本文關(guān)鍵詞：焦點(diǎn)解決短程治療對(duì)腦卒中患者自我感受負(fù)擔(dān)的干預(yù)研究　出處：《承德醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 焦點(diǎn)解決短程治療 焦點(diǎn)解決團(tuán)體治療 腦卒中 自我感受負(fù)擔(dān) 主觀幸福感 生存質(zhì)量

【摘要】：目的:本研究將腦卒中患者作為研究對(duì)象,針對(duì)其自我感受負(fù)擔(dān)水平,構(gòu)建以焦點(diǎn)解決短程治療的理論為指導(dǎo)的護(hù)理心理干預(yù)方案,以期提高臨床醫(yī)護(hù)人員對(duì)自我感受負(fù)擔(dān)的認(rèn)識(shí)和重視程度,拓寬焦點(diǎn)解決短程治療的應(yīng)用領(lǐng)域,為臨床醫(yī)護(hù)人員開展護(hù)理心理干預(yù)提供理論參考和實(shí)證依據(jù)。方法:于2016年1月至2016年9月,在知情同意的基礎(chǔ)上采用便利性抽樣的方法,選取在承德市某三級(jí)甲等醫(yī)院康復(fù)科住院治療的90例腦卒中患者為研究對(duì)象,采用自我感受負(fù)擔(dān)量表(Self-Perceived Burden Scale,SPBS)、紐芬蘭紀(jì)念大學(xué)幸福度量表(Memorial University of Newfoundland Scale of Happiness,MUNSH)、健康調(diào)查簡(jiǎn)表(Medical Outcomes Study 36-item Short Form Health Survey,SF-36)對(duì)其進(jìn)行測(cè)評(píng)。采用隨機(jī)數(shù)字表法將90例研究對(duì)象分為對(duì)照組、焦點(diǎn)個(gè)案組和焦點(diǎn)團(tuán)體組,每組各30例。對(duì)照組給予常規(guī)護(hù)理和康復(fù)治療;焦點(diǎn)個(gè)案組在常規(guī)護(hù)理和康復(fù)治療的基礎(chǔ)上增加“一對(duì)一”形式的焦點(diǎn)解決短程治療,包括:描述問(wèn)題、建構(gòu)具體可行的目標(biāo)、探查例外、給予反饋和評(píng)價(jià)進(jìn)步,一周3次,每次30~45分鐘,共6次;焦點(diǎn)團(tuán)體組在常規(guī)護(hù)理和康復(fù)治療的基礎(chǔ)上增加“團(tuán)體”形式的焦點(diǎn)解決短程治療,一周3次,每次50~60分鐘,共6次。采用SPSS20.0統(tǒng)計(jì)軟件對(duì)數(shù)據(jù)進(jìn)行統(tǒng)計(jì)學(xué)分析,計(jì)量資料以(x±s)表示,兩組組間比較采用獨(dú)立樣本t檢驗(yàn),組內(nèi)比較采用配對(duì)樣本t檢驗(yàn),多組組間比較采用F檢驗(yàn);計(jì)數(shù)資料采用χ2檢驗(yàn),以P0.05為差異具有統(tǒng)計(jì)學(xué)意義。結(jié)果:1.干預(yù)前,對(duì)照組、焦點(diǎn)個(gè)案組和焦點(diǎn)團(tuán)體組3組研究對(duì)象在診斷類型、性別、年齡、受教育程度、職業(yè)、居住地、婚姻狀況、家庭收入、醫(yī)療費(fèi)用支付方式、主要照顧者和主要照顧者身體狀況上[χ2=(0.356~8.708),p=(0.191~0.986)],差異均無(wú)統(tǒng)計(jì)學(xué)意義(p0.05);3組研究對(duì)象在自我感受負(fù)擔(dān)量表(spbs)、紐芬蘭紀(jì)念大學(xué)幸福度量表(mshun)及健康調(diào)查簡(jiǎn)表(sf-36)的各維度及總分上的比較[f=(0.066~2.697),p=(0.073~0.937)],差異均無(wú)統(tǒng)計(jì)學(xué)意義(p0.05),具有可比性。2.干預(yù)前后,干預(yù)因素和時(shí)間因素對(duì)研究對(duì)象的自我感受負(fù)擔(dān)量表(spbs)、紐芬蘭紀(jì)念大學(xué)幸福度量表(mshun)及健康調(diào)查簡(jiǎn)表(sf-36)的總分上的主效應(yīng)及其交互作用[f=(33.419~1516.891),p=0.000],差異均有統(tǒng)計(jì)學(xué)意義(p0.05)。3.干預(yù)前后,對(duì)照組在自我感受負(fù)擔(dān)量表(spbs)[(39.17±4.80)vs(35.30±2.63),t=3.678,p=0.001]、紐芬蘭紀(jì)念大學(xué)幸福度量表(mshun)[(3.67±3.79)vs(19.67±3.64),t=-15.459,p=0.000]及健康調(diào)查簡(jiǎn)表(sf-36)[(19.90±2.84)vs(37.27±7.44),t=-11.049,p=0.000]上的得分比較,差異均有統(tǒng)計(jì)學(xué)意義(p0.05);焦點(diǎn)個(gè)案組在自我感受負(fù)擔(dān)量表(spbs)[(39.27±5.83)vs(22.40±4.03),t=16.248,p=0.000]、紐芬蘭紀(jì)念大學(xué)幸福度量表(mshun)[(4.20±4.50)vs(31.10±3.66),t=-24.136,p=0.000]及健康調(diào)查簡(jiǎn)表(sf-36)[(21.04±4.61)vs(54.04±5.72),t=-20.937,p=0.000]上的得分比較,差異均有統(tǒng)計(jì)學(xué)意義(p0.05);焦點(diǎn)團(tuán)體組在自我感受負(fù)擔(dān)量表(spbs)[(39.57±1.57)vs(22.23±2.47),t=30.302,p=0.000]、紐芬蘭紀(jì)念大學(xué)幸福度量表(mshun)[(5.63±2.24)vs(30.60±4.05),t=-29.363,p=0.000]及健康調(diào)查簡(jiǎn)表(sf-36)[(20.46±3.95)vs(53.08±3.48),t=-34.686,p=0.000]上的得分比較,差異均有統(tǒng)計(jì)學(xué)意義(p0.05)。4.干預(yù)后,對(duì)照組、焦點(diǎn)個(gè)案組和焦點(diǎn)團(tuán)體組3組在自我感受負(fù)擔(dān)量表(spbs)[(35.30±2.63)vs(22.40±4.03)vs(22.23±2.47),f=172.785,p=0.000]、紐芬蘭紀(jì)念大學(xué)幸福度量表(mshun)[(19.67±3.64)vs(31.10±3.66)vs(30.60±4.05),f=87.277,p=0.000]及健康調(diào)查簡(jiǎn)表(sf-36)[(37.27±7.44)vs(54.04±5.72)vs(53.08±3.48),f=79.651,p=0.000]上的得分比較,差異均有統(tǒng)計(jì)學(xué)意義(p0.05)。進(jìn)一步做3組間兩兩比較發(fā)現(xiàn),對(duì)照組和焦點(diǎn)個(gè)案組以及對(duì)照組和焦點(diǎn)團(tuán)體組在自我感受負(fù)擔(dān)量表(spbs)、紐芬蘭紀(jì)念大學(xué)幸福度量表(mshun)及健康調(diào)查簡(jiǎn)表(sf-36)的得分比較[md=(-16.765~13.067),p=0.000],差異均有統(tǒng)計(jì)學(xué)意義(p0.05);焦點(diǎn)個(gè)案組和焦點(diǎn)團(tuán)體組在自我感受負(fù)擔(dān)量表(SPBS)[MD=0.167,P=0.979]、紐芬蘭紀(jì)念大學(xué)幸福度量表(MSHUN)[MD=0.500,P=0.878]及健康調(diào)查簡(jiǎn)表(SF-36)的得分比較[MD=0.962,P=0.813],差異均無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論:1.焦點(diǎn)解決短程治療可有效降低腦卒中康復(fù)期患者的負(fù)擔(dān)感受,提高其主觀幸福感,改善生存質(zhì)量,促進(jìn)其身心健康,值得臨床推廣應(yīng)用;2.焦點(diǎn)解決短程治療對(duì)焦點(diǎn)個(gè)案組和焦點(diǎn)團(tuán)體組的腦卒中患者自我感受負(fù)擔(dān)、主觀幸福感和生存質(zhì)量的干預(yù)效果無(wú)顯著性差異。
