脑卒中后便秘患者的认知行为干预研究  

A cognitive behavioral intervention program for post-stroke patients with constipation

作　　者：王丽[1,2] 周君桂[1] 杨晓华[3] 程代红[1] 杨曼[1] 王静新[1] 蔡文智[2] 

机构地区：[1]南方医科大学南方医院,广东广州510515 [2]南方医科大学护理学院,广东广州510515 [3]南方医科大学珠江医院,广东广州510515

出　　处：《护理学杂志》2014年第3期39-42,共4页

基　　金：广东省科技计划资助项目(2012B031800133)

摘　　要：目的探索认知行为干预对脑卒中后便秘患者的作用,为临床护理干预提供依据。方法按随机数字表法将90例脑卒中后便秘患者随机分为对照组、行为组及认知行为组各30例,对照组行常规便秘护理,行为组增加行为指导,认知行为组再增加定向力、记忆力及注意力等训练,于第1、2个疗程后评价效果。结果干预后三组便秘症状积分及疗效显著优于干预前,组间比较差异有统计学意义(均P<0.01),认知行为组最好,行为组次之,对照组最差(P<0.05,P<0.01);三组认知功能(MMSE)评分及日常生活能力(BI)评分显著高于干预前(均P<0.01);组间比较,差异无统计学意义(均P>0.05);便秘症状积分与MMSE、BI评分呈显著负相关(P<0.05,P<0.01)。结论认知行为干预可有效改善脑卒中后便秘症状,在一定程度上提高了患者的认知能力及日常生活能力。Objective To evaluate the efficacy of cognitive behavioral therapy （CBT） for post-stroke patients with constipation. Me- thods By using random number table, 90 post-stroke patients with constipation were evenly and randomly divided into a control group, a behavioral group and a cognitive behavioral group. Routine nursing for constipation was carried out in the control group; behavioral intervention was added in the behavioral group. As compared with the behavioral group, training of orientation, memory and attention was added in the cognitive behavioral group. The efficiency was evaluated after one or two course（s） of treatment. Re- suits After intervention, constipation symptom and the curative effect were significantly improved, with significant differences be- tween each two groups （P〈0.01 for all）. The curative effect was the best in the cognitive behavioral group, better in the behavio- ral group and good in the control group （P〈0.05, P〈0.01）. The score of Mini-mental State Examination（MMSE） and Barthel Index （BI） in the three groups were significantly increased after intervention （P〈0.01 for both）. But the differences between the groups were not significant （P〉0.05 for all）. Constipation symptoms were negatively correlated with scores of MMSE and BI （P〈0.05 ,P〈0.01）. Conclusion CBT can effectively relieve the clinical symptoms of constipation, and improve patient＇s cognitive ability and the ability of activities of daily life.

关 键 词：脑卒中 便秘 认知行为干预 认知功能 日常生活能力 

分 类 号：R473.5[医药卫生—护理学] R493[医药卫生—临床医学]