聚焦解决模式认知干预对斑块型银屑病患者负性心理、病耻感和心理弹性水平的影响

Effects of cognitive intervention of solution-focused approach on negative psychology, stigma and level of mental resilience in patients with plaque psoriasis

目的:观察聚焦解决模式认知干预对斑块型银屑病患者负性心理、病耻感、心理弹性水平和护理满意度的影响。方法:收集新疆医科大学附属中医医院皮肤科90例斑块型银屑病患者作为观察对象,随机分为对照组和观察组各45例,并给予不同护理干预方案。对照组给予常规认知干预,观察组给予聚焦解决模式认知干预。采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评价焦虑、抑郁等负性心理状态,采用贬低-歧视感知量表评价病耻感,采用心理弹性量表(CDRISC)评价心理弹性水平。比较对照组和观察组SAS评分、SDS评分、病耻感得分、CDRISC评分及护理满意度。结果:经过3个月干预,观察组干预后3个月时的SAS评分(t=-11.283,P<0.001)、SDS评分(t=-7.851,P<0.001),病耻感得分(t=-9.242,P<0.001)均低于对照组,观察组CDRISC评分(t=6.793,P<0.001)高于对照组,差异均有统计学意义。护理满意度方面,观察组和对照组总满意度为93.33%,对照组为77.78%,观察组高于对照组,差异均有统计学意义(χ~2=4.413,P<0.05)。结论:聚焦解决模式认知干预在斑块型银屑病患者中应用效果良好,能够减轻患者焦虑、抑郁等负性心理和病耻感,并提高心理弹性水平和护理满意度,临床上值得应用。

Objective:To observe the effects of cognitive intervention of solution-focused approach on negative psychology,stigma,level of mental resilience and nursing satisfaction in patients with plaque psoriasis.Methods:A total of90 patients with plaque psoriasis were collected as observational objects to be randomly divided into the control group and the observation group with 45 cases in each group in Chinese Medicine Hospital Affiliated to Xinjiang Medical University.The control group was given conventional cognitive intervention,while the observation group was given cognitive intervention of solution-focused approach.Self-rating anxiety scale(SAS)and self-rating depression scale(SDS)were employed to assess negative psychology of anxiety and depression.Perceived devaluation-discrimination scale was employed to assess stigma,and Connor-Davidson Resilience Scale(CDRISC)was employed to assess level of mental resilience.Then,scores of SAS,SDS,stigma,CDRISC and nursing satisfaction were compared between the two groups.Results:The observation group had lower scores of SAS(t=-11.283,P<0.001)and SDS(t=-7.851,P<0.001),lower score of stigma(t=-9.242,P<0.001)and higher score of CDRISC(t=6.793,P<0.001)than the control group three months after intervention with all statistical differences.As to nursing satisfaction,The total nursing satisfaction of the observation group and the control group were 93.33%and 77.78%respectively.The total nursing satisfaction of the observation group was higher than that of the control group,with significant statistical difference(χ~2=4.413,P<0.05).Conclusion:Cognitive intervention of solution-focused approach has well application effect in patients with plaque psoriasis.And it can mitigate negative psychology of anxiety and depression,alleviate stigma,promote level of mental resilience and nursing satisfaction.