基于行为转变理论的团体接纳承诺疗法在青年缺血性脑卒中病人中的应用效果  

Application effect of group acceptance and commitment therapy based on trans-theoretical model in young patients with ischemic stroke

作　　者：付子悦 金瑞华[1] 穆兰 武佳琪 宋丽芳 王改珍 FU Ziyue;JIN Ruihua;MU Lan;WU Jiaqi;SONG Lifang;WANG Gaizhen(Nursing College of Shanxi Medical University,Shanxi 030001 China)

机构地区：[1]山西医科大学护理学院,山西030001

出　　处：《护理研究》2025年第4期633-640,共8页Chinese Nursing Research

摘　　要：目的:研究基于行为转变理论的团体接纳承诺疗法对青年缺血性脑卒中病人病耻感、心理弹性水平与心理僵化程度的干预效果。方法:选取2023年5月—6月山西省某三级甲等医院神经内科入院诊断为缺血性脑卒中的青年住院病人76例,采用随机数字表法分为试验组和对照组,其中试验组38例,对照组38例。对照组接受神经内科的常规护理,试验组在对照组的基础上接受基于行为转变理论的团体接纳承诺疗法护理。干预前后采用慢性病病耻感量表(SSCI)、心理弹性问卷(CD-RISC-10)、接纳与行动问卷(AAQ-Ⅱ)及认知融合问卷(CFQ-F)进行评估。结果:两组病人干预前各项指标得分比较差异均无统计学意义(P>0.05)。干预后即刻、1个月、3个月,试验组SSCI、AAQ-Ⅱ、CFQ-F得分低于对照组,CD-RISC-10得分高于对照组,差异均有统计学意义(P<0.05)。CD-RISC-10、SSCI、AAQ-Ⅱ、CFQ-F得分处理效应、时间效应及交互效应均显著(P<0.05)。结论:基于行为转变理论的团体接纳承诺疗法可有效降低青年缺血性脑卒中病人病耻感,提高心理弹性水平并改善心理僵化。Objective:To study the effect of group acceptance commitment therapy based on trans-theoretical model on stigma,mental resilience and mental rigidity of young patients with ischemic stroke.Methods:A total of 76 young inpatients with ischemic stroke who were admitted to the department of Neurology of a tertiary grade A hospital in Shanxi province from May 2023 to June 2023 were selected.The patients were divided into experimental group and control group with 38 cases in each group by random number table method.The control group patients received neurology routine nursing.The experimental group received group acceptance commitment therapy based on trans-theoretical model.Stigma Scale for Chronic Illness(SSCI),Connor-Davidson Resilience Scale-10(CD-RISC-10),Acceptance and Action Questionnaire-Ⅱ(AAQ-Ⅱ),and Cognitive Fusion Questionnaire-F(CFQ-F)were used to evaluate the experimental group patients and control group patients before and after intervention.Results:There were no significant difference in the scores of all indexes between the two groups before intervention(P>0.05).Immediately after intervention,1 month after intervention and 3 months after intervention,the scores of SSCI,AAQ-Ⅱand CFQ-F in experimental group patients were lower than those in control group patients(P<0.05),and the scores of CD-RISC-10 in experimental group patients were higher than those in control group patients(P<0.05).There were statistically significant differences in the scores of CD-RISC-10,SSCI,AAQ-Ⅱand CFQ-F for treatment effect,time effect and interaction effect(P<0.05).Conclusions:Group acceptance commitment therapy based on behavior change theory could effectively reduce stigma,improve psychological resilience and improve psychological inflexibility in young patients with ischemic stroke.

关 键 词：青年 缺血性脑卒中 病耻感 行为转变理论 接纳承诺疗法 心理弹性 心理僵化 调查研究 

分 类 号：R47[医药卫生—护理学]