正性团体心理指导联合康复训练对脑梗死后偏瘫患者心理负担的影响  

Effects of positive group psychological guidance combined with rehabilitation training on psychological burden of patients with hemiplegia after cerebral infarction

作　　者：康宾宾 张晓雨 KANG Binbin;ZHANG Xiaoyu(Yellow River Water Conservancy Com mission Yellow River Central Hospital,Zhengzhou 450003,China)

机构地区：[1]黄河水利委员会黄河中心医院,河南郑州450003 [2]郑州人民医院

出　　处：《中国健康心理学杂志》2021年第7期1001-1005,共5页China Journal of Health Psychology

基　　金：河南省医学科技攻关计划(编号:201603096)。

摘　　要：目的:观察正性团体心理指导联合康复训练对脑梗死(CI)后偏瘫患者心理负担的影响。方法:按随机数表法将80例CI后偏瘫患者分为正性团体心理指导+康复训练组(联合组,n=40)和康复训练组(对照组,n=40)。于干预前(T1)及干预3个月后(T2)评估两组患者心理状态[抑郁自评量表(SDS)、焦虑自评量表(SAS)]、心理一致感(SOC)[心理一致感量表(SOC-13)]、应对方式[医学应对方式问卷(MCMQ)]、生活能力[功能独立性评定量表(FIM)],比较前后有无差别。结果:T2时,两组SDS、SAS评分均较T1时降低,但两组降低程度差异无统计学意义(t_(SDS)=1.971,P=0.052;t_(SAS)=1.071,P=0.287)。两组SOC-13各维度评分均较T1时升高,且联合组升高程度均大于对照组(t_(理解感)=2.544,P=0.013;t_(可控制感)=6.952,P<0.001;t_(价值感)=3.478,P=0.001)。两组MCMQ面对评分较T1时升高,且联合组升高程度大于对照组(t=3.883,P<0.001),屈服评分较T1时降低,但两组降低程度差异无统计学意义(t=0.472,P=0.638);各组回避评分组内及组间干预前后差异均无统计学意义(t=1.888,P=0.063)。两组认知功能、运动功能、总分评分均较T1时升高,且联合组运动功能、总分评分升高程度大于对照组(t_(运动功能)=2.704,P=0.008;t_(总分)=2.829,P=0.006),但两组认知功能评分升高程度差异无统计学意义(t_(认知功能)=1.112,P=0.265)。结论:正性团体心理指导联合康复训练应用于CI后偏瘫患者有助于减轻其负性情绪,提升其SOC,调整其应对方式,改善其生活能力,有一定价值。Objective:To observe the effects of positive group psychological guidance combined with rehabilitation training on the psychological burden of patients with hemiplegia after cerebral infarction(CI).Methods:Eighty patients with hemiplegia after CI were divided into positive group psychological guidance+rehabilitation training group(combined group,n=40)and rehabilitation training group(control group,n=40)according to the random number table method.Before intervention(T1)and after 3 months of intervention(T2),the psychological status[Self-rating Depression Scale(SDS),Self-rating Anxiety Scale(SAS)],sense of coherence(SOC)[Sense of Coherence Scale(SOC-13)],coping styles[Medical Coping Mode Questionnaire(MCMQ)]and living ability[Functional Independence Measure(FIM)]were evaluated in the two groups,and the differences were compared before and after intervention.Results:At T2,the scores in combined group were lower than those in control group(t=-4.347,-2.855;P<0.05).The scores of dimensions of SOC-13 in combined group were higher than those in control group(t=2.871,9.844,3.919;P<0.05).The score of facing of MCMQ in combined group was higher than that in control group(t=5.843,P<0.05).The scores of yielding in combined group was lower than that in control group(t=-4.081,P<0.05).There was no significant change in the avoidance score between the groups and before and after intervention(P>0.05).The FIM motor function score and total score in combined group were higher than those in control group(t=3.071,3.308;P<0.05).Conclusion:Positive group psychological guidance combined with rehabilitation training for patients with hemiplegia after CI can help to reduce the negative emotions,improve the SOC,adjust the coping styles and promote the living ability,with certain value.

关 键 词：脑梗死 偏瘫 正性团体心理指导 康复训练 心理状态 

分 类 号：R749.92[医药卫生—神经病学与精神病学]