个性化心理干预对降低尘肺病患者心理痛苦程度及改善其生活质量的作用

Effects of personalized psychological intervention on reducing psychological distress and improving quality of life of patients with pneumoconiosis

目的了解个性化心理干预对降低尘肺病患者心理痛苦程度及改善其生活质量的作用。方法于2014年6月-2017年7月对重庆市三峡中心医院收治的尘肺病患者63例进行调查,根据患者意愿分为研究组与对照组,研究组给予个性化心理干预,对照组给予常规住院护理,直至患者出院。干预前后采用心理困扰温度计量表(DT)比较两组心理痛苦情况,使用医院焦虑抑郁量表(HADS)评估患者焦虑、抑郁情况,出院后随访6个月,采用12条目简短生命质量量表(SF-12)评估患者生命质量。结果干预后对照组痛苦尺度由重到轻依次有4、10、14例,显著高于研究组2、6、27例(Z=1.996,P<0.05);引起痛苦的问题分析,研究组生命担忧、睡眠、紧张、无精力、家庭不和谐构成比均显著低于对照组(χ2=7.754、6.185、8.229、5.239、6.185,均P<0.05);出院时对照组抑郁评分(12.5±4.7)、焦虑评分(13.6±3.2),均显著高于研究组(10.1±3.2、10.7±3.6),差异均有统计学意义(t抑郁=2.405、t焦虑=3.356,均P<0.05);随访6个月,对照组生理健康(40.2±9.7)与研究组(42.5±9.3)比较,差异无统计学意义(t=0.957,P>0.05),心理健康(53.5±8.4)显著低于研究组(58.6±8.6),差异有统计学意义(t=2.363,P<0.05)。结论个性化心理干预是促进尘肺病患者心理健康的重要一步,可有效减轻其心理痛苦,使其恢复心理健康。

Objective To investigate the effects of personalized psychological intervention on reducing the psychological distress and improving quality of life of patients with pneumoconiosis.Methods 63 pneumoconiosis patients who were admitted to Chongqing Three Gorges Central Hospital were enrolled in the study between June 2014 and July 2017.They were divided into the study group and the control group according to the patient’s wishes.The study group was given personalized psychological intervention,and the control group was given routine institutional care,till the patient was discharged.The psychological distress was compared between the two groups with the distress thermometer(DT),and the anxiety and depression symptoms of patients were evaluated with the hospital anxiety scale(HADS)before and after the intervention.The patients were followed up for six months after discharge,and their quality of life was evaluated with the 12-Item Short Form Health Survey(SF-12).Results After intervention,the numbers of patients with severe,moderate and mild DT in the control group(4,10 and 14 cases)were significantly larger than those in the study group(2,6 and 27 cases)(Z=1.996,P<0.05).For causes of distress,the composition ratios of worrying about life,sleep,stress,lack of energy,and family disharmony in the study group were significantly lower than those in the control group(χ2=7.754,6.185,8.229,5.239,6.185,all P<0.05).The depression score(12.5±4.7)and anxiety score(13.6±3.2)of the control group at discharge were significantly higher than those of the study group(10.1±3.2,10.7±3.6),the diference was statistically significant(tdepression=2.405,tanxiety=3.356,both P<0.05).During the six months of follow-up,there was no significant difference in physical health between the control group(40.2±9.7)and the study group(42.5±9.3)(t=0.957,P>0.05),but the mental health score of the control group(53.5±8.4)was significantly lower than that of the study group(58.6±8.6),the diference was statistically significant(t=2.363,P<0.05).Conclusion Personalized psychological intervention plays an important role in promoting the mental health of patients with pneumoconiosis.It can effectively alleviate the psychological distress and restore the mental health of patients.