基于聚焦解决模式的心理干预在高血压脑出血患者围手术期护理中的应用

Application of psychological intervention based on solution focused approach in perioperative nursing of patients with hypertensive cerebral hemorrhage

目的:探讨基于聚焦解决模式的心理干预在高血压脑出血(HICH)患者围手术期护理中的应用效果。方法:采用便利抽样法,选取2016年5月—2019年1月在郑州大学第一附属医院行微创血肿清除术治疗的HICH患者为研究对象。最终对照组纳入57例患者,观察组纳入61例患者。对照组给予常规心理干预,观察组在对照组基础上予以基于聚焦解决模式的心理干预。记录两组患者的住院时间、住院费用及护理服务期望与感知差距;比较两组患者干预前及干预2周后的焦虑情绪[状态焦虑量表(SAI)、特质焦虑量表调查(TAI)]、疾病不确定感[中文版Mishel疾病不确定感量表(MUIS)]和积极度[患者积极度量表(PAM)]。结果:观察组患者的住院时间、住院费用均低于对照组,差异有统计学意义(P<0.05)。观察组的护理服务期望与感知差距评分低于对照组,差异有统计学意义(P<0.05)。干预2周后观察组的SAI、TAI评分低于对照组,差异有统计学意义(P<0.05)。干预2周后观察组的MUIS评分低于对照组,PAM评分高于对照组,差异均有统计学意义(P<0.05)。结论:基于聚焦解决模式的心理干预在HICH患者围手术期的应用效果显著,能改善患者的焦虑、疾病不确定感等负性情绪,提高患者积极度,促进患者术后康复。

Objective:To explore the application effects of psychological intervention based on solution-focused approach in perioperative nursing of patients with hypertensive intracerebral hemorrhage(HICH).Methods:Using the convenient sampling method,HICH patients who underwent minimally invasive hematoma evacuation in the First Affiliated Hospital of Zhengzhou University from May 2016 to January 2019 were selected as the research objects.Finally,57 patients were included in the control group and 61 patients were included in the observation group.The control group was given routine psychological intervention,while the observation group was given psychological intervention based on solution-focused approach at basis of the control group.The length of hospital stay,hospital cost and nursing service expectation and perception gap were recorded.The anxiety[State Anxiety Inventory(SAI),Trait Anxiety Inventory(TAI)],disease uncertainty[Chinese version of Mishel's Uncertainty in Illness Scale(MUIS)]and activation[Patient Activation Measure(PAM)]were compared between the two groups before and 2 weeks after intervention.Results:The length of hospital stay and hospital cost of the observation group were both lower than those of the control group,and the differences were statistically significant(P<0.05).The nursing service expectation and perception gap score of the observation group was lower than those of the control group,and the difference was statistically significant(P<0.05).After 2 weeks of intervention,the SAI and TAI scores of the observation group were lower than those of the control group,and the differences were statistically significant(P<0.05).After 2 weeks of intervention,the MUIS score of the observation group was lower than that of the control group,and the PAM score was higher than that of the control group,the differences were statistically significant(P<0.05).Conclusions:The application of the psychological intervention based on solution-focused approach in the perioperative period of HICH patients has a significant effect,which can improve anxiety,disease uncertainty and other negative emotions of patients,improve their positive degree and promote postoperative rehabilitation.