正强化理论联合康复训练在血管性痴呆住院患者中的干预效果

Intervention effect of positive reinforcement theory combined with rehabilitation training on hospitalized patients with vascular dementia

目的 探讨正强化理论联合康复训练对血管性痴呆(VD)住院患者的干预效果。方法 选取2020年6月至2022年6月在上海交通大学医学院附属仁济医院接受住院治疗的131例VD患者为研究对象,用随机信封法将其分为试验组(66例)和对照组(65例)。对照组行常规康复训练,试验组行正强化理论联合康复训练。比较2组干预前后的认知功能、心理状态和生存质量。结果 出院时,2组的抑郁自评量表(SDS)、焦虑自评量表(SAS)评分均较干预前低,且试验组均低于对照组,结果均有统计学差异(P均<0.05);2组的简易认知功能评价量表(MMSE)各维度评分和总评分均高于干预前,且试验组均高于对照组,结果均有统计学差异(P均<0.05)。出院3个月后,2组的世界卫生组织生存质量测定量表(WHOQOL-BREF)中各维度评分及总评分均高于干预前,且试验组均高于对照组,结果差异均有统计学意义(P均<0.05)。结论 正强化理论联合康复训练可改善VD患者的认知功能,调整其心理状态,提高其生存质量。

Objective To investigate the intervention effect of positive reinforcement theory combined with rehabilitation training on hospitalized patients with vascular dementia(VD).Methods A total of 131 VD patients who were hospitalized at Renji Hospital,Shanghai Jiao Tong University School of Medicine from June 2020 to June 2022 were enrolled.The patients were assigned into an experimental group(66 cases)and a control group(65 cases)by envelope randomization.The control group received rehabilitation training,while the experimental group received positive reinforcement theory combined with rehabilitation training.The cognitive function,psychological state,and quality of life of the two groups were compared before and after intervention.Results At discharge,the scores of the Self-Rating Depression Scale(SDS)and the Self-Rating Anxiety Scale(SAS)of both groups were lower than those before intervention,and the scores of the experimental group were lower than those of the control group,with statistical differences(all P<0.05).The various dimension scores and the total score of the Mini-Mental State Examination(MMSE)in both groups were higher than those before intervention,and the scores of the experimental group were higher than those of the control group,with statistical differences(all P<0.05).At 3 months after discharge,the various dimension scores and the total score of the World Health Organization Quality of Life Questionnaire(WHOQOL-BREF)in both groups were higher than those before intervention,and the scores of the experimental group were higher than those of the control group,with statistical differences(all P<0.05).Conclusion Positive reinforcement theory combined with rehabilitation training can improve the cognitive function of patients with VD,adjust their psychological state,and improve their quality of life.