认知行为疗法在心脏瓣膜置换术后护理中的应用  

Application of cognitive behavioral therapy in nursing after heart valve replacement

作　　者：王一珠 胡青霞[1] 孙艳涛 付雪[1] Wang Yizhu;Hu Qingxia;Sun Yantao;Fu Xue(The First Affiliated Hospital of Zhengzhou University,Zhengzhou 450000,Henan,China)

机构地区：[1]郑州大学第一附属医院,河南郑州450000

出　　处：《临床心身疾病杂志》2024年第6期155-160,共6页Journal of Clinical Psychosomatic Diseases

摘　　要：目的探讨认知行为疗法在心脏瓣膜置换术后护理中的应用效果。方法选取82例实施心脏瓣膜置换术的患者为研究对象,随机将其分为观察组和对照组,各41例。对照组患者采取常规护理干预,观察组患者在对照组的基础上采取认知行为疗法干预。比较两组患者心理弹性[心理弹性量表简表(RS-14)评分]、应对方式[医学应对方式问卷(MCMQ)评分]、自我管理效能[心脏健康自我效能和自我管理量表(HH-SESM)评分]、疾病不确定感[疾病不确定感成人量表(MUIS-A)评分]、护理满意度(纽卡斯尔护理满意度量表评分)以及术后并发症。结果干预后,两组患者RS-14各维度评分均较干预前升高,且观察组高于对照组(P<0.01);两组患者MCMQ面对维度评分均较干预前升高,回避、屈服维度评分均较干预前降低,且观察组优于对照组,(P<0.01);观察组患者HH-SESM各维度评分均高于干预前,且高于对照组(P<0.01);两组患者MUIS-A各维度评分均低于干预前,且观察组低于对照组(P<0.01)。观察组患者护理总满意率高于对照组(P<0.05)。观察组患者术后并发症总发生率低于对照组(P<0.05)。结论应用认知行为疗法进行干预,疗效确切,能促进术后康复进程,值得在临床推广。Objective To explore the application effect of cognitive behavioral therapy(CBT)in nursing after heart valve replacement(HVR).Methods Eighty-two patients undergoing the HVR were selected as research objects and were randomy divided into observation and control group,with 41 ones in each.Controls received routing nursing intervention and observation group did the CBT on the basis of controls.Such indexes were compared between two groups as psychological resilience(the 14-item Resilience Scale[RS-14]score),coping styles(Medical Coping Modes Questionnaire[MCMQ]score),self-efficacy and self-management(Heart Health Self-efficacy and Self Management[HH-SESM]score),illness uncer tainty(Mishel Uncer tainty in Illness Scale-Adult[MUIS-A]score),satisfaction with nursing(Newcastle Satisfaction with Nursing Scales[NSNS]score),and postoperative complications.Results After intervention,each dimension scores of the RS-14 in both groups elevated compared with pre-intervention and those were higher in observation than control group(P<0.01).After intervention,confronce scores of the MCMQ in both groups elevated and avoidance and resigntion lowered compared with pre-intervention,and observation was better than control group(P<0.01).After intervention each dimension score of the HH-SESM were higher compared with pre-intervention in observation group and so were those than control group(P<0.01).After intervention each dimension scores of the MUIS-A in both groups were lower compared with pre-intervention and so were those in observation than control group(P<0.01).The satisfaction rate of nursing was higher in observation than control group(P<0.05).The total incidence of postoperative complications was lower in observation than control group(P<0.05).Conclusion The CBT has a definite effect on patients with the HVR,can promote postoperat ive recovery process,and deserves clinical promotion.

关 键 词：认知行为疗法 心脏瓣膜置换术 心理弹性 应对方式 自我管理效能 疾病不确定感 满意度 术后并发症 

分 类 号：R473.74[医药卫生—护理学] R654.2[医药卫生—临床医学]