标题：认知行为干预对漏斗胸患儿NUSS术后心理状况及自我效能的影响

      作者：谭小莉，高乐，何良平，潘晓兰    深圳市儿童医院心胸外科，广东 深圳 518038

      卷次： 2020年31卷6期

      【摘要】 目的 探讨漏斗胸患儿应用认知行为干预对患儿漏斗胸微创矫正术(NUSS)后心理状况及自我效能的影响。方法 选取深圳市儿童医院心胸外科2017年1月至2019年8月收治的漏斗胸患儿98例为研究对象，所有患儿均实施Nuss术治疗。将患儿根据随机数表法分为观察组和对照组，每组49例，对照组常规应用围手术期护理措施，观察组则在此基础上应用认知行为干预措施，干预时间为2周。比较两组患儿干预前后儿童焦虑情绪障碍筛查表(SCARED)、儿童抑郁自评量表(CDI)、自我效能量表及儿童生存质量量表评分的变化。结果 干预后，观察组患儿的CDI、SCARED、自我效能量表评分分别为(23.28±4.09)分、(8.92±2.88)分、(31.96±5.29)分，明显优于对照组的(33.79±6.41)分、(12.53±3.10)分、(24.18±6.17)分，差异均有统计学意义(P<0.05)；干预后，观察组患儿生存质量量表中的生理功能、社会功能、角色功能、情感功能及总分分别为(84.14±20.52)分、(80.46±19.74)分、(79.57±18.44)分、(77.23±17.84)分、(80.38±16.33)分，明显高于对照组的(71.68±17.19)分、(72.51±18.62)分、(68.76±16.48)分、(70.36±18.26)分、(70.48±17.46)分，差异均有统计学意义。结论 认知行为干预能提高漏斗胸患儿NUSS术后的自我效能，缓解患儿的焦虑、抑郁情绪，进而提高患儿生活质量。
      【关键词】 漏斗胸；微创手术；自我效能；心理状况；生存质量
      【中图分类号】 R473.72 【文献标识码】 A 【文章编号】 1003—6350（2020）06—0802—03

Effect of cognitive behavioral intervention on psychological status and self-efficacy of children with pectusexcavatum after Nuss repair.
TAN Xiao-li, GAO Le, HE Liang-ping, PAN Xiao-lan. Department of Cardiothoracic,Shenzhen Children's Hospital, Shenzhen 518038, Guangdong, CHINA
【Abstract】 Objective To explore the effect of cognitive behavioral intervention on psychological status andself-efficacy of children with pectus excavatum after Nuss repair. Methods Ninety-eight children with pectus excava-tum treated in Department of Cardiothoracic, Shenzhen Children's Hospital from January 2017 to August 2019 were se-lected as the study subjects, all of them were treated with Nuss repair. The children were divided into the observationgroup and control group according to random number table method, with 49 cases in each group. The control group re-ceived perioperative nursing measures routinely, while the observation group was treated with cognitive behavioral inter-vention measures on this basis of the treatment of the control group. The intervention time was 2 weeks. The score chang-es of the Screen for Child Anxiety-Related Emotional Disorders (SCARED), Child Depression Inventory (CDI), self-effi-cacy scale, and quality of life (QoL) of children before and after intervention were compared between the two groups.Results After intervention, the scores of CDI, SCARED, and self-efficacy scale in the observation group were 23.28±4.09, 8.92±2.88 and 31.96±5.29 respectively, which were significantly better than corresponding 33.79±6.41, 12.53±3.10and 24.18±6.17 in the control group (all P<0.05). The scores of role function, emotional function and total score in theobservation group were 84.14±20.52, 80.46±19.74, 79.57±18.44, 77.23±17.84, 80.38±16.33, respectively, which weresignificantly higher than corresponding 71.68±17.19, 72.51±18.62, 68.76±16.48, 70.36±18.26, 70.48±17.46 in the con-trol group (all P<0.05). Conclusion Cognitive behavior intervention can effectively improve the self-efficacy of chil-dren with funnel chest after Nuss, alleviate anxiety and depression, and then improve the quality of life of children withfunnel chest.
      【Key words】 Funnel chest; Minimally invasive surgery; Self-efficacy; Psychological status; Quality of life (QoL)·护理·doi:10.3969/j.issn.1003-6350.2020.06.036基金项目：广东省深圳市科技计划项目(编号：JCYJ20170303155657876)；广东省深圳市三名工程项目(编号：SZSM201612003)