结肠造口患者院外心理干预对心理行为反应特征、焦虑及抑郁评分的影响

摘要

目的 观察结肠造口患者院外心理干预对心理行为干预特征、焦虑及抑郁评分的影响.方法 纳入2015年1月至2016年1月于本院接受结肠造口术的62例患者为研究对象,随机分为观察组(n=30)及对照组(n=32).观察组出院后每2周到本院门诊接受专业护理及心理指导,对照组通过电话随访进行一般指导,通过复诊或电话随访记录两组心理行为特征,共进行3个月.于干预后3个月复查或电话随访比较两组汉密顿抑郁评分(SDS)及汉密顿焦虑评分(SAS).结果 患者出院时评估术后心理行为特征,重建、认知、退缩均为中等水平,冲击反应处于较低水平,组间差异无统计学意义(P＞0.05),两组SAS、SDS评分差异无统计学意义(P＞0.05).3个月后,观察组重建、认知、退缩及冲击水平均明显下降,各维度均显著低于对照组(均P＜ 0.05).观察组SAS及SDS分别为(33.81±4.81)分、(37.48±6.28)分,得分均显著低于对照组,差异具有统计学意义(P＜0.05).结论 结肠造口患者院外延续性对应干预可助于优化患者的心理行为特征,改善患者的抑郁及焦虑情绪,利于提高患者生活质量.%Objective To study the effect of postoperative psychological intervention in behavioral response characteristics,anxiety and depression in patients with colostomy.Methods A total of 62 patients with colostomy in our hospital from January 2015 to January 2016 were recruited and were randomly divided into treatment group (n=30) and control group (n=32).Patients in treatment group received professional nursing and psychological guidance via follow-up visit every two weeks after discharge.The control group were given general guidance by telephone follow-up.The psychological and behavioral characteristics were recorded,and the intervention lasted for 3 months.SAS and SDS scores of the two groups were compared at the 3rd month after the intervention.Results At discharge,patients’ reconstruction,cognition and withdrawal were all in the middle level,while the impact response was at a low level,and there was no significant difference between the groups (P ＞ 0.05).The differences of SAS and SDS scores between the two groups were also not significant (P ＞ 0.05).After 3 months,patients’ reconstruction,cognition,withdrawal and impact response all decreased (P ＜0.05),and were significantly lower in the treatment group than the control group (P ＜ 0.05).After 3 months,SAS and SDS scores in the treatment group were (33.81 ± 4.81) and (37.48 ± 6.28),respectively,which were significantly lower than those in the control group (P ＜ 0.05).Conclusion Patients with colostomy might be more inclined to have negative emotions after discharge.Extended intervention after discharge can improve the psychological and behavioral characteristics of these patients,which will further help to improve their quality of life.