心理分级模式的干预对腹腔镜肝脏手术患者负面情绪及应激反应的影响

Effects of psychological grading model based intervention on negative emotions and stress responses in patients undergoing laparoscopic liver surgery

目的:基于心理分级模式的干预对腹腔镜肝脏手术患者负面情绪及应激反应的影响。方法:选取2020年2月-2021年3月于某院行腹腔镜肝脏手术的患者82例,随机分为对照组(n=41)和观察组(n=41)。对照组给予常规心理干预,观察组给予心理分级模式的干预。比较两组干预前后负面情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)评分];比较两组入院时及干预后24 h的应激反应[收缩压(SBP)、舒张压(DBP)、心率(HR)];比较两组患者围术期指标(术后首次下床时间、术后首次排气时间、术后住院时间);并对两组干预后的治疗依从性和满意度进行评估。结果:干预后两组SAS、SDS评分均下降,且观察组SAS、SDS评分低于对照组(t=-5.546,-5.462;P<0.05);干预前两组SBP、DBP、HR比较差异不明显(P>0.05),干预后24 h,观察组SBP、DBP、HR数值变化与干预前比较不明显,对照组SBP、DBP、HR数值变化较干预前明显升高,两组比较差异有统计学意义(t=-4.308,-10.685,-14.189;P<0.05);观察组术后首次下床时间、术后首次排气时间、术后住院时间均明显少于对照组(t=-2.442,-9.130,-5.487;P<0.05);干预后两组治疗依从性均有所提高,但观察组依从性显著高于对照组(χ^(2)=5.513,P<0.05);观察组患者对干预的满意度显著高于对照组(χ^(2)=4.479,P<0.05)。结论:基于心理分级模式的干预能够缓解腹腔镜肝脏手术患者的负面情绪,减轻患者的生理应激反应,促进患者术后恢复,提高患者的治疗依从性和满意度。

Objective:To investigate the effects of psychological grading model on negative emotions and stress responses in patients undergoing laparoscopic liver surgery.Methods:A total of 82 patients who underwent laparoscopic liver surgery in our hospital from February 2020 to March 2021 were selected and randomly divided into control group(n=41)and observation group(n=41).The control group was given routine psychological intervention,and the observation group was given psychological grading model intervention.Negative emotions were compared between the two groups before and after intervention[SELF-rating Anxiety Scale(SAS)and self-rating Depression Scale(SDS)scores].Systolic blood pressure(SBP),diastolic blood pressure(DBP)and heart rate(HR)were compared between the two groups at admission and 24 h after intervention.Perioperative indicators(first postoperative time to get out of bed,first postoperative exhaust time,postoperative length of hospital stay)were compared between the two groups.The treatment compliance and satisfaction of the two groups were evaluated after intervention.Results:SAS and SDS scores of the two groups decreased after intervention,and SAS and SDS scores of the observation group were lower than those of the control group(t=-5.546,-5.462;P<0.05).Before intervention,there were no significant differences in SBP,DBP and HR between the two groups(P>0.05).24 h after intervention,the changes of SBP,DBP and HR in the observation group were not significant compared with those before intervention,while the changes of SBP,DBP and HR in the control group were significantly higher than those before intervention.There were statistically significant differences between the two groups(t=-4.308,-10.685,-14.189;P<0.05).The first time to get out of bed,the first time to exhaust gas and the length of hospital stay in the observation group were significantly lower than those in the control group(t=-2.442,-9.130,-5.487;P<0.05).After intervention,the compliance of both groups was improved,but the compliance of observation group was significantly higher than that of control group(χ^(2)=5.513,P<0.05).The satisfaction of intervention in the observation group was significantly higher than that in the control group(χ^(2)=4.479,P<0.05).Conclusion:Intervention based on psychological grading model can relieve the negative emotions of patients undergoing laparoscopic liver surgery,reduce the physiological stress response of patients,promote postoperative recovery,and improve the treatment compliance and satisfaction of patients.