焦点解决短程治疗对脑卒中患者自我感受负担的干预研究

发布时间：2018-01-18 06:14

  本文关键词：焦点解决短程治疗对脑卒中患者自我感受负担的干预研究　出处：《承德医学院》2017年硕士论文　论文类型：学位论文

  更多相关文章： 焦点解决短程治疗 焦点解决团体治疗 脑卒中 自我感受负担 主观幸福感 生存质量

【摘要】：目的:本研究将脑卒中患者作为研究对象,针对其自我感受负担水平,构建以焦点解决短程治疗的理论为指导的护理心理干预方案,以期提高临床医护人员对自我感受负担的认识和重视程度,拓宽焦点解决短程治疗的应用领域,为临床医护人员开展护理心理干预提供理论参考和实证依据。方法:于2016年1月至2016年9月,在知情同意的基础上采用便利性抽样的方法,选取在承德市某三级甲等医院康复科住院治疗的90例脑卒中患者为研究对象,采用自我感受负担量表(Self-Perceived Burden Scale,SPBS)、纽芬兰纪念大学幸福度量表(Memorial University of Newfoundland Scale of Happiness,MUNSH)、健康调查简表(Medical Outcomes Study 36-item Short Form Health Survey,SF-36)对其进行测评。采用随机数字表法将90例研究对象分为对照组、焦点个案组和焦点团体组,每组各30例。对照组给予常规护理和康复治疗;焦点个案组在常规护理和康复治疗的基础上增加“一对一”形式的焦点解决短程治疗,包括:描述问题、建构具体可行的目标、探查例外、给予反馈和评价进步,一周3次,每次30~45分钟,共6次;焦点团体组在常规护理和康复治疗的基础上增加“团体”形式的焦点解决短程治疗,一周3次,每次50~60分钟,共6次。采用SPSS20.0统计软件对数据进行统计学分析,计量资料以(x±s)表示,两组组间比较采用独立样本t检验,组内比较采用配对样本t检验,多组组间比较采用F检验;计数资料采用χ2检验,以P0.05为差异具有统计学意义。结果:1.干预前,对照组、焦点个案组和焦点团体组3组研究对象在诊断类型、性别、年龄、受教育程度、职业、居住地、婚姻状况、家庭收入、医疗费用支付方式、主要照顾者和主要照顾者身体状况上[χ2=(0.356~8.708),p=(0.191~0.986)],差异均无统计学意义(p0.05);3组研究对象在自我感受负担量表(spbs)、纽芬兰纪念大学幸福度量表(mshun)及健康调查简表(sf-36)的各维度及总分上的比较[f=(0.066~2.697),p=(0.073~0.937)],差异均无统计学意义(p0.05),具有可比性。2.干预前后,干预因素和时间因素对研究对象的自我感受负担量表(spbs)、纽芬兰纪念大学幸福度量表(mshun)及健康调查简表(sf-36)的总分上的主效应及其交互作用[f=(33.419~1516.891),p=0.000],差异均有统计学意义(p0.05)。3.干预前后,对照组在自我感受负担量表(spbs)[(39.17±4.80)vs(35.30±2.63),t=3.678,p=0.001]、纽芬兰纪念大学幸福度量表(mshun)[(3.67±3.79)vs(19.67±3.64),t=-15.459,p=0.000]及健康调查简表(sf-36)[(19.90±2.84)vs(37.27±7.44),t=-11.049,p=0.000]上的得分比较,差异均有统计学意义(p0.05);焦点个案组在自我感受负担量表(spbs)[(39.27±5.83)vs(22.40±4.03),t=16.248,p=0.000]、纽芬兰纪念大学幸福度量表(mshun)[(4.20±4.50)vs(31.10±3.66),t=-24.136,p=0.000]及健康调查简表(sf-36)[(21.04±4.61)vs(54.04±5.72),t=-20.937,p=0.000]上的得分比较,差异均有统计学意义(p0.05);焦点团体组在自我感受负担量表(spbs)[(39.57±1.57)vs(22.23±2.47),t=30.302,p=0.000]、纽芬兰纪念大学幸福度量表(mshun)[(5.63±2.24)vs(30.60±4.05),t=-29.363,p=0.000]及健康调查简表(sf-36)[(20.46±3.95)vs(53.08±3.48),t=-34.686,p=0.000]上的得分比较,差异均有统计学意义(p0.05)。4.干预后,对照组、焦点个案组和焦点团体组3组在自我感受负担量表(spbs)[(35.30±2.63)vs(22.40±4.03)vs(22.23±2.47),f=172.785,p=0.000]、纽芬兰纪念大学幸福度量表(mshun)[(19.67±3.64)vs(31.10±3.66)vs(30.60±4.05),f=87.277,p=0.000]及健康调查简表(sf-36)[(37.27±7.44)vs(54.04±5.72)vs(53.08±3.48),f=79.651,p=0.000]上的得分比较,差异均有统计学意义(p0.05)。进一步做3组间两两比较发现,对照组和焦点个案组以及对照组和焦点团体组在自我感受负担量表(spbs)、纽芬兰纪念大学幸福度量表(mshun)及健康调查简表(sf-36)的得分比较[md=(-16.765~13.067),p=0.000],差异均有统计学意义(p0.05);焦点个案组和焦点团体组在自我感受负担量表(SPBS)[MD=0.167,P=0.979]、纽芬兰纪念大学幸福度量表(MSHUN)[MD=0.500,P=0.878]及健康调查简表(SF-36)的得分比较[MD=0.962,P=0.813],差异均无统计学意义(P0.05)。结论:1.焦点解决短程治疗可有效降低脑卒中康复期患者的负担感受,提高其主观幸福感,改善生存质量,促进其身心健康,值得临床推广应用;2.焦点解决短程治疗对焦点个案组和焦点团体组的脑卒中患者自我感受负担、主观幸福感和生存质量的干预效果无显著性差异。
