ADOPT问题解决模式的心理干预对慢性酒精性肝病患者戒酒情况、心理弹性及适应能力的影响

Effect of psychological intervention of ADOPT problem-solving model on alcohol withdrawal,mental flexibility and adaptability in patients with chronic alcoholic liver disease

目的探讨ADOPT问题解决模式的心理干预对慢性酒精性肝病(alcoholic liver disease,ALD)患者戒酒情况、心理弹性及适应能力的影响。方法选取慢性ALD患者142例作为研究对象,依据入院时间顺序分为对照组和研究组,每组71例。对照组予以常规护理干预,研究组在对照组基础上施行ADOPT问题解决模式的心理干预。比较2组干预前后酒精依赖性[参照密歇根酒精依赖性(michigan alcoholism screening test,MAST)量表评估]、Barratt冲动性、自我效能[参照自我效能感(general self efficacy scale,GSES)量表评估]、心理弹性[参照心理弹性(connor-Davidson resilience scale,CD-RISC)量表评估,包括坚韧、乐观、自强3个维度]、适应能力[参照社会心理适应能力(psychosocial adaptability scale,SPAS)量表评估,包括持续担忧、接受程度、积极的生活态度3个维度]、戒酒依从性及护理满意度。结果干预后,2组MAST、Barratt冲动性评分低于干预前,研究组MAST、Barratt冲动性评分低于对照组(P<0.05)。2组GSES评分均呈升高趋势,研究组GSES评分高于对照组,组间、时点间、组间·时点间交互作用差异有统计学意义(P<0.05)。干预后,2组CD-RISC评分的坚韧、乐观、自强评分高于干预前,研究组CD-RISC评分的坚韧、乐观、自强评分高于对照组(P<0.05)。干预后,2组SPAS评分的持续担忧、接受程度、积极的生活态度评分高于干预前,研究组SPAS评分的持续担忧、接受程度、积极的生活态度评分高于对照组(P<0.05)。研究组戒酒依从率、护理满意度高于对照组,差异有统计学意义(P<0.05)。结论ADOPT问题解决模式的心理干预可提高慢性ALD患者自我效能、心理弹性及适应能力,降低酒精依赖性及冲动性,患者戒酒依从率及护理满意度高。

Objective To explore the effect of psychological intervention of ADOPT problem-solving model on alcohol withdrawal,mental flexibility and adaptability in patients with chronic alcoholic liver disease(ALD).Methods A total of 142 patients with chronic ALD were selected as the research subjects,and were divided into control group(n=71)and research group(n=71)according to the order of admission.The control group received routine nursing intervention,and on this basis,the research group was supplemented with psychological intervention of the ADOPT problem-solving model.The alcohol dependence[Michigan alcoholism screening test(MAST)scale evaluation],Barratt impulsivity,self-efficacy[referring to general self efficacy scale(GSES)evaluation],psychological resilience[connor-Davidson resilience scale(CD-RISC)assessment,including the three dimensions of toughness,optimism,and self-improvement],and psychosocial adaptability[psychosocial adaptability scale(SPAS)evaluation,including three dimensions of continuous worry,acceptance,and positive attitude towards life]scores and alcohol compliance and nursing satisfaction before and after intervention of the two groups were compared.Results After the intervention,the MAST and Barratt impulsivity scores of the research group were lower than those before intervention,and the above indicators were lower in the research group than in the control group(P<0.05).The GSES score was higher in both groups,which was higher in the research group than in the control group;there were significant difference in interaction between groups,time points,and time points between groups(P<0.05).After the intervention,the CD-RISC scores of toughness,optimism,and self-improvement were higher than those before the intervention,which were higher in the research group than in the control group(P<0.05).After the intervention,the SPAS scores of continuous worry,acceptance,and positive attitude towards life were higher than those before the intervention,which were higher in the research group than in the control group(P<0.05).The alcohol compliance rate and nursing satisfaction were higher in the research group than in the control group(P<0.05).Conclusion The psychological intervention of the ADOPT problem-solving model can improve the self-efficacy,mental flexibility and adaptability of chronic ALD patients,reduce alcohol dependence and impulsivity,and have a high rate of compliance with alcohol withdrawal and nursing satisfaction.