“斯金纳”理论下的健康教育配合家属参与式心理干预对脑中风偏瘫患者希望水平、心理弹性、应对方式的影响  

Effects of health education under Skinner theory combined with family-participatory psychological intervention on hope level,psychological resilience and coping styles of patients with stroke hemiplegia

作　　者：宋彦锡 张江山 周艳辉[1] 程启慧[1] 吴海燕 林海丽[1] SONG Yanxi;ZHANG Jiangshan;ZHOU Yanhui;CHENG Qihui;WU Haiyan;LIN Haili(Department of Neurology,Haikou People's Hospital,Haikou 570203,China)

机构地区：[1]海南省海口市人民医院神经内科,570203

出　　处：《中国健康心理学杂志》2023年第12期1831-1836,共6页China Journal of Health Psychology

基　　金：海南省卫生健康行业科研项目(编号:20A200363)。

摘　　要：目的:探究斯金纳理论下的健康教育配合家属参与式心理干预对脑中风偏瘫患者希望水平、心理弹性、应对方式的影响。方法:选取86例脑中风偏瘫患者,按照随机数字表法分为对照组(n=43)和观察组(n=43),对照组患者给予常规干预,观察组在常规干预基础上给予“斯金纳”理论下的健康教育配合家属参与式心理干预。对比两组患者干预前后的希望水平[Herth希望量表(HHI)]、心理弹性[心理韧性评定量表(CD-RISC)]、应对方式[医学应对方式问卷(MCMQ)]及康复锻炼依从性(脑卒中患者功能锻炼依从性量表)结果差异。结果:干预后,观察组HHI量表对现实和未来的积极态度、采取的积极行动、与他人保持亲密关系及总分显著高于对照组(t=-4.158,3.161,2.234,5.139;P<0.05);干预后,观察组CD-RISC量表坚韧、自强、乐观评分及总分显著高于对照组(t=5.431,4.598,5.233,8.064;P<0.05);观察组MCMQ面对评分显著高于对照组干预前(t=4.269,P<0.05),回避、屈服评分显著低于对照组干预前(t=-4.065,-3.018;P<0.05);干预后,观察组患者坚持参与锻炼、锻炼效果监督、锻炼时主动学习依从性以及总体依从性均显著高于对照组(χ^(2)=5.460,4.914,4.440,3.957;P<0.05)。结论:针对脑中风偏瘫患者采取“斯金纳”理论下的健康教育配合家属参与式心理干预,有助于提高患者希望水平、增强患者心理弹性、转变患者不良应对方式,还可提升患者康复锻炼依从性。Objective:To explore the effects of health education under Skinner theory combined with family-participatory psychological intervention on hope level,psychological resilience and coping styles of patients with stroke hemiplegia.Methods:A total of 86 patients with stroke hemiplegia were selected and divided into control group(n=43)and observation group(n=43)according to the random number table method.Patients in the control group were given routine intervention,and patients in the observation group were given health education under Skinner theory combined with family-participatory psychological intervention on the basis of routine intervention.The hope level[Herth Hope Inventory(HHI)],psychological resilience[Connor-Davidson Resilience Scale(CD-RISC)],coping styles[Medical Coping Modes Questionnaire(MCMQ)]and rehabilitation exercise compliance(functional exercise compliance scale for stroke patients)were compared between the two groups of patients before and after intervention.Results:After intervention,the scores of positive attitude towards reality and future,taking positive actions and maintaining close relationship with others and total score of HHI in observation group were significantly higher than those in control group(t=-4.158,3.161,2.234,5.139;P<0.05).After intervention,the scores of resilience,self-reliance and optimism and total score of CD-RISC were significantly higher in observation group than those in control group(t=5.431,4.598,5.233,8.064;P<0.05).The facing score in observation group was significantly higher than that in control group before intervention(t=4.269,P<0.05)while the scores of avoidance and yielding were significantly lower than those in control group before intervention(t=-4.065,-3.018;P<0.05).After intervention,the compliance rates of adherence to exercise,exercise effect supervision and active learning compliance during exercise and overall compliance rate in observation group were significantly higher compared with those in control group(χ^(2)=5.460,4.914,4.440,3.957;P<0.05).Conc

关 键 词：斯金纳理论 健康教育 家属参与式心理干预 脑中风偏瘫 希望 

分 类 号：R395.5[哲学宗教—心理学] R749.92[医药卫生—医学心理学]