摘要
目的：探究ICU机械通气患者的心理状态以及心理干预对患者预后的影响。方法：选取2016年2月-2017年2月于我院重症监护室行机械通气治疗的患者100例,所有患者均神志清楚。采用HAMA（汉密尔顿焦虑量表）和HAMD（汉密尔顿抑郁量表）评估患者的心理状态。将患者随机分为观察组和对照组,每组50例。对照组给予ICU常规生命体征看护,观察组在此基础上给予个体化心理干预。对比两组患者干预后HAMA评分、HAMD评分、机械通气时间、住ICU时间,评估对比两组患者的治疗依从性及意外脱管发生率情况。结果：100例机械通气患者干预前HAMA评分为（24.5＋3.7）分,HAMD评分为（31.7＋4.9）分,平均分数处于中度焦虑/抑郁水平。93例（93.0%）患者均存在不同程度的焦虑/抑郁,其中,重度焦虑和抑郁分别占45.0%和52.0%,无焦虑/抑郁者占7.0%;干预后,观察组患者HAMA、HAMD评分较干预前显著降低,观察组干预后HAMA、HAMD评分低于对照组,差异均有统计学意义（t=-2.65,-3.08;P〈0.05）;观察组与对照组患者总依从率分别为84.0%和58.0%,意外脱管发生率分别为4.0%和12.0%,平均机械通气时间分别为（8.4＋3.8）天和（12.5＋4.9）天,平均住ICU时间分别为（12.3＋5.7）天和（18.4＋5.5）天,差异均有统计学意义（χ~2=8.208,2.174;t=-8.34,-9.25;P〈0.05）。结论：多数ICU内行机械通气的患者合并不同程度的焦虑/抑郁,个体化心理干预治疗可以改善患者心理状态、提高治疗依从性、缩短机械通气时间和住ICU时间。
Objective：To explore the psychological state of patients with ICU mechanical ventilation and the effect of psychological intervention on the prognosis of patients. Methods：From February 2016 to February 2017,100 patients were treated with mechanical ventilation in ICU of our hospital,all patients were conscious. HAMA（ Hamilton anxiety scale） and HAMD（ Hamilton Depression Scale） were used to assess the psychological state of patients. The patients were randomly divided into the observation group and the control group,50 cases in each group.The control group was given routine nursing care of vital signs,and the observation group was given individualized psychological intervention on the basis of ICU.HAMA score,HAMD score,mechanical ventilation time,stay in ICU time,treatment compliance and accidental catheter removal rate ot the two groups of patients were compared.Results：HAMA and HAMD scores were at moderate level in 100 patients with mechanical ventilation before intervention.93 cases（ 93%） patients had different degrees of anxiety/depression,including severe anxiety and depression accounted for 45% and 52%,no anxiety/depression accounted for 7%;After the intervention,the patients＇ in the observation group HAMA,HAMD scores were significantly lower than those before intervention;The HAMA,HAMD scores was of the observation group were lower than those of the control group.The differences were statistically significant（ t =-2.65,-3.08;P〈0.05）;The total compliance rates in the observation group and the control group of patients were 84% and 58%,unplanned extubation rates were 4% and 12% respectively;the average time of mechanical ventilation,average in ICU time between the two groups were statistically significant（ χ~2= 8.208,2.174;t =-8.34,-9.25;P〈0.05）.Conclusion：Most patients with mechanical ventilation in ICU combines with different degrees of anxiety/depression,and individualized psychological intervention can improve the patient＇s psychological state,improve the compliance o
作者
何丽
周玲玲
HE Li;ZHOU Lingling(Department of Critical Care Medicine,Shanghai Tenth People＇s Hospital,Shanghai 200072,China)
出处
《中国健康心理学杂志》
2018年第12期1791-1794,共4页
China Journal of Health Psychology
关键词
重症监护室
机械通气
心理状态
心理干预
依从性
Intensive care unit
Mechanical ventilation
Psy chological state Psychological intervention
Psychological nursing
Compliance
