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目的:探讨叙事医学干预对后遗症期脑卒中患者抑郁情绪的影响,为缓解患者的抑郁情绪、推动叙事医学介入临床提供依据。方法:将100例后遗症期脑卒中患者随机分为研究组和对照组,每组各50例。其中对照组采取常规诊疗方法进行临床诊疗与护理,研究组在常规诊疗的基础上对患者进行叙事医学干预,开展叙事医学访谈以及加强日常的人文关怀。分别在干预前和干预后一个月对两组患者用抑郁自评量表(SDS)进行测评,了解患者的抑郁情况,并对比分析。结果:100例患者干预前抑郁情绪的发生率(标准分≥50)为77%。研究组的50例患者干预前SDS评分为60.2±7.1,干预后为45.0±4.2。对照组的50例患者干预前评分为62.8±7.5,干预后为60.1±4.9。干预后研究组的患者抑郁情绪水平明显低于对照组,差异有统计学意义(P<0.5)。结论:针对后遗症期脑卒中患者,叙事医学干预有助于降低患者的抑郁情绪,临床医学人文、叙事医学理念与实践可结合医院具体情况开展试点并推广。
Objective: To investigate the effect of narrative medical intervention on depression in patients with stroke after sequelae, in order to alleviate depression and promote the intervention of narrative medicine. Methods: One hundred sequelae of stroke patients were randomly divided into study group and control group, with 50 cases in each group. Among them, the control group took routine diagnosis and treatment for clinical diagnosis and treatment, and the research group conducted narrative medical intervention on the basis of routine diagnosis and treatment, carried out narrative medical interviews and strengthened routine humanistic care. Before and one month after intervention, two groups of patients were respectively evaluated by Depression Self-rating Scale (SDS) to understand the depression status of the patients and compared them. Results: The incidence of depression in 100 patients (standard score ≥50) was 77%. The 50 patients in the study group had an SDS score of 60.2 ± 7.1 before intervention and 45.0 ± 4.2 after intervention. The control group of 50 patients before intervention score was 62.8 ± 7.5, after intervention was 60.1 ± 4.9. The level of depression in the study group after intervention was significantly lower than that in the control group (P <0.5). Conclusions: According to the sequelae of stroke patients, the narrative medical intervention can help to reduce the depression of patients. Clinical medical humanities, narrative medical concepts and practice can be combined with the specific conditions of the hospital to carry out pilot and promotion.