系统康复训练联合个性化心理疏导对体外循环心脏瓣膜术后患者心理韧性、应对方式及生活质量的影响

Effect of systematic rehabilitation training combined with individualized psychological counseling on psychological resilience,coping style and quality of life of patients after heart valve surgery under extracorporeal circulation

目的:探讨系统康复训练联合个性化心理疏导对体外循环心脏瓣膜术后患者心理韧性、应对方式及生活质量的影响。方法:采用简单随机抽签法将100例心脏瓣膜术后患者分为对照组(n=50)和观察组(n=50),对照组给予常规干预,观察组在对照组基础上给予系统康复训练联合个性化心理疏导;比较两组干预后中文版Connor-Davidson心理韧性量表评分、中文版医学应对方式问卷(MCMQ)评分、心功能改善情况及出院时简明健康调查问卷(SF-36)评分。结果:干预后,观察组心理韧性各维度(坚韧、自强、乐观)评分均明显高于对照组(t=7.938,6.719,8.393;P<0.01);干预后,观察组MCMQ量表中面对评分明显高于对照组(t=2.002,P<0.05),回避、屈服等评分明显低于对照组(t=-3.818,-4.395;P<0.01)。观察组较对照组心功能改善率明显提高(χ~2=5.005,P<0.05),出院时6min步行距离明显增加(t=4.616,P<0.01)。出院时,观察组SF-36量表中躯体功能、身体疼痛、总体健康、活力、社会功能等评分均明显高于对照组,差异均有统计学意义(t=3.586,2.486,4.190,2.418,2052;P<0.05)。结论:系统康复训练联合个性化心理疏导能够改善体外循环心脏瓣膜术后患者心理韧性、应对方式,有助于提高患者心功能及生活质量。

Objective:To explore the effect of systematic rehabilitation training combined with personalized psychological counseling on psychological resilience,coping style and quality of life of patients after heart valve surgery under extracorporeal circulation.Methods:A total of 100 patients who had underwent heart valve surgery were divided into the control group(n=50)and the observation group(n=50)by simple random drawing method.The control group was given routine nursing,while the observation group was given the systematic rehabilitation training combined with individualized psychological counseling on the basis of routine nursing.The scores of Chinese version Connor-Davidson psychological resilience scale and Chinese version of Medical Coping Style Questionnaire(MCMQ),improvement of cardiac function and simple health questionnaire(SF-36)score were compared between the two groups after the intervention.Results:After the intervention,the scores of different dimensions of psychological resilience(tenacity,self-improvement,optimism)of the observation group were significantly higher than those of the control group(t=7.938,6.719,8.393;P<0.01).After the intervention,the score of confrontation in MCMQ scale of the observation group was significantly higher than that of the control group(t=2.002,P<0.05),while the scores of avoidance and yielding were significantly lower than those of the control group(t=-3.818,-4.395;P<0.01).The improvement rate of cardiac function in the observation group was significantly higher than that in the control group(χ2=5.005,P<0.05),and the 6 min walking distance increased significantly at discharge(t=4.616,P<0.01).The scores of physical function,physical pain,general health,vitality and social function in the SF-36 scale of the observation group were significantly higher than those of the control group at discharge(t=3.586,2.486,4.190,2.418,2052;P<0.05).Conclusion:Systematic rehabilitation training combined with individualized psychological counseling can improve the psychological resilience and coping style of patients after heart valve surgery under extracorporeal circulation,and improve the cardiac function and quality of life of patients.