心理护理综合干预对脑卒中患者生命质量及主观幸福感的影响

摘要

目的 探讨心理护理综合干预对脑卒中患者生命质量及主观幸福感的影响.方法 本研究选取神经内科脑卒中患者310人,其中心理护理综合干预组200人,对照组110人.对照组患者采用神经内科常规治疗,干预组患者从入院起在常规治疗的基础上进行心理护理综合干预至出院时结束,平均干预时间4~6周.采用SF-36健康调查表和MUN-SH主观幸福感量表对两组脑卒中患者干预前后的生命质量和主观幸福感状况进行评分,评价心理护理综合干预对脑卒中患者的影响,并采用多重线性回归分析其影响因素.结果 心理护理综合干预组在生理功能(PF)、生理职能(RP)、躯体疼痛(BP)、总体健康(GH)、活力(VT)、社会功能(SF)、情感职能(RE)、精神健康(MH)等8个维度得分均高于对照组,差异具有统计学意义(t=15.070、7.777、48.839、14.448、8.875、14.422、8.525、22.629,P<0.05),但两组间主观幸福感的差异无统计学意义(t=0.775,P>0.05).年龄、年总收入、心理护理综合干预等因素可在不同维度上影响患者生命质量,吸烟及年总收入为主观幸福感的保护因素,年龄为主观幸福感的危险因素.结论 心理护理综合干预可提高脑卒中患者的生命质量,但对患者的主观幸福感无明显影响.%Objective To study the impact of psychological care and comprehensive intervention on the quality of life and subjective well-being of patients with stroke. Methods Quality of life and subjective well-being were investigated in 310 patients with stroke in the department of neurology. They were randomly divided into psychological care and comprehensive in-tervention group (n=200) and control group (n=110). Psychological care and comprehensive intervention started at admission and ended at discharge. The average intervention time was 4-6 weeks. After the intervention,quality of life and subjective well-being of patients with stroke were measured and evaluated using the SF-36 and MUN-SH scale in accordance with the interna-tional standard. Then using multiple linear regression to analyze its influencing factors. Results Physiological function (PF), physiological role (RP),bodily pain (BP),general health (GH),vitality (VT),social function (SF),emotional role (RE) and mental health( MH) scores in the psychological care and comprehensive intervention group were higher than those in the control group (t=15. 070、7. 777、48. 839、14. 448、8. 875、14. 422、8. 525、22. 629,P<0. 05). Subjective well-being between the two groups were not shown the statistical difference (t=0. 775,P>0. 05). Age,total annual income,psychological care and oth-er factors can affect the quality of life of patients in different dimensions. Multivariate analysis of subjective well-being of pa-tients with stroke showed that total annual income and smoking were protective factors,whereas age was a risk factor. Conclu-sion Psychological care and comprehensive intervention factors can improve the quality of life of stroke patients,but had no significant effect to the patient′s subjective well-being.