SARS患者临床心理干预模式及疗效评估  

Psychological Crisis Intervention Model in Xiaotangshan Hospital of PLA

作　　者：王择青[1] 祝卓宏[1] 朱鸿武[1] 张红梅[2] 刘金花[2] 刘竞[1] 傅小玲[1] 

机构地区：[1]解放军总医院医学心理科(小汤山医院心理咨询中心) [2]石家庄陆军指挥学院

出　　处：《中国心理卫生杂志》2003年第9期587-590,共4页Chinese Mental Health Journal

摘　　要：目的 :对北京解放军小汤山医院SARS患者实施心理危机干预措施并评估疗效和影响因素 ,探索对封闭环境下急性病人进行临床心理干预的有效模式。方法 :总共 680名SARS患者 (其中男性 3 79名 ,女性 3 0 1名 ) ,对 483名干预组患者进行综合心理干预 ,包括电话心理咨询 (主动和被动 )、文字材料自我调适以及面对面危机干预 (临床医务人员和心理医生 )。采用SCL -90对干预组和对照组进行入院时和出院前的心理健康状况评估 ,并采用自编的“心理干预效果评定表”对干预对象进行干预效果评定。结果 :患者入院时SCL -90各因子分值明显高于地方常模的分值 ,差异有显著性。入院时干预组和对照组的SCL -90各因子均分没有明显差异 ,而出院时干预组和对照组患者SCL -90各因子均分相比 ,在多个因子上干预组均分均显著低于对照组 (t=2 1～ 5 7,P <0 0 1～ 0 0 5 )。其中患者主动电话咨询的有效率最高 ( 95 7% ) ,文字材料的有效率最低 ( 19 5 % ) ,临床主管医生经过培训后进行临床心理干预的效果和心理医生进行心理干预的有效率都很高 ,均高达 80 %以上。主动求助、被动求助以及文字干预对文化程度较低的患者效果要低于文化程度较高者 ,但经过培训的临床医生和心理医生其干预效果无明显差异。结论 :SARS患者在接受药?Objective: To explore an effective model of psychological intervention to SARS patients Method:680 SARS inpatients were divided into experimental (n=483) group and control group Three interventions were provided to the patients once a day for one week, including hotline counseling (active versus passive), counseling through paper and pencil, and face-to-face crisis intervention (medical staff versus psychotherapists) SCL-90 and a self-designed assessing scale were administered to both groups when check in and before discharge to evaluate the effect of the interventions Result:SCL-90 assessing showed that patients had significantly higher score than local people, but the two groups had no significant difference at check-in This situation changed before discharge, the intervention group had significantly lower scores in many factors than control except for phobia, paranoia and psychotic Comparing different ways of intervention, the most effective one was active hotline counseling (effective rate 95 7%), the effective rate of face-to-face intervention was 80% for both medical staff after training and psychotherapists The paper-pencil method was the most ineffective (the rate was only 19 5%) Education had influence on the outcome of intervention, those patients with higher education had better results in hotline counseling and paper-pencil counseling Conclusion:Psychological crisis intervention is effective in patients infected by SARS Active hotline counseling is the most effective way

关 键 词：严重急性呼吸综合征 SARS 心理危机 干预措施 SCL-90 

分 类 号：R563.1[医药卫生—呼吸系统]