标题：心理访谈疗法对维持性血透患者负性情感与生存质量的影响

      作者：付燕红 1，李冬梅 2    长庆油田职工医院血液净化科 1、普外科 2，陕西 西安 710201

      卷次： 2019年30卷17期

      【摘要】 目的 探讨心理访谈疗法对维持性血透患者负性情感与生存质量的影响。方法 选取2017年1月至2018年9月期间长庆油田职工医院收治的60例维持性血透患者为研究对象，采用随机数表法将其随机分为三组(n=20)。对照组采取常规健康教育，观察1组、观察2组分别进行为期1个月、3个月的心理访谈疗法。干预后，采用疼痛视觉模拟评分(VAS)评估动静脉内瘘穿刺疼痛程度；采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评估受试者焦虑、抑郁状态；采用生命质量测评量表(FACT-B)评估生活质量；采用主观幸福感问卷、匹兹堡睡眠质量指数(PSQI)评价受试者主观幸福感、睡眠质量；采用心理资本问卷评估心理资本状况，该问卷包含希望、乐观、韧性、自我效能四个方面。结果 干预后，观察 1组和观察 2组受试者的VAS评分分别为(4.01±0.44)分、(3.49±0.39)分，低于对照组的(4.40±0.80)分，观察2组与观察1组差异均有统计学意义(P<0.05)；干预后，观察1组和观察 2组受试者的HAMA、HAMD评分分别为(11.59±1.04)分、(10.17±0.97)分和(13.96±0.99)分、(12.15±0.80)分，均低于对照组的(12.44±1.11)分、(13.96±0.99)分，观察2组又低于观察1组，差异均有统计学意义(P<0.05)；干预后，观察1组和观察2组受试者在生理、功能、情感、社会家庭、附加关注等维度FACT-B评分均高于对照组，观察2组又高于观察 1组，差异均有统计学意义(P<0.05)；干预后，观察 1组和观察 2组受试者主观幸福感评分分别为(127.18±9.24)分、(140.79±11.30)分，明显高于对照组的(116.30±8.49)分，观察2组又高于观察1组，差异均有统计学意义(P<0.05)；干预后，观察 1组和观察 2组受试者 PSQI评分分别为(11.49±1.89)分、(8.06±1.46)分，明显低于对照组的(14.18±1.55)分，观察2组又低于观察1组，差异均有统计学意义(P<0.05)；干预后，观察1组和观察2组受试者在自我效能、希望、韧性、乐观等心理资本维度评分均高于对照组，观察 2组又高于观察 1组，差异均有统计学意义(P<0.05)。结论 心理访谈疗法可有效缓解维持性血透患者动静脉内瘘穿刺时疼痛程度，改善负性情感，提高主观幸福感及生存质量，且干预时间越长，改善程度越好。
      【关键词】 血液透析；维持性；心理访谈疗法；负性情感；生存质量
      【中图分类号】 R459.5 【文献标识码】 A 【文章编号】 1003—6350（2019）17—2209—04

Effect of psychological interview therapy on negative emotion and quality of life in maintenance hemodialysispatients.
FU Yan-hong 1, LI Dong-mei 2. Blood Purification Department 1, General Surgery 2, the Staff Hospital ofChangqing Oilfield, Xi'an 710201, Shaanxi, CHINA
【Abstract】 Objective To investigate the effect of psychological interview therapy on negative emotion andquality of life in patients with maintenance hemodialysis. Methods A total of 60 patients with maintenance hemodialy-sis, who admitted to Changqing Oilfield Staff Hospital from January 2017 to September 2018 were selected as researchobjects and randomly divided into three groups by random number table method (n=20). The control group received rou-tine health education, and the observation group 1 and observation group 2 received psychological interview therapyfor 1 month and 3 months respectively. After intervention, visual analogue scale (VAS) was used to evaluate the paindegree of puncture of arteriovenous internal fistula. Hamilton Anxiety Rating Scale (HAMA) and Hamilton DepressionRating Scale (HAMD) were adopted to evaluate the anxiety and depression state of the subjects. Quality of life was as-sessed using the quality of life scale (FACT-B). Subjective well-being questionnaire and Pittsburgh sleep quality index(PSQI) were used to evaluate subjects' subjective well-being and sleep quality. Psychological capital status was evaluat-ed by psychological capital questionnaire, which includes four aspects: hope, optimism, resilience and self-efficacy.Results After intervention, the VAS scores of the subjects in the observation group 1 and the observation group 2 were4.01±0.44 and 3.49±0.39, respectively, which were significantly lower than 4.40±0.80 in the control group; there was al-so significant difference between the two observation groups (P<0.05). After intervention, HAMA and HAMD scores ofsubjects in the observation group 1 and observation group 2 were 11.59±1.04, 10.17±0.97 and 13.96±0.99, 12.15±0.80,respectively, which were lower than corresponding 12.44±1.11 and 13.96±0.99 in the control group; there were also sig-nificant differences between the two observation groups in HAMA and HAMD scores (P<0.05). After intervention, thesubjects in the observation group 1 and observation group 2 had significantly higher FACT-B scores in physiological,functional, emotional, social and family, additional attention and other dimensions than those in the control group, and