情绪性意象脱敏疗法对学龄期四肢骨折患儿创伤后应激障碍的干预效果评价

Effect of emotional imagery desensitization therapy on post-traumatic stress disorder among school-age children with fracture

目的探讨情绪性意象脱敏疗法对学龄期四肢骨折患儿创伤后应激障碍的影响,以达到减轻患儿不良心理状态的目的。方法采用随机对照试验,选择2021年7月至2023年7月济宁医学院附属医院收治的78例学龄期四肢骨折患儿,按照入院时间分为试验组和对照组各39例。2组均给予常规围手术期护理,对照组在此基础上实施常规心理辅导,试验组实施情绪性意象脱敏疗法。干预前和干预3个月,采用创伤后应激障碍自评量表(PTSD-SS)、医学应对方式问卷(MCMQ)评价干预效果。结果研究过程中对照组因失联脱落2例,试验组因失联及主动要求退出脱落4例,对照组37例患儿[男20例,女17例,年龄(9.27±1.62)岁]完成干预,试验组35例患儿[男21例,女14例,年龄(9.57±1.63)岁]完成干预。干预前,2组PTSD-SS、MCMQ评分比较差异均无统计学意义(均P>0.05)。干预后,试验组PTSD-SS中主观评定、反复重现体验、回避症状、警觉性增高、社会功能受损等因子得分和总分分别为(1.51±1.06)、(10.74±3.30)、(10.86±2.93)、(11.94±3.18)、(2.31±1.30)、(37.37±6.37)分,低于对照组的(2.08±0.80)、(12.92±3.63)、(12.73±2.99)、(14.65±4.23)、(2.97±0.87)、(45.35±5.86)分,差异均有统计学意义(t值为2.53~5.54,均P<0.05)。干预后,试验组MCMQ中面对分量表评分为(23.49±2.48)分,高于对照组的(21.89±2.38)分,回避、屈服分量表评分分别为(10.31±1.89)、(6.83±1.98)分,低于对照组的(11.57±1.79)、(7.86±2.12)分,差异均有统计学意义(t=2.79、2.89、2.14,均P<0.05)。结论情绪性意象脱敏疗法能有效降低学龄期四肢骨折患儿创伤后应激障碍水平,促进患儿采取积极应对方式。

Objective To explore the effect of emotional imagery desensitization therapy on posttraumatic stress disorder among school-age children with fracture,to alleviate the adverse psychological state of the children.Methods By a randomized controlled trials,a total of 78 school-age children with fracture at the Affiliated Hospital of Jining Medical University from July 2021 to July 2023 were divided into experimental group and control group according to the admission time,with 39 cases in each group.Both groups carried out routine care,the control group was given routine psychological intervention,the experimental group implemented emotional imagery desensitization therapy.Before and after 3 months of intervention,the effects was assessed by Post-Traumatic Stress Disorder Self-rating Scale(PTSD-SS)and Medical Coping Modes Questionnaire(MCMQ),respectively.Results During the research process,there were 2 cases of dropout in the control group due to disconnection,and 4 cases in the experimental group due to disconnection and voluntary withdrawal.37 children in the control group[20 males and 17 females,age(9.27±1.62)years],and 35 children in the experimental group[21 males and 14 females,age(9.57±1.63)years]completed the intervention.Before intervention,the difference of PTSD-SS and MCMQ scores between two groups was no statistically significant(all P>0.05).After intervention,the subjective assessment,re-experiencing,avoidance symptoms,hypervigilance,functional impairment factor scores and total PTSD-SS scores were(1.51±1.06),(10.74±3.30),(10.86±2.93),(11.94±3.18),(2.31±1.30),(37.37±6.37)in the experimental group,lower than in the control group(2.08±0.80),(12.92±3.63),(12.73±2.99),(14.65±4.23),(2.97±0.87),(45.35±5.86),the differences were statistically significant(t=2.53-5.54,all P<0.05).After intervention,the confrontation subscale scores were(23.49±2.48),higher than in the control group(21.89±2.38),the avoidance,acceptance-resignation subscale were(10.31±1.89)and(6.83±1.98),lower than in the control group(11.57±1.79)and(7.86±2.12),the differences were statistically significant(t=2.79,2.89,2.14,all P<0.05).Conclusions Emotional imagery desensitization therapy can effectively alleviate post-traumatic stress disorder and promote positive coping mode in school-age children with fracture.