心理干预对断肢(指)手外伤患者术后心理状态的影响

目的探讨断肢(指)手外伤患者不同阶段的心理状态及护理对策。方法将60例断肢(指)手外伤患者按随机数字表法分为2组,每组30例。常规护理组患者行显微外科断肢(指)再植手术后采用常规护理方法(全身护理、局部护理、生命体征观察等)进行护理。心理干预组在对照组常规护理的基础上加心理护理干预。采用医院焦虑抑郁量表(HADS)分别于术后当天、出院时和出院6个月对2组患者的心理状态进行评估。对2组患者术后不同时段的HADS评分(焦虑和抑郁)情况进行比较。结果术后当天,2组患者HADS评分比较差异无统计学意义(P>0.05);出院时心理干预组的HADS评分明显低于常规护理组(P<0.05)。经6个月随访,常规护理组患者焦虑和抑郁阳性率分别为52.0%和54.0%;心理干预组焦虑和抑郁阳性率分别为8.0%和6.0%,2组比较差异均有统计学意义(均P<0.05)。结论断肢(指)手外伤患者具有较高的焦虑和抑郁发生率,针对患者不同的心理特点采取心理干预措施,对患者的心理调整和促进断肢(指)再植的成活十分有利。

Influence of Psychological Intervention on Psychological States in Patients with Limb or Finger Mutilation Injuries

Objective To analyze the psychological states of patients with limb or finger mutilation injuries at different stages, and to explore the nursing strategies. Methods Sixty patients with limb or finger mutilation injuries were divided into two groups, with 30 patients in each group. Patients in conventional care group were given whole-body care, local care and vital signs monitoring after microsurgical limb or finger replantation. Patients in psychological intervention group were given psychological nursing intervention on the basis of conventional care. Psychological states of patients were evaluated by Hospital Anxiety and Depression Scale （HADS） and were compared between the two groups on the day after surgery, at discharge and 6 months after discharge. Results On the day after surgery, there were no significant differences in HADS scores between the two groups （P〉0.05）. At discharge, HADS scores in psychological intervention group were significantly lower than those in conventional care group（P〈0.05）. After 6 months of follow-up,the incidences of anxiety and depression in psychological intervention group were obviously lower than those in conventional care group （8.0% and 6.0% vs 52.0% and 54.0%, respectively; P〈0.05）. Conclusion The incidences of anxiety and depression are higher in patients with limb or finger mutilation injuries. Individualized psychological intervention has beneficial effect on psychological adjustment and survival of limb or finger after replantation.