求助者中心疗法对血液透析患者心理危机及应对方式的影响

Effect of helper center therapy on psychological crisis and coping style of hemodialysis patients

目的探讨求助者中心疗法对血液透析患者心理危机及应对方式的影响.方法将90例血液透析患者按随机数字表法分为两组,每组45例.对照组予以常规护理干预,观察组在对照组基础上予以求助者中心疗法,观察3个月.干预前后采用症状自评量表评定心理状态,医学应对问卷评定应对方式,社会支持评定量表评定社会支持度,生存质量量表评定生存质量纽卡斯尔护理满意度量表评定护理满意度.结果干预后观察组症状自评量表躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖、偏执、精神病性及其他因子评分均显著低于对照组(P<0.01);医学应对问卷屈服、回避维度评分均显著低于对照组(P<0.01),面对维度评分显著高于对照组(P<0.01);社会支持评定量表主观支持、客观支持、支持利用度评分均显著高于对照组(P<0.01);生存质量量表生理领域、社会关系领域、心理领域维度评分均显著高于对照组(P<0.05).观察组护理满意率(93.3%)显著高于对照组(71.1%)(P<0.01).结论求助者中心疗法应用于血液透析患者,可缓解或消除心理危机,增强社会适应能力,建立积极应对方式,改善生存质量,提高护理满意度.

Objective To explore the efect of helper center therapy on psychological crisis and coping style of hemodialysis patients.Methods 90 patients with hemodialysis were divided into two groups according to random number table method,45 cases in each group.The control group was given routine nursing in-tervention,and the observation group was given helper central therapy on the basis of the control group,all of them were observed for 3 months.Before and after the intervention,the Symptom checklist-90 was used to assess mental status,the Medical Coping Method Questionnaire was used to assess coping styles,the Social Support Rating Scale was used to assess social support,and the Quality of Life Scale was used to assess quality of life.The Newcastle Nursing Satisfaction Scale was used to assess nursing satisfaction.Results After intervention,the somatization,compulsion,interpersonal relationships,depression,anxie-ty,hostility,terror,paranoia,psychosis and other factors scores in SCL.90 of the observation group were significantly lower than the control group(P<0.01).The yielding and avoiding dimension scores in MC-MQ were significantly lower than the control group(P<0.01),and the face dimension score was signifi-cantly higher than the control group(P<0.01).The subjective support,objective support,and support utilization scores of the Social Support Rating Scale were significantly higher than those of the control group(P<0.01).The dimension scores in the physiological,social,and psychological fields of the quali-ty of life scale were significantly higher than those in the control group(P<0.05).The nursing satisfac-tion of the observation group(93.3%)was significantly higher than that of the control group(71.1%)(P<0.01).Conclusions Helper centered therapy ap-plied to hemodialysis patients can alleviate or eliminate psychological crisis,enhance social adaptability,establish positive coping styles,improve quality of life,and increase nursing satisfaction.