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目的分析住院乙型肝炎肝硬化患者发生抑郁的危险因素,并探讨心理护理干预对患者抑郁的效果。方法回顾性分析郑州市第六人民医院2014年1月—2015年12月间收治的200例住院病毒性肝炎肝硬化患者病例,以抑郁自评量表(SDS)评估患者抑郁情况,采用单因素分析法对患者发生抑郁的危险因素进行分析。采用随机数字法将伴抑郁患者分为2组。对照组给予常规护理,观察组在常规护理基础上给予心理护理干预。并采用心身症状自评量表(SCL-90)、SDS评估患者心理状态变化,对心理护理干预的效果进行评估。结果住院乙型肝炎肝硬化患者抑郁的发生率为47.0%,以轻度和中度抑郁为主。年龄小、学历低、家庭收入低、肝硬化严重、乙型肝炎感染>5年是患者出现抑郁的危险因素。心理护理干预后,观察组SCL-90各指标(躯体化、强迫、人际关系、抑郁、焦虑、敌对、恐怖、精神症状)和SDS得分均较干预前显著降低(P<0.05),且明显低于对照组各指标评分(P<0.05)。结论住院乙型肝炎肝硬化患者易发生抑郁,年龄小、学历低、家庭收入低、肝硬化严重、乙型肝炎感染>5年是患者发生抑郁的危险因素,优质心理护理干预可有效改善患者抑郁情绪,因此临床上不仅要重视患者发生抑郁的危险因素,还要针对性地采用心理护理来改善患者心理状态。
Objective To analyze the risk factors of depression in hospitalized patients with hepatitis B cirrhosis and to explore the effect of psychological nursing intervention on patients’ depression. Methods A retrospective analysis of 200 cases of hospitalized patients with cirrhosis of liver cirrhosis admitted to the Sixth People’s Hospital of Zhengzhou City from January 2014 to December 2015 was conducted. Patients with depression were evaluated by Self-Rating Depression Scale (SDS) Analysis of patients with depression risk factors were analyzed. Patients with depression were divided into two groups using random number method. The control group was given routine care, the observation group was given psychological nursing intervention on the basis of routine nursing. Psychosocial symptoms self-rating scale (SCL-90) and SDS were used to evaluate the psychological status of the patients, and the effect of psychological nursing intervention was evaluated. Results The incidence of depression in hospitalized patients with hepatitis B cirrhosis was 47.0%, with mild and moderate depression. Small age, low education, low family income, severe cirrhosis, hepatitis B infection> 5 years is a risk factor for depression in patients. After psychological nursing intervention, the scores of SCL-90 (somatization, compulsion, interpersonal relationship, depression, anxiety, hostility, terror, psychiatric symptoms) and SDS scores in the observation group were significantly lower than those before intervention (P <0.05) The indexes of the control group were scored (P <0.05). Conclusions Inpatients with hepatitis B cirrhosis are prone to depression, young age, low education level, low family income and severe cirrhosis. Hepatitis B infection> 5 years is a risk factor for depression in the patients. High quality psychological nursing intervention can effectively reduce depression Emotional, so not only clinically important patients should pay attention to the risk of depression, but also the use of psychological care to improve the patient’s psychological state.