基于PERMA模式的护理措施对烧伤后瘢痕整形患者创伤后应激障碍、社会心理适应及生活质量的影响

Impact of PERMA-based nursing interventions on post-traumatic stress disorder,psychosocial adaptation,and quality of life in patients undergoing post-burn scar plastic surgery

目的探讨基于PERMA模式的护理措施在烧伤后瘢痕整形患者中的应用效果。方法前瞻性纳入2020年4月至2023年10月郑州大学第一附属医院收治的烧伤后瘢痕整形患者122例,按随机数表法分为研究组和对照组各61例。对照组患者接受常规护理,研究组患者在对照组基础上给予基于PERMA模式的护理措施,干预12周。比较两组患者干预前和干预12周后(干预后)的负性情绪[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、应对方式[简易应对方式问卷(SCSQ)]、创伤后应激障碍[创伤后应激障碍平民版量表(PCL-C)]、社会心理适应水平[疾病心理社会适应自评量表(PAIS-SR)]和生活质量[生活质量综合评定问卷-74(GQOL-74)]。结果干预后,研究组患者的SAS、SDS评分分别为(41.29±4.21)分、(43.17±7.11)分,明显低于对照组的(50.03±5.07)分、(51.39±8.35)分,差异均有统计学意义(P<0.05);干预后,研究组患者SCSQ量表中的积极应对维度评分为(30.07±1.41)分,明显高于对照组的(21.63±3.05)分,消极应对维度评分为(7.15±2.11)分,明显低于对照组的(12.43±3.09)分,差异均有统计学意义(P<0.05);干预后,研究组患者的PCL-C、PAIS-SR评分分别为(25.14±4.06)分、(27.96±4.12)分,明显低于对照组的(36.20±4.71)分、(43.26±5.75)分,差异均有统计学意义(P<0.05);干预后,研究组患者GQOL-74中的躯体功能、心理功能、社会功能、物质生活状态评分及总分分别为(95.87±1.25)分、(90.16±2.16)分、(88.76±3.52)分、(97.14±1.02)分、(371.93±10.14)分,明显高于对照组的(90.15±2.06)分、(82.63±3.77)分、(79.26±3.16)分、(93.21±2.21)分、(345.25±12.27)分,差异均有统计学意义(P<0.05)。结论基于PERMA模式的护理措施可改善烧伤后瘢痕整形患者负性情绪,减轻创伤后应激障碍,调节应对方式,提升社会心理适应水平及生活质量。

Objective To investigate the effect of PERMA-based nursing interventions in patients undergoing post-burn scar plastic surgery.Methods A total of 122 patients undergoing post-burn scar plastic surgery admitted to the First Affiliated Hospital of Zhengzhou University from April 2020 to October 2023 were prospectively included and randomly divided into a study group and a control group according to a random number table method,with 61 patients in each group.The patients in the control group received routine care,while the patients in the study group received nursing interventions based on the PERMA model in addition to the routine care,for a period of 12 weeks.The negative emotions(Self-rating Anxiety Scale,SAS);Self-rating Depression Scale,SDS),coping styles(Simplified Coping Style Questionnaire,SCSQ),post-traumatic stress disorder(Post-traumatic Stress Disorder Checklist-Civilian Version,PCL-C),social psychological adaptation level(Psychosocial Adjustment to Illness Scale—Self-report,PAIS-SR),and quality of life(Generic Quality of Life Inventory 74,GQOL-74)were compared between the two groups before and after intervention.Results After intervention,the SAS and SDS scores of patients in the study group were(41.29±4.21)points and(43.17±7.11)points,respectively,which were significantly lower than(50.03±5.07)points and(51.39±8.35)points of the control group(P<0.05).After intervention,the positive coping dimension score of patients in the study group in the SCSQ scale was(30.07±1.41)points,which was significantly higher than(21.63±3.05)points of the control group,and the negative coping dimension score was(7.15±2.11)points,which was significantly lower than(12.43±3.09)points of the control group,with statistically significant differences(P<0.05).After intervention,the PCL-C and PAIS-SR scores of patients in the study group were(25.14±4.06)points and(27.96±4.12)points,respectively,which were significantly lower than(36.20±4.71)points and(43.26±5.75)points of the control group(P<0.05).After intervention,the physical function,psychological function,social function,material life status scores,and total scores in GQOL-74 of patients in the study group were(95.87±1.25)points,(90.16±2.16)points,(88.76±3.52)points,(97.14±1.02)points,(371.93±10.14)points,respectively,which were significantly higher than(90.15±2.06)points,(82.63±3.77)points,(79.26±3.16)points,(93.21±2.21)points,and(345.25±12.27)points of the control group,respectively(P<0.05).Conclusion PERMA-based nursing interventions can improve the negative emotions of patients with post-burn scar plastic surgery,alleviate post-traumatic stress disorder,regulate coping styles,and enhance their social psychological adaptation and quality of life.