training can effectively alleviate anxiety and depression,improve sleep quality and well-being,reduce psychological stress and improve pregnancy success rate in patients treated with IVF-ET.