本文選題：心理干預(yù)　切入點(diǎn)：連續(xù)性血液濾過(guò)　出處：《青島大學(xué)》2017年碩士論文　論文類型：學(xué)位論文

【摘要】：目的觀察心理干預(yù)在連續(xù)性血液濾過(guò)治療急性重癥胰腺炎患者中的作用;探討如何通過(guò)有效的心理干預(yù)減輕患者的焦慮和抑郁情緒,提高患者對(duì)護(hù)理工作的滿意度,進(jìn)而縮短患者住院日,提高患者治愈率,節(jié)省有限的醫(yī)療資源。方法收集2013年1月~2015年10月入住單縣中心醫(yī)院重癥醫(yī)學(xué)科的急性重癥胰腺炎并行連續(xù)性血液濾過(guò)的64例患者,采用隨機(jī)分組的方法將其分為干預(yù)組和對(duì)照組。對(duì)照組給予對(duì)癥治療和常規(guī)治療及護(hù)理,干預(yù)組在此基礎(chǔ)上實(shí)施個(gè)性化心理干預(yù)。在干預(yù)前使用SAS量表(self-rating anxiety scale,SAS)及SDS量表(self-rating depression scale,SDS對(duì)兩組患者進(jìn)行焦慮、抑郁評(píng)分,并進(jìn)行急性胰腺炎的CT嚴(yán)重指數(shù)(CTSI)評(píng)分,記錄所有數(shù)據(jù);干預(yù)兩周后,再次對(duì)兩組患者進(jìn)行焦慮、抑郁評(píng)分及急性胰腺炎的CT嚴(yán)重指數(shù)(CTSI)評(píng)分,記錄所有數(shù)據(jù),并與干預(yù)前進(jìn)行相應(yīng)比較,最后使用本院制定的患者滿意度調(diào)查表調(diào)查兩組患者對(duì)護(hù)理工作的滿意度情況并做出比較。結(jié)果1.64名患者入院時(shí)的SAS及SDS評(píng)分的標(biāo)準(zhǔn)分與中國(guó)常模比較(uSAS=10.52,PSAS0.01;uSDS=7.42,PSDS0.01),差異具有統(tǒng)計(jì)學(xué)意義,由此我們可以看出64名患者的心理健康狀況明顯低于國(guó)內(nèi)正常人群的常模水平,其中78%的患者有不同程度的焦慮,71%的患者有不同程度的抑郁。2.患者入院時(shí)對(duì)照組與干預(yù)組的SAS評(píng)分比較(t=-1.746,P0.05)、SDS評(píng)分比較(t=-0.400,P0.05),差異均無(wú)統(tǒng)計(jì)學(xué)意義;2周后再次對(duì)兩組患者進(jìn)行評(píng)分,對(duì)照組與干預(yù)組的評(píng)分比較SAS評(píng)分比較(t=-8.289,P0.05)、SDS評(píng)分比較(t=10.352,P0.05),差異均具有統(tǒng)計(jì)學(xué)意義。3.入院時(shí)對(duì)照組與干預(yù)組患者的CTSI比較無(wú)統(tǒng)計(jì)學(xué)意義(t=-0.607,P0.05);干預(yù)實(shí)施2周后再進(jìn)行兩組數(shù)據(jù)的比較差異就具有了統(tǒng)計(jì)學(xué)意義(t=35.587,P0.05),差異具有統(tǒng)計(jì)學(xué)意義,表明心理干預(yù)對(duì)降低急性重癥胰腺炎患者的CTSI評(píng)分有一定影響。4.兩組患者的滿意度調(diào)查結(jié)果比較顯示(F=6.694,P0.05),其差異具有統(tǒng)計(jì)學(xué)意義。5.兩組患者治療后總有效率的結(jié)果比較顯示(F=51.883,P0.05),其差異具有統(tǒng)計(jì)學(xué)意義。結(jié)論心理干預(yù)能有效改善行連續(xù)性血液濾過(guò)治療的急性重癥胰腺炎患者的焦慮和抑郁情緒;能降低行連續(xù)性血液濾過(guò)治療的急性重癥胰腺炎患者的CTSI評(píng)分;能提高患者對(duì)護(hù)理工作的滿意度,并對(duì)患者的治療效果有一定的影響。
[Abstract]:Objective to observe the role of psychological intervention in the treatment of severe acute pancreatitis by continuous hemofiltration, and to explore how to reduce the anxiety and depression of patients by effective psychological intervention, and to improve their satisfaction with nursing work. Methods 64 patients with severe acute pancreatitis and continuous hemofiltration who were admitted to the Department of intensive Medicine of Shanxian Central Hospital from January 2013 to October 2015 were collected. They were randomly divided into two groups: the intervention group and the control group. The control group was given symptomatic treatment, routine treatment and nursing care. Before intervention, the two groups were assessed with self-rating anxiety scale (SAS) and self-rating depression scale (SDS) for anxiety and depression, and CT severity index (CTSI) score for acute pancreatitis, and all the data were recorded. After two weeks of intervention, anxiety, depression scores and CT severity index (CTSI) scores of acute pancreatitis were scored again, and all data were recorded and compared with those before intervention. Results 1.The standard scores of SAS and SDS scores of 64 patients at admission were compared with those of the Chinese norm. The difference was statistically significant. From this, we can see that the mental health status of 64 patients is obviously lower than the norm level of the normal population in China. 78% of the patients had different degree of anxiety and 71% had different degree of depression. 2. The SAS scores of the control group and the intervention group were compared at admission. Comparison of SAS scores between the control group and the intervention group; the comparison of the SAS score between the control group and the intervention group was statistically significant. 3. There was no significant difference in CTSI between the control group and the intervention group at the time of admission, and the number of the two groups after 2 weeks of intervention was not significantly different from that of the control group and the intervention group. According to the comparison, the difference was statistically significant, and the difference was statistically significant. The results show that psychological intervention has certain influence on reducing CTSI score of patients with severe acute pancreatitis. The result of satisfaction investigation between the two groups shows that the difference between the two groups is statistically significant. 5. the total effective rate of the two groups after treatment is higher than that of the control group. The difference was statistically significant. Conclusion Psychological intervention can effectively improve anxiety and depression in patients with severe acute pancreatitis treated with continuous hemofiltration therapy. It can reduce the CTSI score of the patients with severe acute pancreatitis who received continuous hemofiltration therapy, improve the patients' satisfaction with nursing work, and have a certain effect on the therapeutic effect of the patients.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R473.5

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