认知与情感干预对妇科腹腔镜术后患者心理健康及康复的影响

Effects of cognitive and affective intervention on mental health and rehabilitation of gynecological patients received laparoscopic surgery

目的探讨认知与情感干预对妇科腹腔镜手术患者心理健康和康复效果的影响。方法妇科腹腔镜患者80例,按入院顺序编号,单号40例为对照组、采取常规模式干预,双号的40例为观察组、实施认知与情感干预,两组均干预3周;于干预前1天及干预后第2天时采用自我负担感量表(SPBS)和压力应激量表(PSS)评估患者的心理负担与应激状况、焦虑自评量表(SAS)和抑郁自评量表(SDS)评估患者负性情绪、心理弹性量表(CD-RISC)评估患者的心理弹性;记录两组患者术后首次排气、下床时间和住院时间;采用世卫组织生活质量简表(WHOQOL-BREF)对患者的生活质量进行评分。结果干预后观察组患者SPBS、PSS、SAS、SDS评分均明显低于对照组(P<0.05),CD-RISC各维度评分明显高于对照组(P<0.05),观察组首次排气时间、首次下床时间和住院时间均明显短于对照组(P<0.05),观察组WHOQOL-BREF量表各维度评分明显高于对照组(P<0.05)。结论认知与情感干预妇科腹腔镜手术患者能有效减轻患者的心理负担与应激反应,改善心理状态和心理弹性水平,并有助于提高生活质量,促进术后康复。

Objective To investigate the effect of cognitive and affective intervention on mental health and rehabilitation of patients received gynecological laparoscopic surgery.Methods A total of 80 gynecological laparoscopic patients were selected and numbered according to the time of admission to hospital.Forty patients(odd number)as control group for routine intervention,40 patients(even number)as observation group for cognitive and affective intervention,both groups received intervention for three weeks.On Day 1 before intervention and Day 2 after the intervention,the self-perceived burden scale(SPBS)and the perceived stress scale(PSS)were used to evaluate patients'psychological burden and stress response;self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were adopted to evaluate negative emotions of patients,and the resilience of patients was assessed by the connor-davidson resilience scale(CD-RISC).The first postoperative discharging gas,the time of getting off bed and the length of hospital stay were recorded in both groups.WHO quality of life-BREF(WHOQOL-BREF)was used to score patients'quality of life.Results After intervention,the scores of SPBS,PSS,SAS,and SDS in observation group were significantly lower than those of control group(P<0.05).The CD-RISC scores of observation group was significantly higher than that of control group(P<0.05).The first gas discharge time,first time to get off bed and hospital stay in the observation group were significantly shorter than those of control group(P<0.05).The score of WHOQOL-BREF in the observation group was significantly higher than that of control group(P<0.05).Conclusion Cognitive and affective intervention can effectively reduce the psychological burden and stress response of patients received gynecological laparoscopic surgery,improve the level of mental state and mental resilience,and improve the quality of life to promote postoperative rehabilitation.