认知行为干预对慢性乙型肝炎患者遵医行为、自我效能及生活质量的影响

Effect of cognitive-behavioral intervention on compliance behavior,self-efficacy and quality of life of patients with chronic hepatitis B

目的:探讨基于认知行为干预对慢性乙型肝炎(chronic hepatitis B,CHB)患者遵医行为、自我效能及生活质量影响。方法:选取2017年1月-2019年2月在某院进行治疗的70例CHB患者作为研究对象,随机分为观察组和对照组各35例,对照组给予常规干预治疗,观察组在对照组基础之上给予基于认知行为干预,两组患者均治疗6周。统计两组患者干预前后遵医行为总遵从率,采用我效能感量表(general self-efficacy scale,GSES)、Connor-Davidson韧性量表(Connor-Davidson resilience scale,CD-RISC)、生活质量评估量表(Medical Outcomes Study Short-Form 36,SF-36)、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)分别对两组患者干预前后自我效能、心理韧性、生活质量、焦虑及抑郁水平进行评估。结果:干预后,观察组患者总遵从率明显高于对照组(Z=2.074,P<0.05);干预后,观察组GSES及CD-RISC均明显高于对照组(t=3.499,4.045;P<0.05);干预后,观察组综合健康状况、躯体功能、角色受限、机体疼痛、心理健康、社会性功能各维度评分均明显高于对照组(t=4.987,2.533,3.791,2.630,2.118,4.527;P<0.05);干预后,观察组SAS评分低于对照组(t=3.212,P<0.05)。结论:基于认知行为干预可以提高患者遵医行为、自我效能、心理韧性及生活质量并降低患者心中焦虑和抑郁水平。

Objective:To explore the effect of cognitive-behavioral intervention on compliance behavior,self-efficacy and quality of life in patients with chronic hepatitis B(CHB).Methods:A total of 70CHB patients treated in our hospital from January 2017to February 2019were selected as research objects,and were randomly divided into observation group and control group with 35cases in each group.The control group was given routine intervention treatment,while the observation group was given cognitive and behavioral intervention based on the control group.Both groups were treated for 6weeks.The general self-efficacy scale(GSES),Connor-Davidson resilience scale(CD-RISC),Medical Outcomes Study Short-Form 36(SF-36),self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were used to evaluate the self-efficacy,resilience,anxiety and depression of the patients before and after intervention.Results:After intervention,the total compliance rate of patients in the observation group was significantly higher than that in the control group(Z=2.074,P<0.05).After intervention,GSES and CD-RISC in the observation group were significantly higher than those in the control group(t=3.499,4.045;P<0.05).After intervention,the scores of comprehensive health status,somatic function,role limitation,body pain,mental health,and social function in the observation group were significantly higher than those in the control group(t=4.987,2.533,3.791,2.630,2.118,4.527;P<0.05);After intervention,SAS scores in the observation group were lower than those in the control group(t=3.212,P<0.05).Conclusion:Cognitive-behavioral intervention can improve patients’compliance behavior,self-efficacy,psychological resilience and quality of life,and reduce patients’anxiety and depression levels.