家庭正向行为支持联合认知训练对脑卒中后认知功能障碍患者心理应激及疾病不确定感的影响  

Influence of family positive behavior support combined with cognitive training on psychological stress status and disease uncertainty in patients with post-stroke cognitive impairment

作　　者：孔一帆 顾亮亮[1] 王云香[1] 潘峰[1] KONG Yifan;GU Liangliang;WANG Yunxiang;PAN Feng(Special Needs Ward,Department of Neurology,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]河南省南阳市中心医院神经内科特需病区,473000

出　　处：《中国健康心理学杂志》2024年第9期1346-1352,共7页China Journal of Health Psychology

基　　金：河南省医学科技攻关计划联合共建项目(编号:LHGJ20191454)。

摘　　要：目的:探究家庭正向支持行为联合认知训练对脑卒中后认知功能障碍(PSCI)患者心理应激情况及疾病不确定感的影响。方法:选取2023年1月-2024年1月某院收治的88例PSCI患者为研究对象,随机分为联合组和对照组,两组各44例患者。对照组患者在常规干预的基础上予以认知训练,联合组患者在对照组的基础上予以家庭正向行为支持干预。观察两组患者干预前后认知功能、心理应激情况、疾病不确定感、家庭亲密度与适应性的变化。结果:经2个月干预后,联合组患者相较对照组患者在蒙特利尔认知评估量表(MoCA)和简易精神状态量表(MMSE)评分上更高(t=3.100,3.125;P<0.05);联合组患者相较对照组患者在应激反应问卷(SRQ)上量表躯体反应、情绪反应、行为反应3个维度评分和Mishel疾病不确定感量表(MUSIA)上量表不确定性、复杂性、不可预测性、信息缺乏性4个维度上评分明显更低(t=3.427,2.920,3.299,3.088,2.827,3.270,3.299;P<0.05);联合组患者相较对照组患者在家庭亲密度和适应性中文版量表(FACES II)上家庭亲密度和适应性2个维度评分上明显更高(t=3.298,3.317;P<0.05)。结论:家庭正向行为支持联合认知训练应用于PSCI患者可促进认知功能恢复,减轻心理应激反应,帮助其消除疾病不确定感,并增加家庭亲密度和适应性。Objective:To explore the influence of family positive support behavior combined with cognitive training on psychological stress status and disease uncertainty in patients with post-stroke cognitive impairment(PSCI).Methods:A total of 88 patients with PSCI in the hospital from January 2023 to January 2024 were selected as the study subjects,and were randomly divided into combined group and control group,with 44 cases in each group.The patients in the control group were given cognitive training on the basis of routine intervention,whereas the patients in the combined group carried out family positive behavior support intervention on the basis of the control group.The changes in cognitive function,psychological stress status,disease uncertainty,family intimacy and adaptability before and after intervention were observed in the two groups.Results:After 2 months of intervention,the Montreal Cognitive Assessment Scale(MoCA)score and Mini-Mental State Scale(MMSE)score in combined group were higher than those in control group(t=3.100,3.125;P<0.05).Compared with control group,patients in the combined group had significantly lower scores on the three dimensions of physical response,emotional response and behavioral response of Stress Response Questionnaire(SRQ)and the four dimensions of uncertainty,complexity,unpredictability and lack of information ofMishel Uncertainty in Illness Scale(MUSIA)(t=3.427,2.920,3.299,3.088,2.827,3.270,3.299;P<0.05).Compared withcontrol group,the scores of family intimacy and adaptability of Family Adaptability and CohesionScale(FACES II)were significantly higher in combined group(t=3.298,3.317;P<0.05).Conclusion:The application of family positive behavior support combined with cognitive training in PSCI patients can promote the recovery of cognitive function,relieve the psychological stress response,help them eliminate disease uncertainty,and increase family intimacy and adaptability.

关 键 词：家庭正向行为支持 认知训练 脑卒中后认知功能障碍 心理应激 疾病不确定感 

分 类 号：R749.92[医药卫生—神经病学与精神病学] R395.5[医药卫生—临床医学]