强制干预对精神科住院患者心理影响及其应对方式的研究

Study on the Psychological Effects of Compulsory Intervention on Inpatients in Psychiatry and their Coping Styles

目的:分析强制干预对精神科住院患者心理影响及其应对方式的效果。方法:选取2016年1月—2020年12月在抚州市第三医院精神科住院的62例患者作为研究对象,所有患者采取强制干预。对比干预前和干预后患者的心理状态、应对方式、胁迫体验、精神障碍、症状自评量表、自知力因子、并发症发生率、中间型防御方式、病耻感及认知功能变化。结果:干预后患者焦虑、抑郁心理较干预前高,差异有统计学意义(t=8.035、7.681,P<0.05);干预后患者积极应对较干预前低,且消极应对较干预前高,差异有统计学意义(t=29.694、35.211,P<0.05);干预后患者精神障碍、自知力因子较干预前低,且胁迫体验较干预前高,差异有统计学意义(t=23.177、5.401、48.585,P<0.05);干预后患者强迫、敌对、偏执、精神病性临床症状较干预前少,差异有统计学意义(t=61.520、9.964、28.508、40.562,P<0.05);干预后患者回避、消耗倾向、隔离、理想化分数较干预前高,差异有统计学意义(t=17.089、20.747、25.133、17.518,P<0.05);干预后患者歧视度、病情掩饰分数较干预前高,且积极效应较干预前低,差异有统计学意义(t=18.853、16.377、16.943,P<0.05);干预后患者吸引和排斥、脆弱性、寻求赞许、依赖性分数较低,且强制性分数较干预前高,差异有统计学意义(t=13.097、5.658、6.290、3.226、5.752,P<0.05)。结论:强制干预对精神科住院患者虽可以缓解精神障碍,但会增加患者负性情绪,让患者处于消极应对状态,出现胁迫体验,提高患者的防御功能,让患者感到羞耻,临床应尽量减少强制干预。

Objective:To analyze the effect of compulsory intervention on the psychological impact of psychiatric inpatients and their coping styles.Methods:A total of 62 patients who were hospitalized in the hospital from January 2016 to December 2020 were selected as the research subjects,and all patients received compulsory intervention.The psychological state,coping style,coercive experience,mental disorder,symptom self-rating scale,insight factor,complication rate,intermediate defense style,stigma and cognitive function were compared before and after the intervention.Results:After the intervention,the anxiety and de⁃pression of the patients were higher than those before the intervention,and the difference was statistically significant(t=8.035,7.681,P<0.05).After the intervention,the positive coping of the patients was lower than that before the intervention,and the nega⁃tive coping was higher than that before the intervention,and the difference was statistically significant(t=29.694,35.211,P<0.05).After the intervention,the factors of mental disorder and insight were lower than those before the intervention,and the coercion ex⁃perience was higher than that before the intervention,and the differences were statistically significant(t=23.177,5.401,48.585,P<0.05).After the intervention,the clinical symptoms of compulsion,hostility,paranoia and psychosis were less than those before the intervention,and the difference was statistically significant(t=61.520,9.964,28.508,40.562,P<0.05).The scores of avoidance,consumption tendency,isolation and idealization of patients after intervention were higher than those before intervention,and the difference was statistically significant(t=17.089,20.747,25.133,17.518,P<0.05).After the intervention,the degree of discrimina⁃tion and disease concealment scores of the patients were higher than those before the intervention,and the positive effect was lower than that before the intervention,and the differences were statistically significant(t=18.853,16.377,16.943,P<0.05).After the in⁃tervention,the scores of attraction and rejection,vulnerability,seeking approval,and dependence were lower,and the coercive scores were higher than those before the intervention,and the differences were statistically significant(t=13.097,5.658,6.290,3.226,5.752,P<0.05).Conclusion:Although compulsory intervention can alleviate mental disorders in psychiatric hospitalized patients,it will increase the negative emotions of patients,make patients in a negative coping state,experience coercive experiences,improve patients’defense function,and make patients feel ashamed.Clinically,compulsory intervention should be minimized.