神经外科重症患者家属心理症状群及其影响因素分析

目的 探讨神经外科重症监护室(NICU)患者家属心理症状群及其影响因素,为缓解NICU重症患者家属心理症状提供参考.方法 采用便利抽样法,选取190例在NICU住院患者的家属应用简明心境量表(BPOMS-SF)、简易应对方式问卷(SCSQ)进行问卷调查,分析症状群及其与应对方式的关系.结果 在被调查的30个症状中发生率排在前五位的依次是焦虑、担忧、孤弱无助、困惑、不确定感.经过探索性因子分析,30个症状可归为四个症状群:紧张-焦虑症状群(担忧、紧张、焦虑、不安,)、精力不足症状群(疲倦、疲惫不堪、疲乏、无精打采、精疲力竭)、信息缺乏症状群(不确定感、困扰、孤弱无助,慌张)、怨恨症状群(生气、恼火、有怨气).应对方式、患者与家属的关系、格拉斯哥昏迷评分以及家属文化程度是心理症状群的影响因素(P<0.05).结论 神经外科NICU患者家属心理症状群种类多且复杂,应对方式等因素对其有着重要影响,临床医护人员在关注患者的同时关注患者家属的心理症状,教会家属积极应对方式,减轻心理困扰.

Psychological symptom clusters and its influence factors in the family member of severe neurosurgical patients

Objective To explore the psychological symptom clusters and its influence factors for decreasing psychological distress of the family member of neurosurgical intensive care unit (ICU) patients.Methods A convenient sampling method was used to select 190 patients who were hospitalized in neurosurgical intensive care unit (NICU) and the brief profile of mood states (BPOMS) and sim-plified coping style questionnaire (SCSQ) was used to analyze the relationship between the psychological symptom clusters and the cop -ing style.Results Among the 30 symptoms,the top 5 symptoms of highest incidence were anxiety ,worry,helplessness,confusion and uncertainty.The exploratory factor analysis revealed that 30 symptoms could be classified into 4 symptom clusters:nervous-anxiety symptom clusters (worry,nervousness,anxiety,unease),lack of energy symptom cluster (weariness,tiredness,fatigue,listlessness and exhaustion),lack of information symptom cluster (uncertainty,distress,helplessness,bewilderment),resentment symptom cluster (an-ger,annoyance,grievance).The coping styles,relationship between the patient and family member ,Glasgow coma scale,and degree of family education were the influencing factors of the psychological symptom clusters (P <0.05).Conclusions The psychological symp-tom clusters of the family member of neurosurgical ICU patients are much more complex and various .Coping styles and other factors have important influence on them .The staff should pay more attention to the psychological symptom clusters of the family member of neurosurgical ICU patients and take measures to teach family members the coping skills to decrease the psychological distress .