精神分裂症患者自我病耻感与病耻抵抗的影响因素及基于“积极心理学理论”的护理效果分析

Influencing factors of self shame and shame resistance in schizophrenics and the analysis of nursing effect based on the theory of positive psychology

目的探究精神分裂症患者自我病耻感与病耻抵抗的影响因素及基于"积极心理学理论"的护理效果分析。方法选取精神分裂症患者90例,按护理方式的不同分为对照组和观察组,各45例。对照组给予常规护理干预治疗,观察组在此基础上给予积极心理学理论指导的心理干预,2组均连续治疗2周。统计2组干预前后ISMI评分的差异。结果患者有抑郁,既往住院次数≥3次,病程>5年,生存质量差,BPRS评分≥35分,无家属照顾等ISMI标准分均较高(P<0.01);经过多因素Logistic回归分析,抑郁、住院次数、病程、生存质量、BPRS评分以及无家属照顾为精神分裂症患者自我病耻感的危险因素(P<0.05);干预后2组的ISMI评分均显著降低(P<0.05),且观察组低于对照组(P<0.01)。结论影响精神分裂症患者自我病耻感与病耻抵抗的因素较多,根据相关因素实施基于"积极心理学理论"的心理干预可显著降低患者自我病耻感,增强病耻抵抗能力,改善患者精神状态及社会功能,提高积极应对能力,值得临床推广应用。

Objective To explore the influencing factors of self-stigma and stigma resistance in schizophrenia patients and to analyze the nursing effect based on the theory of positive psychology.Methods A total of 90 cases of patients with schizophrenia were selected.The patients were divided into control group and observation group according to different nursing methods,45 cases each.The control group received conventional nursing intervention treatment,and the observation group received psychological intervention guided by positive psychology theory on this basis.Both groups received continuous treatment for 2 weeks.The difference of ISMI score between the two groups before and after intervention was calculated.Results The patients had depression,had been hospitalized more than three times in the past,had a course of more than five years,had poor quality of life,had a BPRS score of more than 35,and had no family care,and had a higher ISMI standard score(P<0.01).After multiariable Logistic regression analysis,depression,hospitalization time,duration,quality of survival,BPRS scores and no families to take care of self for schizophrenia patients disease shame of risk factors(P<0.05).Compared with before intervention,the total score of value negation,discrimination experience,social withdrawal,stereotype identification,stigma resistance and ISMI standard score in both groups were significantly reduced after intervention(P<0.05),and the observation group was lower than the control group(P<0.01).Conclusion There are many factors affecting self-stigma and stigma resistance of schizophrenic patients.Psychological intervention based on"positive psychology theory"according to relevant factors can significantly reduce patients’self-stigma,enhance stigma resistance,improve their mental state and social function,and improve their positive coping ability,which is worthy of clinical promotion and application.