[Abstract]:Objective: To study the stroke patients as the research object, according to the level of self perceived burden, constructing psychological nursing intervention program to focus brachytherapy theory as the guide, in order to improve the clinical medical staff on the self perceived burden of understanding and attention, broaden the application field of focus for medical treatment short. Personnel to carry out psychological nursing intervention to provide theoretical reference and empirical basis. Methods: from January 2016 to September 2016, using convenience sampling method based on informed consent, were selected in three grade hospitals in Chengde City, the Department of rehabilitation of 90 cases of hospitalized patients with cerebral apoplexy as the research object, using the self perceived burden scale (Self-Perceived Burden Scale, SPBS), Memorial University of Newfoundland scale of happiness (Memorial University of Newfoundland Scale of Happiness, MUNSH), health survey questionnaire (Medica L Outcomes Study 36-item Short Form Health Survey, SF-36) were evaluated. Randomly 90 cases were divided into control group, focus group and focus group case group, 30 cases in each group. The control group was given routine nursing care and rehabilitation; focus group "case on the basis of routine nursing and rehabilitation on the treatment of a focus on one form of solving short-range treatment, including: describe the problem, constructing feasible objectives and exploration of exception, giving feedback and evaluation of progress, 3 times a week, every 30~45 minutes, a total of 6 times; focus groups increased" focus groups "in the form of routine nursing and rehabilitation treatment the solution to short-term treatment, 3 times a week, every 50~60 minutes, a total of 6 times. The data were analyzed using SPSS20.0 statistical software, measurement data with (x + s) said that the comparison between the two groups by using independent sample t test, group ratio Compared with paired samples t test, comparison between group using F test; count data using 2 test, with P0.05 as the difference was statistically significant. Results: 1. before intervention, the control group, the focus of case group and focus group group of 3 groups in gender, age, diagnosis, type, level of education, occupation, residence, marital status, family income, payment of medical expenses, caregivers and caregivers' physical condition [x 2= (0.356~8.708), p= (0.191~0.986)], there were no significant differences (P0.05); the 3 groups in the self perceived burden scale (SPBs), the Memorial University of Newfoundland to measure happiness table (mshun) and short form health survey (SF-36) [f= on each dimension and the total score (0.066~2.697), p= (0.073~0.937)], there were no significant differences (P0.05), comparable to.2. before and after the intervention, the intervention factors and time factors on the study of the sense of self 鍙楄礋鎷呴噺琛，

本文编号：1439784