Neuman理论对高血压脑出血患者术后心理状况的影响

Neuman理论对高血压脑出血患者术后心理 状况的影响 ［摘要］目的探讨Neuman理论对高血压脑出血患 者术后心理状况的影响。方法 收集2011年6月〜2014年 1月来我院救治的120例高血压脑出血并已行手术的患者， 按患者入院顺序随机把所选患者分为实验组与对照组各60 例，对照组患者给予一般的常规护理，实验组患者在常规护 理的基础上依据Neuman理论设计心理护理干预措施，并采 用汉密尔顿抑郁量表HAMD及症状自评量表SCL-90来 检测、评价及比较两组患者的护理的效果。结果干预前两 组患者的HAMD总评分间的差异不大，干预12周后实验组患 者的HAMD总评分明显改善，特别是绝望感、焦虑/躯体化及 认知障碍等方面实验组患者改善得更加明显；干预12周后 实验组患者的抑郁、焦虑、强迫症状、恐怖、敌对及精神病 性评分均明显低于对照组。结论Neuman理论对高血压脑 出血患者术后心理状况的改善有较高的应用价值，值得在临 床工作中大力推广应用。 ［关键词］Neuman理论；高血压；脑出血；心理状况 ［中图分类号］R473. 5 ［文献标识码］B ［文章编号］ 1673-9701 2015 12-0130-04 The influence of Neuman theory on postoperative mental status of the patients with hypertensive cerebral hemorrhage WANG Huimeil CHEN Junxial CHEN Qinfenl WANG Xiaofangl LV Xuexia2 1. Department of Neurosurgery Second Area, Lishui People s Hospital in Zhejiang Province , Lishui 323000 , China ； 2. Department of Rehabilitation Medicine , Lishui People s Hospital in Zhejiang Province, Lishui 323000, China [Abstract] Objective To explore the influence of Neuman theory on postoperative mental status of the patients with hypertensive cerebral hemorrhage. s According to their admission order , 120 patients with hypertensive intracerebral hemorrhage who accepted operation in our hospital from June 2011 to January 2014 were divided into the experimental group and the control group , each group with 60 patients. The patients in the control group were treated with routine care while the patients in the experimental group were given psychological care interventions designed in accordance with Neuman theory on the basis of the routine care. The nursing effects of the two groups were compared, detected and uated by Hamilton Depression Rationg Scale HAMD and Self-reporting inventory SCL-90 . Results The differences of HAMD total score of the two groups before interventions were not statistically significant. After 12 weeks intervention, HAMD total score of the experimental group significantly improved, especially in hopelessness, anxiety/somatization and cognitive impairment. The depression , anxiety , obsessive-compulsive symptoms, horror, hostility and psychosis of the experimental group were significantly lower than those of the control group after 12 weeks intervention. Conclusion Neuman theory has very high value of application to improve postoperative psychological status of the patients with hypertensive cerebral hemorrhage and is worthy of being promoted and applied in clinical work. [Key words] Neuman theory； High blood pressure； Cerebral hemorrhage； Mental status 高血压脑出 血是由于血压过高而引起颅内小血管破裂进而出现脑实质 的出血[1]。随着人们生活水平的不断提高，高血压的发病 率呈现逐年上升的趋势，而高血压脑出血是高血压最严重的 一种并发症，具有起病急、发展快、致残率及病死率高等特 点［2, 3］,及时手术治疗是治疗高血压脑出血的关键o Neuman 理论的核心是将人看成一个整体、多维的开放系统，不断与 应激源［4］（环境中的压力源）进行互动，并通过自身的防 御系统及反应能力不断对整个系统进行协调以达到平衡，此 过程中会出现一系列从生理到心理的病理反应及危机状态 ［5］。本研究以120例高血压脑出血并行手术的患者为研究 对象，通过给予患者不同的护理措施，来探讨Neuman理论 对高血压脑出血患者术后心理状况的影响。 1资料与方法 1. 1临床资料 收集2011年6月〜2014年1月来我院救治的高血压脑 出血并已行手术的患者120例为研究对象，其中男72例， 女48例，年龄41〜70岁，平均（58.2 3.4）岁。既往均 有高血压史，且均经影像学被证实为脑出血，均