正念减压疗法对肺结核患者病耻感自我效能及应对方式的影响  

Effects of mindfulness-based stress reduction on stigma,self-efficacy and coping style of pulmonary tuberculosis patients

作　　者：张全英[1] 贾冠华 张彦平 王霞[1] 朱玉花[1] Zhang Quanying;Jia Guanhua;Zhang Yanping;Wang Xia;Zhu Yuhua(The First Affiliated Hospital of Xinxiang Medical University,Weihui 453100,Henan,China)

机构地区：[1]新乡医学院第一附属医院,河南卫辉453100

出　　处：《临床心身疾病杂志》2021年第4期98-102,共5页Journal of Clinical Psychosomatic Diseases

基　　金：河南省医学科技攻关计划一般项目(编号RKX202002029)。

摘　　要：目的探讨正念减压疗法对肺结核患者病耻感、自我效能及应对方式的影响。方法将108例肺结核患者采用抛硬币法按照病区分为两组,每组54例。两组均给予常规护理,研究组在此基础上给予正念减压疗法治疗,观察8周。干预前后采用社会影响量表评定患者的病耻感水平,采用慢性病自我效能感量表评定患者的自我效能水平,采用医学应对方式问卷评定患者的应对方式,比较两组护理满意度。结果(1)病耻感:干预后两组社会影响量表总分及社会歧视、经济歧视、自我羞耻感、社会隔离维度分均显著低于干预前(P<0.01),研究组显著低于对照组(P<0.05或0.01)。(2)自我效能:干预后研究组慢性病自我效能感量表的疾病症状管理信心、疾病共性管理信心、自我效能感维度分显著高于干预前(P<0.01),且显著高于对照组(P<0.01),对照组干预前后则无显著变化(P>0.05)。(3)应对方式:干预后两组医学应对方式问卷的面对维度分均较干预前显著升高(P<0.01),回避、屈服维度分均较干预前显著降低(P<0.01),研究组显著优于对照组(P<0.01)。(4)护理满意度:研究组护理总满意率显著高于对照组(P<0.01)。结论正念减压疗法能有效降低肺结核患者的病耻感,提高患者的自我效能水平及护理满意度,转变应对方式。Objective To explore the effects of mindfulness-based stress reduction(MBSR)on stigma,self-efficacy and coping style of pulmonary tuberculosis patients.Methods A total of 108 cases of tuberculosis patients were divided into two groups according to the ward area by coin toss method,54 cases in each group.Both groups received routine nursing care.The study group received 8 weeks of MBSR.Before and after the intervention,the social impact scale(SIS)was used to assess the stigma level of patients,the chronic self-efficacy scale(CSES)was used to assess the self-efficacy level of patients,the medical coping modes questionnaire(MCMQ)was used to assess the coping styles of the two groups.The nursing satisfaction of the two groups was compared.Results(1)Stigma:after the intervention,the total scores of SIS and the dimensions of social discrimination,economic discrimination,self-shame,and social isolation in 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<0.05 or 0.01).(2)Self-efficacy:after the intervention,the dimensions of disease symptom management confidence,disease common management confidence,and self-efficacy in CSES were significantly higher than those before the intervention(P<0.01),and significantly higher than the control group(P<0.01).There was no significant change in the control group before and after intervention(P>0.05).(3)Coping style:after the intervention,the face dimension scores of the two groups in MCMQ were significantly higher than those before the intervention(P<0.01),and the avoidance and yield dimension scores were significantly lower than those before the intervention(P<0.01),and the study group was significantly better than the control group(P<0.01).(4)Nursing satisfaction:the total nursing satisfaction rate of the study group was significantly higher than that of the control group(P<0.01).Conclusions MBSR can effectively reduce the stigma of pulmonary tuberculosis patients,improve the level

关 键 词：肺结核 正念减压疗法 病耻感 自我效能 应对方式 

分 类 号：R521[医药卫生—内科学] R471[医药卫生—临床医学]