心理社会评估干预体系在功能性便秘患者生物反馈治疗中的应用

摘要

目的 探讨心理社会评估干预体系在功能性便秘(functional constipation,FC)患者生物反馈治疗中的作用.方法 采用症状积分量表、Zung焦虑/抑郁自评量表(Self-Rating Anxiety Scale/Self-Rating Depression Scale,SAS/SDS)和汉化版简明健康调查问卷(The Short Form-36 Health Survey,SF-36)全面评估196例功能性便秘患者的临床症状、心理状况和生活质量,并给予心理社会干预和生物反馈训练,比较干预前后患者临床症状、心理状况、生活质量改善情况及生物反馈的有效率、满意度.结果 功能性便秘患者 SAS、SDS评分高于中国常模(P<0.01);SF-36的8个维度得分均低于中国常模(P<0.01);SAS、SDS得分与症状积分呈正相关(P<0.05),与SF-36各维度得分呈负相关(P<0.01).心理社会干预后,SAS、SDS得分显著降低(P<0.01);SF-36各维度评分均显著提高(P<0.01);症状积分明显下降(P<0.01),总有效率为86.7%,总满意率为91.8%.结论 以心理社会评估为基础的心理社会干预有较好的生物反馈治疗功能性便秘的疗效,可缓解异常的心理状态,提高生活质量和满意度,全面改善患者预后.%Objective To explore the effects of social psychological assessment and intervention on biofeedback therapy of functional constipation (FC). Methods A total of 196 patients with FC receiving biofeedback training were interviewed with Bowel symptom Measure, Zung' s Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS) and Chinese version of the MOS Short Form- 36 Health Survey (SF-36) before and after biofeedback. Results Abnormal psychological statuses were observed among FC patients whose scores of SAS and SDS were markedly higher than those of domestic norm (P<0.01) and the SF-36 scores in all dimensions in FC patients were significantly lower than those in Chinese norm (P<0.01). The scores of SAS and SDS were positively correlated to scores of symptoms (P<0.05), while negatively related with all scores of dimensions of SF-36 (P<0.01). After social psychological intervention (including biofeedback training), clinical symptom and psychological condition of patients with FC were greatly improved (P<0.01). Conclusion Social psychological assessment and intervention besides biofeedback therapy are effective for patients with functional constipation.