行为习惯逆转疗法结合家属参与健康教育模式在老年瘙痒症病人护理中的应用

Application of habit reversal therapy combined with family participation health education model in nursing of patients with senile pruritus

[目的]探讨行为习惯逆转疗法(HRT)结合家属参与健康教育模式对老年性皮肤瘙痒症(SP)病人搔抓行为、皮肤瘙痒症状、焦虑、抑郁、生活质量的影响。[方法]选择2018年1月—2019年5月老年科收治的142例SP病人,随机分为两组各71例。对照组给予12周的常规健康教育和心理干预,观察组给予12周的HRT结合家属参与健康教育模式干预。观察两组病人干预后搔抓次数及中重度瘙痒、新增皮肤破损、皮肤感染发生情况,采用皮肤瘙痒症综合评价量表、焦虑自评量表(SAS)、抑郁自评量表(SDS)、皮肤病生活质量指数(DLQI)进行测评。[结果]干预后观察组瘙痒症状总分为(5.48±0.43)分,对照组瘙痒症状总分为(7.94±0.69)分,两组比较差异有统计学意义(P<0.05);干预后观察组搔抓次数及中重度瘙痒、新增皮肤破损、皮肤感染发生情况均低于对照组(P<0.05),瘙痒程度、累及部位、瘙痒频率评分、SAS评分、SDS评分、DLQI评分均低于对照组(P<0.05)。[结论]HRT结合家属参与健康教育模式可改善SP病人搔抓行为和临床症状,减轻焦虑、抑郁程度,提高其生活质量。

Objective:To explore the effect of behavioral habit reversal therapy(HRT)combined with family participation in health education on scratching behavior,skin pruritus symptoms,anxiety,depression,and quality of life in patients with senile pruritus(SP).Methods:A total of 142 SP patients admitted to the Department of Geriatrics from January 2018 to May 2019 were selected and randomly divided into two groups with 71 cases in each group.The control group received 12 weeks of regular health education and psychological intervention,and the observation group received 12 weeks′intervention of HRT combined with family members′participation in health education mode.Observe the number of scratches and the occurrence of moderate to severe itching,new skin breaks,and skin infections after the intervention.Pruritus Comprehensive Evaluation Scale,Self-Rating Anxiety Scale(SAS),and SelfRating Depression Scale(SDS),and Dermatology Life Quality Index(DLQI)were used for evaluation.Results:After the intervention,the total score of pruritus in the observation group was(5.48±0.43)points,and(7.94±0.69)points in the control group.The difference between the two groups was statistically significant(P<0.05).After the intervention,the number of scratches and the occurrence of moderate to severe itching,new skin damage,and skin infection in the observation group were lower than those in the control group(P<0.05);the degree of itching,involved location,itching frequency score,SAS score,SDS score,and DLQI score were all lower than those in the control group(P<0.05).Conclusions:HRT combined with family participation health education model could relieve the scratching behavior and clinical symptoms of SP patients,reduce anxiety and depression,and improve their quality of life.