[Abstract]:Objective: To study the stroke patients as the research object, according to the level of self perceived burden, constructing psychological nursing intervention program to focus brachytherapy theory as the guide, in order to improve the clinical medical staff on the self perceived burden of understanding and attention, broaden the application field of focus for medical treatment short. Personnel to carry out psychological nursing intervention to provide theoretical reference and empirical basis. Methods: from January 2016 to September 2016, using convenience sampling method based on informed consent, were selected in three grade hospitals in Chengde City, the Department of rehabilitation of 90 cases of hospitalized patients with cerebral apoplexy as the research object, using the self perceived burden scale (Self-Perceived Burden Scale, SPBS), Memorial University of Newfoundland scale of happiness (Memorial University of Newfoundland Scale of Happiness, MUNSH), health survey questionnaire (Medica L Outcomes Study 36-item Short Form Health Survey, SF-36) were evaluated. Randomly 90 cases were divided into control group, focus group and focus group case group, 30 cases in each group. The control group was given routine nursing care and rehabilitation; focus group "case on the basis of routine nursing and rehabilitation on the treatment of a focus on one form of solving short-range treatment, including: describe the problem, constructing feasible objectives and exploration of exception, giving feedback and evaluation of progress, 3 times a week, every 30~45 minutes, a total of 6 times; focus groups increased" focus groups "in the form of routine nursing and rehabilitation treatment the solution to short-term treatment, 3 times a week, every 50~60 minutes, a total of 6 times. The data were analyzed using SPSS20.0 statistical software, measurement data with (x + s) said that the comparison between the two groups by using independent sample t test, group ratio Compared with paired samples t test, comparison between group using F test; count data using 2 test, with P0.05 as the difference was statistically significant. Results: 1. before intervention, the control group, the focus of case group and focus group group of 3 groups in gender, age, diagnosis, type, level of education, occupation, residence, marital status, family income, payment of medical expenses, caregivers and caregivers' physical condition [x 2= (0.356~8.708), p= (0.191~0.986)], there were no significant differences (P0.05); the 3 groups in the self perceived burden scale (SPBs), the Memorial University of Newfoundland to measure happiness table (mshun) and short form health survey (SF-36) [f= on each dimension and the total score (0.066~2.697), p= (0.073~0.937)], there were no significant differences (P0.05), comparable to.2. before and after the intervention, the intervention factors and time factors on the study of the sense of self 鍙楄礋鎷呴噺琛，

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