关注与阐释疗法对重症脑卒中患者及家属希望水平和ICU后综合征发生情况的影响

Effects of attention and interpretation therapy on hope levels and post-ICU syndrome in severe stroke patients and their families

目的探讨关注与阐释疗法对重症脑卒中患者及家属希望水平和重症监护室(ICU)后综合征发生情况的影响,以期为制定提高重症脑卒中患者及家属希望水平和减少ICU后综合征的方案提供参考。方法选取2020年9月-2022年6月首都医科大学附属北京世纪坛医院收治的220例重症脑卒中住院患者及其主要照顾家属220人(每例患者仅纳入1人)作为研究对象,采用随机数字表法分为观察组和对照组,每组各110例患者与110名家属。转出ICU后,对照组患者采用脑卒中常规护理干预,家属采用常规健康宣教;观察组患者及家属在对照组患者及家属干预基础上采用关注与阐释疗法进行干预。比较2组患者及家属干预前后的希望水平和ICU后综合征发生情况。结果干预前,2组患者及家属Herth希望量表(HHI)的积极态度、积极行动、亲密关系3个维度评分及总分比较,差异均无统计学意义(P>0.05);干预后,2组患者HHI量表的3个维度评分及总分均高于干预前,且观察组均高于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者ICU后综合征问卷(PICSQ)评分比较,差异无统计学意义(P>0.05);干预后,2组患者PICSQ评分均低于干预前,且观察组低于对照组,差异均有统计学意义(P<0.05)。干预前,2组患者家属照顾者负担量表(ZBI)及能力感受问卷(SCQ)评分比较,差异均无统计学意义(P>0.05);干预后,2组患者家属ZBI及SCQ评分均低于干预前,且观察组均低于对照组,差异均有统计学意义(P<0.05)。结论应用关注与阐释疗法对重症脑卒中患者及家属进行干预,可显著提升患者自身及家属的希望水平,预防ICU后综合征的发生,值得临床推广应用。

Objective To explore the effects of attention and interpretation therapy on hope levels and post-intensive care unit syndrome(PICS)in severe stroke patients and their families,aiming to provide a reference for improving hope levels for patients and their families and reducing PICS.Methods From September 2020 to June 2022,220 inpatients with severe stroke and their primary caregivers(one caregiver per patient)were selected from Beijing Shijitan Hospital,Capital Medical University.Using a random number table,they were allocated to an observation group and a control group,with 110 patients and 110 caregivers in each group.After ICU discharge,the control group received standard stroke care and health education on family members,while the observation group additionally received attention and interpretation therapy.Hope levels of patients and their families and PICS occurrence were compared before and after intervention.Results Before intervention,there were no significant differences in the Herth Hope Index(HHI)scores,including the positive attitude,positive action,and close relationship dimensions,as well as the total scores between the two groups of patients and their families(P>0.05).After intervention,the HHI scores for the three dimensions and the total scores in both groups were higher than before intervention,with the observation group scoring significantly higher than the control group(P<0.05).Before intervention,no significant differences were observed in the Post-Intensive Care Syndrome Questionnaire(PICSQ)scores between the two groups(P>0.05).After intervention,the PICSQ scores in both groups were lower than before intervention,with the observation group scoring significantly lower than the control group(P<0.05).Before intervention,no significant differences were found in the Zarit Burden Interview(ZBI)and Sense of Competence Questionnaire(SCQ)scores among the families of the patients in both groups(P>0.05).After intervention,the ZBI and SCQ scores in the families of both groups were lower than before intervention,with the observation group scoring significantly lower than the control group(P<0.05).Conclusion The application of attention and interpretation therapy for severe stroke patients and their families can significantly improve their levels of hope and prevent the occurrence of PICS.This approach is worth promoting in clinical practice.