15例新型冠状病毒肺炎患者全病程心理分析及心理干预模式探讨  

Psychological analysis of 15 COVID-19 patients and exploration of psychological intervention strategies

作　　者：刘杉杉 罗澍[1] 刘敏[1] 唐梅[1] 林思勤 LIU Shanshan;LUO Shu;LIU Min;TANG Mei;LIN Siqin(Psychosomatic Department,the People’s Hospital of Deyang,Deyang 618000,China)

机构地区：[1]德阳市人民医院心身医学科,四川德阳618000

出　　处：《健康研究》2020年第3期268-272,共5页Health Research

摘　　要：目的了解新型冠状病毒性肺炎(corona virus disease 2019,COVID-19)患者全病程的心理状态,并探索相关心理干预模式。方法选取15例COVID-19确诊患者,采用9项患者健康问卷(PHQ-9)、7项广泛性焦虑障碍量表(GAD-7)、中文版失眠严重指数量表(ISI)、急性应激障碍量表(ASDS)和自杀风险评估量表(NGASR),从入院开始进行间隔2 d、每3天复评的动态心理追踪评价。结果 15例COVID-19患者首访心理评估结果显示:PHQ-9平均分为(4. 47±2. 30)分,7例(46. 7%)患者出现轻度抑郁情绪、1例(6. 7%)患者出现中度抑郁情绪;GAD-7平均分为(3. 93±2. 60)分,4例患者(26. 7%)出现轻度焦虑情绪、1例患者(6. 7%)出现重度焦虑情绪;ISI平均分为(4. 20±3. 23)分,1例患者(6. 7%)出现轻度失眠、2例患者(13. 3%)出现中度失眠;15例患者急性应激障碍测评结果均为阴性,均为自杀低风险。患者住院后6个测量时间点的抑郁、焦虑情绪比较,差异均有统计学意义(P<0. 05)。COVID-19患者在住院第1周情绪波动明显,之后各项心理指数下降并趋于稳定,部分患者在出院前1周焦虑情绪有升高。结论 COVID-19患者在病程不同时期呈现不同的心理状态,需进行分级分阶段有针对性的心理干预,加强住院前期与后期的心理干预力度,持续跟进出院后的心理支持。Objective To observe the whole course status of psychological of corona virus disease 2019(COVID-19)patients and explore the effective psychological intervention strategies.Methods A total of 15 COVID-19 patients were selected.PHQ-9,GAD-7,ISI,ASDS and NGASR were used to conduct a dynamic psychological follow-up evaluation at the interval of two days and every three days from admission.Results The results of the first visit psychological evaluation of 15 COVID-19 patients showed that PHQ-9 had an average score of(4.47±2.30)points,seven patients(46.7%)had mild depression,one patient(6.7%)had moderate depression;and GAD-7 had an average score of(3.93±2.60)points,four patients(26.7%)had mild anxiety,one patient(6.7%)had severe anxiety;and ISI had an average score of(4.20±3.23)points,one patient(6.7%)had mild insomnia,two patients(13.3%)had moderate insomnia.15 patients had negative results of acute stress disorder,all of which were low risk of suicide.There were significant differences in depression and anxiety of patients at six time points after hospitalization(P<0.05).COVID-19 patients’mood fluctuated obviously in the first week of hospitalization,and then all psychological indexes decreased and tended to be stable.Some patients’anxiety increased in the first week before discharge.Conclusions COVID-19 patients presented different psychological states at different stages of the disease course,which required graded and phased targeted psychological intervention,enhanced psychological intervention in the early and late stage of hospitalization,and continued follow-up of psychological support after discharge.

关 键 词：新型冠状病毒肺炎 心理干预 干预模式 

分 类 号：R18[医药卫生—流行病学]