IMB模型联合认知行为干预对老年下肢骨折患者术后疼痛情绪自我效能感及生活质量的影响  

Effects of IMB model intervention combined with cognitive behavioral intervention on the postoperative pain,emotional,self-efficacy and quality of life in elderly patients with lower limb fractures

作　　者：王广云 祝盼盼 Wang Guang yun;Zhu Panpan(First Affiliated Hospital of Zheng zhou University,Zheng zhou 450044,Henan,China)

机构地区：[1]郑州大学第一附属医院,河南郑州450044

出　　处：《临床心身疾病杂志》2020年第3期106-109,114,共5页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨信息-动机-行为技巧模型干预联合认知行为干预对老年下肢骨折患者术后疼痛、情绪、自我效能感、自护能力及生活质量的影响.方法将行手术治疗的94例老年下肢骨折患者按随机数字表法分为两组,每组47例.两组术后均予以常规护理干预,研究组在此基础上予以信息-动机-行为技巧模型干预联合认知行为干预.观察1个月.统计两组治疗依从性及并发症发生情况,于术后采用视觉模拟评分法评定疼痛程度,于干预前后采用焦虑自评量表、抑郁自评量表、康复自我效能感量表、自我护理能力测定量表及简明健康状况量表评定焦虑抑郁情绪、自我效能感、自护能力及生活质量.结果研究组治疗依从性显著优于对照组(P<0.01),并发症发生率显著低于对照组(P<0.05).术后12 h、24 h及48 h,研究组视觉模拟评分法评分均显著低于对照组(P<0.01).干预后两组焦虑自评量表、抑郁自评量表评分均较干预前显著降低(P<0.01),研究组显著低于对照组(P<0.01).干预后两组康复自我效能感量表、自我护理能力测定量表及简明健康状况量表评分均较干预前显著提高(P<0.01),研究组显著高于对照组(P<0.01).结论信息-动机-行为技巧模型干预联合认知行为干预能显著缓解老年下肢骨折患者术后的焦虑、抑郁情绪,有效降低术后疼痛程度及并发症发生率,提高其治疗依从性、自我效能感及自我护理能力,改善生活质量.Objective To explore the effects of information-motivation-behavioral skill(IMB)model combined with cognitive behavioral intervention on postoperative pain,mood,self-efficacy,self-care ability and quality of life in elderly patients with lower limb fractures.Methods 94 elderly patients with lower extremity fractures received surgery were divided into two groups according to the random number table method,with 47 cases in each group.The control group was given routine nursing intervention,and the research group was given IMB model combined with cognitive behavior intervention on the basis of the control group for 1 month.Analyze the treatment compliance and complications of the two groups.VAS was used to assess the pain after surgery,and SAS,SDS,SER,ESCA,and SF-36 were used to evaluate anxiety and depression,self-efficacy,self-care ability and life quality.Results The compliance of the study group was significantly better than that of the control group(P<0.01),and the incidence of complications was significantly lower than that of the control group(P<0.05).At 12 h,24 h and 48 h after surgery,the VAS scores in the study group were significantly lower than those in the control group(P<0.01).After the intervention,the SAS and SDS scores of the two groups were significantly lower than those before the intervention(P<0.01),and the study group was significantly lower than the control group(P<0.01).After the intervention,the SER,ESCA and SF-36 scores of the two groups were significantly higher than before the intervention(P<0.01),and the study group was significantly higher than the control group(P<0.01).Conclusions IMB model combined with cognitive behavioral intervention can significantly improve the psychological status of elderly patients with lower limb fracture,reduce the degree of pain after operation,improve treatment compliance,and effectively improve the self-efficacy of patients,enhance self-care ability,and improve the quality of life.

关 键 词：下肢骨折 外科手术 信息-动机-行为技巧模型 认知行为干预 治疗依从性 情绪 自我效能感 自护能力 并发症 

分 类 号：R274.12[医药卫生—中医骨伤科学] R473.6[医药卫生—中医学]