自我决定理论的康复干预模式对重症烧伤患者心理状况、功能恢复及生活质量的影响

Effects of rehabilitation intervention mode based on self-determination theory on psychological status,functional recovery and quality of life of patients with severe burns

目的:探讨基于自我决定理论的康复干预模式在重症烧伤患者中的应用及对患者心理状况、功能恢复及生活质量等的影响。方法:选择2017年1月-2018年11月104例重症烧伤患者为研究对象,采用随机数字表法分成观察组和对照组各52例,对照组康复期进行常规心理干预及康复训练,观察组在对照组基础上以自我决定理论为指导进行干预,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评价患者干预前、干预后3个月心理状况,采用社会支持评定量表(SSRS)评价患者干预前、干预后3个月社会支持水平;干预后6个月,评价患者功能恢复效果,并采用简明烧伤健康量表(BSHS-A)评价患者生活质量。结果:干预后3个月,观察组患者SAS、SDS评分均显著低于对照组(t=-8.458,-6.386;P<0.05),SSRS评分中客观支持、主观支持、支持利用度及总分均显著高于对照组(t=4.101,3.979,3.452,5.863;P<0.05)。干预后6个月,观察组患者功能恢复优良率73.08%,高于对照组的53.85%,差异有统计学意义(χ^2=4.147,P<0.05);观察组患者BSHS-A中躯体功能、心理健康、社会活动、一般健康各维度及总分均显著高于对照组(t=2.810,3.274,2.731,4.103,4.699;P<0.05)。结论:基于自我决定理论的康复干预模式可改善重症烧伤患者心理状态,从而有利于促进患者功能恢复,改善患者生活质量。

Objective:To explore the application of rehabilitation intervention mode based on self-determination theory in patients with severe burns and its effects on psychological status,functional recovery and quality of life of patients.Methods:A total of 104 patients with severe burns from January 2017 to November 2018 were selected for the study.They were divided into observation group and control group by random number table method,with 52 cases in each group.Control group was given routine psychological intervention and rehabilitation training during rehabilitation,and observation group was given intervention treatment under the guidance of the self-determination theory on the basis of the control group.The psychological status of the patients before intervention and at 3 months after intervention were evaluated by Self-rating Anxiety Scale(SAS)and Self-rating Depression Scale(SDS).The Social Support Rating Scale(SSRS)was used to evaluate the social support level before intervention and at 3 months after intervention,and the functional recovery effects were evaluated at 6 months after intervention.The quality of life of the patients was evaluated by Burn Specific Health Scale-Brief(BSHS-A).Results:At 3 months after intervention,the scores of SAS and SDS in observation group were significantly lower than those in control group(t=-8.458,-6.386;P<0.05),and the scores of objective support,subjective support and support utilization and total score of SSRS scale in the observation group were significantly higher than those in control group(t=4.101,3.979,3.452,5.863;P<0.05).At 6 months after intervention,the excellent and good rate of functional recovery in observation group was higher than that in control group(73.08%vs 53.85%),which has significant difference(χ^2=4.147,P<0.05),and the scores of dimensions of physical function,mental health,social activities and general health and total score of BSHS-A in observation group were significantly higher than those in control group(t=2.810,3.274,2.731,4.103,4.699;P<0.05).Conclusion:The rehabilitation intervention mode based on self-determination theory can improve the psychological status of patients with severe burns,which is conducive to promote functional recovery and improve the quality of life of patients.