认知行为心理护理对躯体形式障碍患者疗效的影响.docVIP

认知行为心理护理对躯体形式障碍患者疗效的影响 　　[摘要] 目的 探讨认知行为心理护理对躯体形式障碍患者疗效的影响。方法 将84例躯体形式障碍患者分为两组，对照组采用单纯药物治疗加常规护理，研究组在对照组治疗基础上联合认知行为心理护理；以 HAMD、HAMA量表为评定工具分别在患者入院时及治疗后第1、2、4、8周末进行评估，判断治疗效果。 结果 自治疗第2周末HAMD、HAMA评分研究组较对照组即有明显下降（P0.05）；治疗8周末评定研究组显效率为78.95%、对照组为58.70%，两组相比差异有统计学意义（P0.05）。 结论 认知行为心理护理能提高躯体形式障碍的治疗效果，值得推广。 　　[关键词] 躯体形式障碍；认知行为；心理护理；疗效 　　[中图分类号] R749.7 [文献标识码] B [文章编号] 2095-0616（2013）22-124-03 　　The effect of cognitive behavior psychological nursing in patients with somatoform disorders 　　MA Zhiwen 　　Mental Health Center in Linyi of Shandong Province，Linyi 276005，China 　　[Abstract] Objective To explore the effect of cognitive behavior psychological nursing in patients with somatoform disorders. Methods 84 patients with somatoform disorders were randomly divided into two groups.Patients in the control group only received the routine nursing care plus pure drug therapy，and patients in the experiment group received cognitive behavioral psychological nursing plus pure drug therapy.Patients were assessed with Hamilton Depression Scale （HAMD） and Hamilton Anxiety Scale（HAMA） before and after 1，2，4，8 weeks treatment. Results There was a significant decrease of HAMD and HAMA scores in the treatment group after 2 weeks treatment（P0.05）；in the study group the rate of improvement was 78.95% after 8 weeks treatment（in the control group was 58.70%）.There was no significant difference between these two groups（P0.05）. Conclusion Cognitive behavior psychological nursing could improve the curative effect of somatoform disorders， and it was recommendable. 　　[Key words] Somatoform disorder；Cognitive-behavioral；Psychological nursing；Curative effect 　　躯体形式障碍是临床上常见的一种精神障碍，以持久地担心或相信各种躯体症状的优势观念为特征的神经症。患者因这些症状反复就医，各种医学检查阴性和医生的解释，均不能打消其疑虑，即使有时存在某种躯体障碍，也不能解释所诉症状的性质、程度或其痛苦与优胜观念，经常伴有焦虑或抑郁情绪。尽管症状的发生和持续与不愉快的生活事件、困难或冲突密切相关，但患者常否认心理因素的存在，本障碍男女都有，为慢性波动性病程。躯体形式障碍近年来受到研究者的关注，但大多数研究[1-2]集中在躯体形式障碍患者的药物治疗上，对护理在疗效方面的影响探讨较少[3]。而本研究对躯体形式障碍患者，实施单独药物治疗和药物结合认知行为护理疗法治疗对照观察，以评价两种方法的治疗反应及长期疗效。 　　1 资料与方法 　　1.1