基于5步共情模型干预方案在急性脑梗死患者中的应用效果观察

Application of empathy intervention based on 5-step empathetic model in patients with acute cerebral infarction

目的评估基于5步共情模型(5-SEM)干预方案对急性脑梗死(ACI)患者负性情绪、心理应激反应和睡眠质量的应用效果.方法选择2022年11月至2023年4月温州医科大学附属第二医院收治的100例ACI住院患者作为研究对象.按住院时间将患者分为对照组与观察组,每组50例.对照组采用常规护理方法,观察组在对照组的基础上采用5-SEM共情干预方案.具体方案为:组建干预团队,成立共情干预方案管理小组,该小组由有5年以上工作经验且学历为本科及以上的主治医师、心理医生、主管护师和护师组成;干预团队基于中国知网、万方数据库、美国国立医学图书馆PubMed数据库、荷兰医学文摘EMBase数据库等检索并整理相关文献,由心理医生评估患者情况,形成基于5-SEM患者共情干预方案最终稿,主管护师负责5-SEM干预方案落实,由护师实施干预.采用阿森斯失眠量表(AIS)评估患者的睡眠质量;采用医院焦虑抑郁量表(HADS)评估患者的焦虑抑郁程度;采用心理应激反应问卷(SRQ)评估心理应激反应干预效果.结果两组干预后睡眠质量评分、焦虑抑郁评分、心理应激反应评分均较干预前明显降低[睡眠质量评分(分):对照组为6.74±1.77比12.08±2.94,观察组为4.84±2.04比11.90±2.80;焦虑评分(分):对照组为7.14±2.20比8.58±2.38,观察组为6.06±2.47比8.34±2.03;抑郁评分(分):对照组为7.28±2.12比8.72±2.34,观察组为6.26±2.03比8.82±2.80;躯体反应评分(分):对照组为17.72±4.29比22.94±3.73,观察组为16.10±3.19比22.62±3.25;情绪反应评分(分):对照组为21.82±2.98比26.80±3.21,观察组为20.60±2.45比26.32±4.32;行为反应评分(分):对照组为12.68±1.75比15.46±3.18,观察组为11.16±1.98比14.90±2.24;心理应激反应评分(分):对照组为55.40±4.89比69.46±6.28,观察组为50.98±4.68比68.08±6.18,均P<0.05],且干预后观察组各项评分均明显低于对照组(均P<0.05).结论基于5-SEM的共情干预方案能缓解ACI患者焦虑抑郁和心理应激反应,改善睡眠质量.

Objective To evaluate the effect of an empathy intervention program based on 5-step empathetic model(5-SEM)on stress response,anxiety and depression,and sleep quality among patients with acute cerebral infarction.Methods The 1o0 participants were admitted to the Second Affiliated Hospital of Wenzhou Medical University from November 2022 to April 2023.According to the admission time,they were divided into two groups,with 50 cases in each group.The patients in the control group received normal care,while those in the observation group underwent an empathy intervention program based on 5-SEM.This program includes the establishment of an empathetic intervention team,comprised of physicians,psychologists,head nurses,and nurses with more than 5 years of work experience and a bachelor's degree or higher.The intervention team,based on searches and collation of relevant literature from databases such as CNKI,Wanfang Data,the National Library of Medicine's PubMed database,and the Dutch medical abstracts EMBase database,is responsible for assessing patient conditions.A final draft of the empathetic intervention plan based on the 5-SEM is then formed by the supervising nurse.nurses in the empathetic intervention team was responsible for implementing the 5-SEM intervention plan.The outcomes were evaluated by Athens insomnia scale(AIS),hospital anxiety and depression scale(HADS),and stress response questionnaire(SRQ).Results Affer intervention,the scores for sleep quality,anxiety and depression,and stress response in both groups showed a significant decrease compared to pre-intervention[sleep quality scores:control group was 6.74±1.77 vs.12.08±2.94,observation group was 4.84±2.04 vs.11.90±2.80 anxiety scores:control group was 7.14±2.20 vs.8.58±2.38,observation group was 6.06±2.47 vs.8.34±2.03;depression scores:control group was 7.28±2.12 vs.8.72±2.34,observation group was 6.26±2.03 vs.8.82±2.80;physical reaction scores:control group was 17.72±4.29 vs.22.94±3.73,observation group was 16.10±3.19 vs.22.62±3.25;emotional reaction scores:control group was 21.82±2.98 vs.26.80±3.21,observation group was 20.60±2.45 vs.26.32±4.32;behavioral reaction scores:control group was 12.68±1.75 vs.15.46±3.18,observation group was 11.16±1.98 vs.14.90±2.24;stress response scores:control group was 55.40±4.89 vs.69.46±6.28,observation group was 50.98±4.68 vs.68.08±6.18,all P<0.05],post-intervention,the scores in the observation group were significantly lower than those in the control group(all P<0.05).Conclusion The empathy intervention program based on the 5-SEM could alleviate anxiety,depression,and stress responses among patients with acute cerebral infarction,while also improving sleep quality.