积极心理学对慢性心力衰竭伴2型糖尿病患者心理和心脏功能的影响  

Effects of positive psychology on the mental toughness,self-management ability and cardiac function in elderly patients with chronic heart failure complicated by type 2 diabetes

作　　者：冯红云[1] 赵媛媛[1] 张哲 于玲 FENG Hongyun;ZHAO Yuanyuan;ZHANG Zhe(The First Hospital of Hebei Medical University,Hebei,Shijiazhuang 050031,China)

机构地区：[1]河北医科大学第一医院,石家庄市050031

出　　处：《河北医药》2023年第10期1582-1585,1589,共5页Hebei Medical Journal

摘　　要：目的基于积极心理学视角下的延续性护理对老年慢性心力衰竭(CHF)伴2型糖尿病患者心理韧性,自我管理能力、糖化血红蛋白和心功能的影响,探讨CHF伴糖尿病患者院外治疗策略。方法分析2018年1~7月60例CHF伴2型糖尿病的患者,按照不同护理方式分为对照组和干预组,每组30例。对照组患者给予常规延续性护理;干预组在常规延续性护理的基础上实施基于积极心理学视角下的延续性护理。评价2组患者的心理韧性、自我管理能力、糖化血红蛋白和心功能。结果2组患者出院时心理韧性、自我管理能力、糖化血红蛋白和心功能比较均无统计学意义(P>0.05),干预组出院6个月后心理韧性各维度,坚强与乐观、毅力与控制、镇静与超越、执着与果断、精神力量评分均显著高于对照组(P<0.01)。干预组6个月后6MWT明显增加(P<0.05)LVEF%均增加不明显(P>0.05)BNP水平明显降低(P<0.05),干预组患者出院6个月2组患者自我管理水平的各维度,药物管理维度、饮食管理制度、心理/社会适应管理维度、症状管理维度各项评分均显著高于对照组(P<0.01)。结论基于积极心理学视角下实施延续性护理能提升慢性心力衰竭伴2型糖尿病患者的心理韧性,促使患者采取积极健康行为,提高患者自我管理能力,有效改善患者运动耐量,降低患者糖化血红蛋白数值,改善患者健康结局,值得推广应用。Objective To investigate the effects of positive psychology on the mental toughness,self-management ability and cardiac function in elderly patients with chronic heart failure(CHF)complicated by type 2 diabetes,so as to explore the extramural hospital treatment strategies.Methods A total of elderly patients with CHF complicated by type 2 diabetes were divided into control group and observation group according to different nursing methods,with 30 cases in each group.The patients in control group were given routine continuous care,however,the patients in observation group,on the basis of control group,were given routine continuous nursing based on positive psychology.The mental toughness,self management ability,glycosylated hemoglobin and cardiac function were observed and compared between the two groups.Results On discharging from hospital there were no significant differences in mental toughness,self management ability,glycosylated hemoglobin and cardiac function between the two groups(P>0.05).After 6-month intervention the scores of mental toughness in each dimension,firmness and optimism,perseverance and control,sedation and transcendence,persistence and decisiveness,and mental strength in observation group were significantly higher than those in control group(P<0.01),and the 6MWT in observation group was significantly increased(P<0.05),LVEF%was not significantly increased(P>0.05),but BNP levels were significantly decreased(P<0.05).At 6 months after discharging from hospital the scores of self-management,drug management,diet management system,psychological/social adjustment management and symptom management in observation group were significantly higher than those in control group(P<0.01).Conclusion The continuous nursing based on positive psychology can improve the mental toughness of patients with CHF complicated by type 2 diabetes,improve the self management ability of patients,effectively improve exercise tolerance,reduce glycated hemoglobin levels,so as to improve the prognosis of patients,thus,it is worth

关 键 词：积极心理学 心力衰竭 慢性 2型糖尿病 心理韧性 自我管理能力 心功能 

分 类 号：R473.5[医药卫生—护理学]