基于归因理论的正念情绪调节模式对脑卒中后患者情绪障碍及希望水平的影响  

The effect of a mindfulness emotional regulation model based on attribution theory on emotional disorders and hope levels in post-stroke patients

作　　者：冯阳阳 张洁 王维 Feng Yangyang;Zhang Jie;Wang Wei(Department of Neurological RehabilitationⅢ,Shaanxi Provincial Rehabilitation Hospital,Xi'an 710065,China;Department of Vocational Rehabilitation Center,Shaanxi Provincial Rehabilitation Hospital,Xi'an 710065,China;Department of Spinal Cord Rehabilitation,Shaanxi Provincial Rehabilitation Hospital,Xi'an 710065,China)

机构地区：[1]陕西省康复医院神经康复三科,西安710065 [2]陕西省康复医院职业康复中心,西安710065 [3]陕西省康复医院脊柱脊髓康复科,西安710065

出　　处：《国际护理学杂志》2025年第6期983-988,共6页international journal of nursing

基　　金：国家重点研发计划项目(2018YFC2002300)。

摘　　要：目的探索将归因理论融入正念情绪调节模式中,对脑卒中后患者的情绪障碍和希望水平产生的影响。方法按数表法随机将陕西省康复医院2022年4月到2023年3月期间收治的112例脑卒中患者分为对照组和试验组,每组各56例。对照组给予常规护理措施,试验组则在此基础上实施基于归因理论的正念情绪调节模式;通过持续6个月干预,比较两组治疗前后的氨基酸类神经递质[谷氨酸(Glu)、γ-氨基丁酸(GABA)、甘氨酸(Gly)]和患者状态自尊水平[状态自尊量表(SSES)]、情绪障碍[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)]、康复进展[美国国立卫生研究院卒中量表(NIHSS)]以及希望水平[Herth希望量表(HHI)]。结果①干预后,两组患者的Glu、GABA、Gly水平表达相较干预前均有显著改善;其中,试验组GABA、Gly水平均高于对照组,而Glu水平低于对照组(P<0.05)。②干预后,两组患者的SSES各维度评分相较干预前均有显著提高;且试验组外表、行为、社会这三项自尊评分均高于对照组(P<0.05)。③干预后,两组患者的情绪障碍、康复进展相较干预前均有显著改善;且试验组HAMA、HAMD、NIHSS评分均低于对照组(P<0.05)。④干预后,两组患者的HHI评分相较干预前均有显著改善;其中,试验组患者的HHI各项评分相较高于对照组(P<0.05)。结论基于归因理论的正念情绪调节模式能有效改善脑卒中后患者的情绪障碍,提升自尊和希望水平,促进康复进展。ObjectiveTo explore the effect of integrating attribution theory into the mindfulness emotion regulation model on the emotional disorders and hope levels of patients after stroke.MethodsA total of 112 stroke patients admitted to Shaanxi Provincial Rehabilitation Hospital from April 2022 to March 2023 were randomly divided into control group and experimental group,with 56 cases in each group.The control group was given routine nursing measures,while the experimental group implemented the mindfulness-based emotion regulation model based on attribution theory.After a 6-month intervention,the levels of amino acid neurotransmitters[glutamate(Glu),γ-aminobutyric acid(GABA),glycine(Gly)],state self-esteem[State Self-Esteem Scale(SSES)],emotional disorders[Hamilton Anxiety Scale(HAMA),Hamilton Depression Scale(HAMD)],rehabilitation progress[National Institutes of Health Stroke Scale(NIHSS)]and hope levels[Herth Hope Index(HHI)]were compared between the two groups before and after treatment.Results①After intervention,the expression levels of Glu,GABA and Gly in both groups were significantly improved compared with before intervention.The levels of GABA and Gly in the experimental group were higher than those in the control group,while the levels of Glu were lower than those in the control group(P<0.05).②After intervention,the scores of each dimension of SSES for the two groups of patients were significantly higher compared with those before the intervention.The appearance,behavior and social self-esteem scores of the experimental group were higher than those of the control group(P<0.05).③After intervention,the emotional disorders and rehabilitation progress of patients in both groups were significantly improved compared with before intervention.The HAMA,HAMD and NIHSS scores of the experimental group were lower than those of the control group(P<0.05).④After intervention,HHI scores in both groups were significantly improved compared with those before intervention.Among them,the scores of each item of HHI for the p

关 键 词：归因理论 正念情绪调节模式 脑卒中 情绪障碍 希望水平 

分 类 号：R473.74[医药卫生—护理学]