心理干预对连续性血液滤过治疗急性重症胰腺炎患者的效果观察

发布时间：2018-03-19 10:40

本文选题：心理干预　切入点：连续性血液滤过　出处：《青岛大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的观察心理干预在连续性血液滤过治疗急性重症胰腺炎患者中的作用;探讨如何通过有效的心理干预减轻患者的焦虑和抑郁情绪,提高患者对护理工作的满意度,进而缩短患者住院日,提高患者治愈率,节省有限的医疗资源。方法收集2013年1月~2015年10月入住单县中心医院重症医学科的急性重症胰腺炎并行连续性血液滤过的64例患者,采用随机分组的方法将其分为干预组和对照组。对照组给予对症治疗和常规治疗及护理,干预组在此基础上实施个性化心理干预。在干预前使用SAS量表(self-rating anxiety scale,SAS)及SDS量表(self-rating depression scale,SDS对两组患者进行焦虑、抑郁评分,并进行急性胰腺炎的CT严重指数(CTSI)评分,记录所有数据;干预两周后,再次对两组患者进行焦虑、抑郁评分及急性胰腺炎的CT严重指数(CTSI)评分,记录所有数据,并与干预前进行相应比较,最后使用本院制定的患者满意度调查表调查两组患者对护理工作的满意度情况并做出比较。结果1.64名患者入院时的SAS及SDS评分的标准分与中国常模比较(uSAS=10.52,PSAS0.01;uSDS=7.42,PSDS0.01),差异具有统计学意义,由此我们可以看出64名患者的心理健康状况明显低于国内正常人群的常模水平,其中78%的患者有不同程度的焦虑,71%的患者有不同程度的抑郁。2.患者入院时对照组与干预组的SAS评分比较(t=-1.746,P0.05)、SDS评分比较(t=-0.400,P0.05),差异均无统计学意义;2周后再次对两组患者进行评分,对照组与干预组的评分比较SAS评分比较(t=-8.289,P0.05)、SDS评分比较(t=10.352,P0.05),差异均具有统计学意义。3.入院时对照组与干预组患者的CTSI比较无统计学意义(t=-0.607,P0.05);干预实施2周后再进行两组数据的比较差异就具有了统计学意义(t=35.587,P0.05),差异具有统计学意义,表明心理干预对降低急性重症胰腺炎患者的CTSI评分有一定影响。4.两组患者的满意度调查结果比较显示(F=6.694,P0.05),其差异具有统计学意义。5.两组患者治疗后总有效率的结果比较显示(F=51.883,P0.05),其差异具有统计学意义。结论心理干预能有效改善行连续性血液滤过治疗的急性重症胰腺炎患者的焦虑和抑郁情绪;能降低行连续性血液滤过治疗的急性重症胰腺炎患者的CTSI评分;能提高患者对护理工作的满意度,并对患者的治疗效果有一定的影响。
[Abstract]:Objective to observe the role of psychological intervention in the treatment of severe acute pancreatitis by continuous hemofiltration, and to explore how to reduce the anxiety and depression of patients by effective psychological intervention, and to improve their satisfaction with nursing work. Methods 64 patients with severe acute pancreatitis and continuous hemofiltration who were admitted to the Department of intensive Medicine of Shanxian Central Hospital from January 2013 to October 2015 were collected. They were randomly divided into two groups: the intervention group and the control group. The control group was given symptomatic treatment, routine treatment and nursing care. Before intervention, the two groups were assessed with self-rating anxiety scale (SAS) and self-rating depression scale (SDS) for anxiety and depression, and CT severity index (CTSI) score for acute pancreatitis, and all the data were recorded. After two weeks of intervention, anxiety, depression scores and CT severity index (CTSI) scores of acute pancreatitis were scored again, and all data were recorded and compared with those before intervention. Results 1.The standard scores of SAS and SDS scores of 64 patients at admission were compared with those of the Chinese norm. The difference was statistically significant. From this, we can see that the mental health status of 64 patients is obviously lower than the norm level of the normal population in China. 78% of the patients had different degree of anxiety and 71% had different degree of depression. 2. The SAS scores of the control group and the intervention group were compared at admission. Comparison of SAS scores between the control group and the intervention group; the comparison of the SAS score between the control group and the intervention group was statistically significant. 3. There was no significant difference in CTSI between the control group and the intervention group at the time of admission, and the number of the two groups after 2 weeks of intervention was not significantly different from that of the control group and the intervention group. According to the comparison, the difference was statistically significant, and the difference was statistically significant. The results show that psychological intervention has certain influence on reducing CTSI score of patients with severe acute pancreatitis. The result of satisfaction investigation between the two groups shows that the difference between the two groups is statistically significant. 5. the total effective rate of the two groups after treatment is higher than that of the control group. The difference was statistically significant. Conclusion Psychological intervention can effectively improve anxiety and depression in patients with severe acute pancreatitis treated with continuous hemofiltration therapy. It can reduce the CTSI score of the patients with severe acute pancreatitis who received continuous hemofiltration therapy, improve the patients' satisfaction with nursing work, and have a certain effect on the therapeutic effect 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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