冠心病病人心理社会适应的干预模式构建与效果评价

目的为冠心病心绞痛病人构建心理社会适应干预模式，并评价其应用效果。方法选择78例心绞痛病人为研究对象，随机分为研究组(40例)和对照组(38例)。对照组接受常规干预，研究组在对照组基础上接受心理社会适应干预，将病人身心调适分为迷茫反思期、适应重建期、接受整合期三个阶段，并提供针对性的干预方案。结果6个月后2组病人疾病心理社会适应量表评分均明显下降(P < 0.01)，研究组总分明显低于对照组(P < 0.01)。研究组6个月后卫生保健、性生活、交流情况、娱乐情况、心理状况评分均低于对照组(P < 0.05~P < 0.01)。6个月后2组病人疾病感知问卷简易量表评分明显下降(P < 0.01)，社会支持量表评分明显上升(P < 0.01)；研究组疾病感知问卷简易量表评分和社会支持评分均明显低于对照组(P < 0.01)。6个月后复测结果显示，研究组积极应对评分与一般自我效能感量表评分高于对照组(P < 0.05)，消极应对评分低于对照组(P < 0.01)，且2组积极应对评分与一般自我效能感量表评分均高于基线(P < 0.05~P < 0.01)，消极应对评分低于基线(P < 0.05~P < 0.01)。结论心理社会适应干预模式可改善冠心病心绞痛病人疾病应对方式、疾病认知与自我效能感，促进病人心理社会适应。

Construction and effect evaluation of the intervention model of psychosocial adaptation in patients with coronary heart disease

ObjectiveTo establish a psychosocial adaptation intervention model in patients with coronary heart disease and angina pectoris, and evaluate its application effects.MethodsA total of 78 patients with angina pectoris were selected as the research objects, and randomly divided into the study group(40 cases) and control group(38 cases).The control group was treated with conventional intervention, and the study group was treated with psychosocial adaptation intervention based on the control group.The psychosocial adaptation was divided into three stages: confusion reflection period, adaptation and reconstruction period, acceptance integration period, and the targeted intervention programs were provided.ResultsAfter 6 months, the scores of self-report psychosocial adjustment to illness scale in two groups decreased significantly(P < 0.01), and which in study group was significantly lower than that in control group(P < 0.01).After 6 months, the scores of health care, sexual life, communication, entertainment and psychological status in study group were lower than those in control group(P < 0.05 to P < 0.01).After 6 months, the brief illness perception questionnaire scores in two groups decreased significantly(P < 0.01), the social support scale scores increased significantly in two groups(P < 0.01), and the brief illness perception questionnaire score and social support scale score in study group were significantly lower than those in control group(P < 0.01).After 6 months, the retest results showed that the positive coping score and general self-efficacy scale score in study group were higher than those in control group(P < 0.05), while the negative coping score in study group was lower than that in control group(P < 0.01).The positive coping score and general self-efficacy scale score were higher than that of the baseline(P < 0.05 to P < 0.01), and the negative coping score was lower than that of the baseline in two groups(P < 0.05 to P < 0.01).ConclusionsThe psychosocial adaptation intervention model can improve the disease coping style, disease cognition and self-efficacy of patients with angina pectoris, and promote the psychosocial adaptation of patients.