应激理论模式对腹腔镜胆囊切除术老年患者的干预效果观察

Observation of intervention effects of stress theory model on elderly patients undergoing laparoscopic cholecystectomy

目的探究应激系统理论指导下干预模式用于腹腔镜胆囊切除术(LC)老年患者对心理弹性及疾病认知的影响。方法选择2020年1月-2023年1月亳州市中医院普通外科就诊的老年LC患者作为观察对象,选取接受应激系统理论指导下干预模式的患者纳入观察组(n=42),同期接受常规干预措施的患者纳入对照组(n=43)。回顾性分析2组患者的临床资料。比较干预前、干预1个月2组疾病知识水平(采取自拟问卷评分)、心理弹性[采用心理弹性量表(CD-RISC)评分]、应激情况[采取创伤后应激症状表(PTSD)评分]、生活质量[采用SF-36评分表(SF-36)评分]的变化。结果干预1个月后,2组疾病知识水平评分、CD-RISC评分、SF-36评分均明显高于同组干预前(P<0.05),且观察组各评分均高于对照组(P<0.05);2组PTSD评分均显著低于同组干预前(P<0.05),且观察组PTSD评分低于对照组(P<0.05);2组下床活动时间差异无统计学意义(P>0.05);而观察组住院时长、排气时间短于对照组,并发症发生率低于对照组,差异均有统计学意义(P<0.05)。结论老年LC患者采用应激系统理论指导下的干预方案,可有效提高患者的疾病认知水平,改善其心理弹性,有利于患者术后康复,具有一定的临床应用价值。

Objective To explore the effects of stress system theory-guided intervention model on psychological resilience and disease cognition in elderly patients undergoing laparoscopic cholecystectomy(LC).Methods The elderly patients who were going to undergo LC in Department of General Surgery,Hospital of Traditional Chinese Medicine of Bozhou City from January 2020 to January 2023 were selected as the observation subjects.Patients who received stress system theory-guided intervention model were included in observation group(n=42),and patients who received routine intervention measures during the same period were included in control group(n=43).The changes in disease knowledge level(self-made questionnaire score),psychological resilience[Connor-Davidson Resilience Scale(CD-RISC)score],stress situation[Post-Traumatic Stress Disorder Scale(PTSD)score]and quality of life[36-item Short-Form Health Survey(SF-36)score]were compared between the two groups before intervention and after 1 month of intervention.Results After 1 month of intervention,the scores of disease knowledge level,CD-RISC and SF-36 of both groups were significantly higher than those of the same group before intervention(P<0.05),and the scores of the observation group were higher than those of the control group(P<0.05);the scores of PTSD of both groups were significantly lower than those of the same group before intervention(P<0.05),and the scores of the observation group were lower than those of the control group(P<0.05).There was no significant difference in getting out of bed time between the two groups(P>0.05).The hospital stay and exhaust time in the observation group were shorter than those in the control group,and the incidence of complications was lower than that in the control group,with statistical significances(P<0.05).Conclusion The stress system theory-guided intervention regimen can effectively improve the disease cognition level and psychological resilience in elderly LC patient,and is beneficial to their postoperative rehabilitation,which has certain clinical application value.