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中华老年骨科与康复电子杂志

中华老年骨科与康复电子杂志 ›› 2021, Vol. 07 ›› Issue (02) : 93 -98. doi: 10.3877/cma.j.issn.2096-0263.2021.02.005

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脊柱专题

聚焦解决模式对脊髓损伤伴截瘫患者残障接受度影响的研究
臧苑彤1, 张丽天1, 杨美英1, 赵小娟1, 李莉1,†()   
  1. 1. 010030　呼和浩特市，内蒙古医科大学第二附属医院
  • 收稿日期:2019-10-18 出版日期:2021-04-05
  • 通信作者: 李莉
  • 基金资助:
    内蒙古自治区卫生和计划生育委员会科研计划项目(201703119); 内蒙古医科大学科技百万工程项目(YKD2018KJBW（LH）050)

A study on the effect of solution focused approach on the acceptance of disability in patients with spinal cord injury with paraplegia

Yuantong Zang1, Litian Zhang1, Meiying Yang1, Xiaojuan Zhao1, Li Li1,†()   

  1. 1. Department of Rehabilitation, The First Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010030, China
  • Received:2019-10-18 Published:2021-04-05
  • Corresponding author: Li Li
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臧苑彤, 张丽天, 杨美英, 赵小娟, 李莉. 聚焦解决模式对脊髓损伤伴截瘫患者残障接受度影响的研究[J]. 中华老年骨科与康复电子杂志, 2021, 07(02): 93-98.

Yuantong Zang, Litian Zhang, Meiying Yang, Xiaojuan Zhao, Li Li. A study on the effect of solution focused approach on the acceptance of disability in patients with spinal cord injury with paraplegia[J]. Chinese Journal of Geriatric Orthopaedics and Rehabilitation(Electronic Edition), 2021, 07(02): 93-98.

目的

探讨聚焦解决模式对脊髓损伤伴截瘫患者残障接受度的影响，以提高脊髓损伤伴截瘫患者的残障接受度。

方法

将64例脊髓损伤伴截瘫患者按随机数字表法分为2组各32例，对照组给予常规护理，试验组在对照组基础上实施聚焦解决模式干预，采用残障接受度量表、自我感受负担量表和医院焦虑抑郁量表分别在干预前和干预3个月后对患者进行调查，评价两组患者的残障接受度、自我感受负担和焦虑抑郁情况。

结果

干预3个月后，试验组残障接受度量表中扩大维度、服从维度、控制维度、转变维度及总分均明显高于对照组（均P<0.05）,试验组自我感受负担得分和焦虑抑郁总分均明显低于对照组（t=5.263，P<0.05；t=3.613，P<0.05）干预前，上述各指标两组间比较均无统计学差异（P>0.05）。干预3个月后，试验组残障接受度总分明显高于干预前（Z=-3.946，P<0.05），对照组干预前后差异无统计学意义（P>0.05）。

结论

聚焦解决模式能够提高脊髓损伤伴截瘫患者的残障接受度，减轻患者的自我感受负担和焦虑抑郁水平。

关键词: 心理疗法, 脊髓损伤, 残障
Objective

To explore the effect of solution focused approach on the acceptance of disability in patients with spinal cord injury combined with paraplegia, to improve the patient's acceptance of disability.

Methods

Totally 64 patients with spinal cord injury combined with paraplegia were randomly divided into the experimental group and the control group with 32 cases in each group. The experimental group received the solution focused approach on the basis of routine nursing, while the control group patient only received routine nursing. Acceptance of disability scale, Self-feeling burden scale and hospital anxiety and depression scale were used to evaluate the intervention effect at different time.

Results

After 3 months of intervention, the dimensions of expansion, obedience, control, transformation and total scores of disability Acceptance Scale in the experimental group were significantly higher than those in the control group (all P<0.05). The self-feeling burden score and the total anxiety and depression score of the experimental group were significantly lower than those of the control group (t=5.263, P<0.05; t=3.613, P<0.05). Before intervention, there was no statistical difference between the two groups (P>0.05). After 3 months of intervention, the total score of disability acceptance in the experimental group was significantly higher than that before intervention (Z=-3.946, P<0.05), while the difference before and after intervention in the control group was no statistically significant (P>0.05).

Conclusion

Solution Focused Approach can improve the acceptance of disability and reduce the patient's self-feeling burden and anxiety and depression levels in patients with spinal cord injury combined with paraplegia.

Key words: Psychotherapy, Spinal cord injuries, Disabled persons
表1 两组脊髓损伤伴截瘫患者患者一般资料比较
组别 例数 性别（例） 年龄（岁，±s） 文化程度（例） 婚姻状况（例） 医疗支付方式（例）
男 女 初中以下 高中以上 未婚 已婚 自费 医保
对照组 32 27 5 37±11 10 22 7 25 14 18
干预组 32 25 7 34±11 8 24 9 23 19 13
统计值   χ2=0.410 t=0.941 χ2=0.309 χ2=0.333 χ2=1.564
P值   0.522 0.350 0.578 0.564 0.211
表2 两组脊髓损伤伴截瘫患者干预前后残障接受度得分比较（分，±s）
组别 例数 扩大维度 t值 P值 服从维度 t值 P值 控制维度 t值 P值
干预前 干预后 干预前 干预后 干预前 干预后
对照组 32 46±13 51±15 -1.532 0.131 13±6 16±6 -2.014 0.051 43±19 45±19 -0.420 0.676
试验组 32 45±16 59±12 -3.821 0.000 13±6 20±6 -4.440 0.000 42±17 57±21 -3.066 0.003
t值   0.253 -2.159     0.302 -2.233     0.229 -2.348    
P值   0.801 0.035     0.764 0.029     0.819 0.022    
组别 例数 转变维度 t值 P值 总分 t值 P值
干预前 干预后 干预前 干预后
对照组 32 41±19 42±14 -0.302 0.764 144±31 155±29 -1.502 0.138
试验组 32 41±18 54±16 -3.104 0.003 141±33 189±32 -5.879 0.000
t值 - -0.014 -3.215     0.288 -4.435    
P值 - 0.989 0.002     0.774 0.000    
表3 两组脊髓损伤伴截瘫患者干预前后残障接受度总分比较[例（%）]
组别 例数 干预前 干预后 χ2值 P值
低接受度 中接受度 高接受度 低接受度 中接受度 高接受度
对照组 32 10（31.2） 22（68.8） 0 8（25） 24（75） 0 0.309 0.578
试验组 32 14（43.8） 17（53.1） 1（3.1） 1（3.1） 25（78.1） 6（18.8） 12.539 0.000
χ2值     1.067     4.655      
P值     0.302     0.031      
表4 两组脊髓损伤伴截瘫患者干预前后自我感受负担得分比较（分，±s）
组别 例数 干预前 干预后 t值 P值
对照组 32 35±5 32±4 0.145 0.052
试验组 32 34±5 28±4 2.321 0.001
t值 - 1.569 5.263    
P值 - 0.051 0.001    
表5 两组脊髓损伤伴截瘫患者干预前后焦虑抑郁得分比较（分，±s）
组别 例数 干预前 干预后 t值 P值
对照组 32 8.4±2.1 6.7±2.1 1.201 0.063
试验组 32 8.3±3.0 3.9±4.2 3.423 0.001
t值 - 1.235 3.613    
P值 - 0.072 0.001    
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