团体认知疗法配合心理支持在维持性血液透析患者的应用及对心理韧性、希望水平和生存质量的影响

Application of group cognitive therapy combined with psychological support in MHD patients and its influence on psychological resilience,hope level and quality of life

目的:探究团体认知疗法配合心理支持在维持性血液透析(MHD)患者的应用及对心理韧性、希望水平和生存质量的影响。方法:选择某院收治的114例维持性血液透析患者,并以随机数字表法均分为对照组(n=57)与干预组(n=57),对照组患者予以心理支持干预,干预组患者在对照组基础上予以团体认知疗法干预。于干预前、干预6个月后比较两组患者生化指标、压力水平、心理韧性、希望水平以及生存质量的差异。结果:干预6个月后,干预组尿素氮(t=4.99,P<0.05)水平均显著低于对照组;干预6个月后,干预组患者生理压力源(t=3.15,P<0.05)、心理压力源(t=3.14,P<0.05)、社会压力源(t=2.033,P<0.05)3个维度评分及HSS量表总分(t=4.83,P<0.05)均显著低于对照组;干预6个月后,干预组患者坚韧(t=4.66,P<0.05)、力量(t=3.08,P<0.05)、乐观(t=8.27,P<0.05)3个维度评分均显著高于对照组;干预6个月后,干预组患者积极的行动(t=4.04,P<0.05)、对现实和未来的积极态度(t=5.61,P<0.05)、与他人保持亲密关系(t=3.46,P<0.05)3个维度评分均显著高于对照组;干预6个月后,干预组干预后的生存质量评分高于对照组(t=4.001,P<0.05)。结论:对MHD患者应用团体认知疗法配合心理支持干预能够改善患者血清生化指标,降低压力水平,增加患者心理韧性,提高患者希望水平,改善生存质量。

Objective:To explore the application of group cognitive therapy combined with psychological support in MHD patients and its influence on psychological resilience, hope level and quality of life.Methods:A total of 114 patients with maintenance hemodialysis in our hospital were randomly divided into control group(n=57)and intervention group(n=57).Patients in control group were given psychological support intervention, while patients in intervention group were given group cognitive therapy intervention on the basis of control group.The differences of biochemical indexes, stress level, psychological resilience, hope level and quality of life between the two groups were compared before intervention and 6 months after intervention.Results:After 6 months of intervention, the levels urea nitrogen(t=4.99,P<0.05)in the intervention group were significantly lower than those in the control group.Six months after the intervention, the patients in the intervention group scored lower than the control group in physiological stressors(t=3.15,P<0.05),psychological stressors(t=3.14,P<0.05),social stressors(t=2.033,P<0.05)and the total score of HSS scale(t=4.83,P<0.05);After 6 months of intervention, the scores of tenacity(t=4.66,P<0.05),strength(t=3.08,P<0.05)and optimism(t=8.27,P<0.05)in the intervention group were significantly higher than those in the control group.After 6 months of intervention, patients in the intervention group scored significantly higher in active action(t=4.04,P<0.05),positive attitude towards reality and future(t=5.61,P<0.05),and close relationship with others(t=3.46,P<0.05)than the control group.After 6 months of intervention, the quality of life score of intervention group was higher than that of control group(t=4.00,P<0.05).Conclusion:The application of group cognitive therapy combined with psychological support intervention in MHD patients can improve serum biochemical indexes, reduce stress level, increase psychological resilience, improve hope level and improve quality of life.