认知干预对慢性乙型肝炎患者心理状态和治疗依从性的影响  

Influence of cognitive intervention on the psychological status and therapeutic compliance in patients with chronic hepatitis B

作　　者：张姝娜[1] 安平[1] 曹艳雪[1] 戴文颖[1] 卞丽[1] 吕丹[1] 王佳贺[2] 

机构地区：[1]沈阳市传染病医院肝病研究所,辽宁省沈阳市110006 [2]中国医科大学附属第一医院感染科,辽宁省沈阳市110001

出　　处：《中国临床康复》2005年第12期44-45,共2页Chinese Journal of Clinical Rehabilitation

摘　　要：目的:研究认知干预对慢性乙型肝炎患者心理状态及抗病毒治疗依从性的影响,为慢性乙型肝炎的康复干预介入提供依据。方法:选择2003-06/2003-12沈阳市传染病医院肝病研究所收治的慢性乙型肝炎患者76例为研究对象。按病例来诊先后顺序分为干预组38例与对照组38例。全部患者能够按计划随访并完成测查。对照组实施抗病毒药物治疗,干预组在相同抗病毒药物治疗下实行针对性的认知干预。抗病毒治疗前后让患者填写症状自评量表,评价两组心理状态差异、抗病毒依从性及抗病毒疗效。结果:干预组在接受认知干预后症状自评量表中抑郁、焦虑、敌对及恐怖方面评分明显较干预前改善(t=6.383,3.498,3.216,4.953,P<0.01)。干预组抗病毒依从率明显优于对照组(97%,84%,χ2=6.832,P<0.05);干预组抗病毒治疗应答率明显优于对照组(95%,76%,χ2=6.801,P<0.05)。结论:对慢性乙型肝炎患者进行认知干预,有助于建立良好的医患关系,提高患者对慢性乙肝的认知行为,从而有效提高其对抗病毒治疗的依从性,提高疗效。AIM: To study the influence of cognitive intervention on the mental status and compliance of anti viral treatment in patients of chronic hepatitis B.METHODS: Seventy six patients with chronic hepatitis B, who were treated in the Institute of Hepatic Disease, Shenyang Infectious Disease Hospital from June to December 2003, were divided into intervention group (n=38) and control group (n=38) according to their order of hospitalization. All the patients were followed up as planned and finished the examination. Patients in both groups were treated with anti viral drugs, besides those in the intervention group received special cognitive intervention. All the patients were assessed with the symptom checklist 90 (SCL 90) before and after anti viral treatment, and difference of mental status, anti viral compliance and the anti viral efficacy were evaluated between the two groups.RESULTS: After cognitive intervention, the scores of depression, anxiety, hostility and phobic anxiety in SCL 90 were all significantly improved in the intervention group as compared with those before intervention (t=6.383, 3.498, 3.216, 4.953, P< 0.01). The anti viral compliance rate was obviously superior in the intervention group (97%) to the control group (84%) (χ2=6.832, P < 0.05). The anti viral response rate in the intervention group (95%) was markedly better than that in the control group (76%) (χ2=6.801,P< 0.05).CONCLUSION: Cognitive intervention to the patients of chronic hepatitis B helps to establish good relationships between medical staff and the patients, improve the cognitive behavior of the patients, and further enhance the compliance and efficacy of anti viral treatment.

关 键 词：认知 肝炎 乙型 慢性/心理学 病人依从 

分 类 号：R749.1[医药卫生—神经病学与精神病学]