聚焦解决模式对PCI术后患者负性情绪及疾病不确定感的影响

发布时间：2018-02-04 23:38

本文关键词： PCI术后聚焦解决模式负性情绪疾病不确定感　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的运用聚焦解决模式对冠心病PCI术后患者进行临床干预,从患者自身优势及资源出发,调动患者的积极主动性,降低患者的负性情绪及疾病不确定感,患者的负性情绪包括焦虑情绪和抑郁情绪,进而改变患者行为活动。方法选取自2015年12月-2016年6月,于青岛某三甲医院心血管内科,收集PCI成功术后患者110例,自愿参加临床干预研究并签署知情同意书;采用随机数字表法将患者分为对照组和干预组各55人,随访过程中,有2人自动退出,4人失访,最终对照组和干预组各52人;对照组和干预组在干预前均填写焦虑自评量表(SAS)、抑郁自评量表(SDS)、Mishel疾病不确定感量表(MUIS)以及一般资料量表;对照组患者术后接受常规健康宣教,干预组在接受常规健康宣教的基础上予以聚焦解决模式进行临床干预实验;两组患者出院当天均填写MUIS量表;出院后1个月内每周电话随访一次并进行院外持续干预,来院复查填写SAS、SDS;出院后3个月内每2周电话随访1次并进行院外持续干预,回院复查患者再次填写SAS、SDS、服药依从性量表,及收集患者各项血脂指标和院外吸烟、饮酒、锻炼情况。结果1.冠心病PCI术后患者在年龄、性别、文化程度等一般资料,焦虑评分、抑郁评分、疾病不确定感评分等基线资料均无统计学意义(P0.05);2.冠心病PCI术后患者接受临床聚焦解决模式干预后,出院当天对照组和干预组患者疾病不确定感总分及其各维度比较差异有统计学意义(P0.01);且与术后当天患者疾病不确定感比较,两组患者均有统计学差异(P0.01);3.随访1个月、3个月后冠心病PCI术后患者,对照组和干预组焦虑、抑郁评分差异均有统计学意义(P0.01);4.随访3个月后复查各项危血脂指标,对照组和干预组差异无统计学意义(P0.05)。5.患者出院3个月来院复查,对照组和干预组患者的服药依从性以及吸烟饮酒锻炼情况比较,结果只有两组患者的吸烟情况统计学无差异(P0.05),服药依从性、饮酒、锻炼情况比较结果(P0.01)。结论聚焦解决模式临床护理干预有效的降低患者术后焦虑、抑郁情绪及疾病不确定感;聚焦解决模式可以提高患者的院外依从性,还通过缓解患者的焦虑、抑郁情绪调节患者的血脂指标。
[Abstract]:Objective to use the focus solution model to intervene the patients with coronary heart disease (PCI) after operation, and to mobilize the positive and initiative of the patients from their own advantages and resources, so as to reduce the negative emotion and the sense of uncertainty of the patients. The negative emotion of the patients included anxiety and depression, and then changed the behavior of the patients. Methods from December 2015 to June 2016, the patients were selected in the Department of Cardiovascular Medicine of a third Class A Hospital in Qingdao. 110 successful PCI patients were enrolled in the clinical intervention study and signed informed consent. The patients were divided into control group and intervention group by random number table method. During the follow-up, 2 patients quit the interview automatically, and 52 patients in the control group and the intervention group. Before intervention, the control group and the intervention group all completed SAS, SDS / Mishel disease uncertainty scale (MUISS) and general information scale. The patients in the control group received routine health education after operation, and the intervention group underwent clinical intervention experiment on the basis of routine health education. The patients in both groups completed MUIS scale on the day of discharge. One month after discharge, the patients were followed up by telephone once a week and continued to intervene outside the hospital. Every 2 weeks after discharge, the patients were followed up by telephone every 2 weeks and continued to intervene outside the hospital. The patients who returned to the hospital filled in the SAS SDS again, took the compliance scale, and collected the blood lipid index and smoking outside the hospital. Results 1. Patients with coronary heart disease after PCI in age, sex, education and other general information, anxiety score, depression score. 2. No statistical significance was found in baseline data such as disease uncertainty score (P0.05). 2.After the intervention of clinical focus mode after coronary heart disease (PCI) operation, there were significant differences in the total score of disease uncertainty and its dimensions between the control group and the intervention group on the day of discharge (P 0.01). And compared with the patients after the day of disease uncertainty, the two groups of patients have a statistical difference (P0.01); 3. Follow up for 1 month, after 3 months of coronary heart disease PCI patients, the control group and the intervention group anxiety, depression score differences were statistically significant (P 0.01); 4. After 3 months follow-up, there was no significant difference between the control group and the intervention group. The patients were discharged from hospital for 3 months. Control group and intervention group patients' compliance to take medicine and smoking and drinking exercise, the results showed that there was no statistical difference between the two groups of smoking, P0.05, drug compliance, alcohol consumption. Conclusion the clinical nursing intervention of focus solution model can effectively reduce the anxiety, depression and uncertainty of patients after operation. The focus solution model can improve the patients' compliance outside hospital, and regulate the blood lipid index by relieving the anxiety and depression of the patients.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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