刘勇+许筱伦+仇永亮

[摘要] 目的 调查心理护理干预对肝硬化患者自我疾病感知和生活质量的影响，分析其在促进患者康复中的作用。方法 选取84例肝硬化患者，随机分为实验组和对照组，对实验组进行心理干预，对照组仅给予常规护理。实施干预后两组患者分别进行疾病感知问卷（IPQ-R）评分和生命质量调查量表（SF-36）评分，评估心理护理干预效果。结果 接受心理护理干预的患者疾病感知水平明显优于对照组（P<0.05），SF-36量表评分中的生理功能、社会功能、总体健康和心理健康的四个维度均优于对照组（P<0.05）。 结论 心理护理干预可提升肝硬化患者的疾病感知水平，改善患者的生活质量，有利于患者康复，全面促进患者的身心健康。

[关键词] 肝硬化；心理护理干预；疾病感知；IPQ-R；SF-36

[中图分类号] R657.3；R473 [文献标识码] B [文章编号] 1673-9701（2016）23-0145-04

[Abstract] Objective To investigate the effects of mental nursing intervention on self disease awareness and life quality in the patients with liver cirrhosis， and to analyze its effects on improving patients rehabilitation. Methods 84 patients with liver cirrhosis were selected and randomly assigned to the experiment group and the control group. Mental intervention was carried out for the experiment group， and the control group was only given regular nursing. After the intervention， the two groups of patients were both scored according to IPQ-R and SF-36， and the effects of mental nursing intervention were evaluated. Results Disease awareness level in the patients receiving mental nursing intervention was significantly better than that in the control group（P<0.05）， and scores of four dimensions of physiological functions， social functions， overall health and mental health in SF-36 scale were all better than those in the control group （P<0.05）. Conclusion Mental nursing intervention is able to improve disease awareness level in the patients with liver cirrhosis， and enhance patients life quality， which is beneficial to patients recovery and comprehensively promotes patients physical and mental health.

[Key words] Liver cirrhosis； Mental nursing intervention； Disease awareness； IPQ-R； SF-36

肝硬化是肝脏在致病因素下导致的慢性炎症迁延不愈而出现的不可逆病理变化，是肝细胞在多种致病因素（如肝炎病毒、酒精、自身免疫性疾病和遗传疾病）及各种炎性因子的刺激下，肝脏内静息的星状细胞过度分泌胶原修复的一种保护机制[1]。这类疾病发展到后期，易产生不同的代谢紊乱，并发上消化道出血、肝性脑病等。临床中医护人员往往忽视了患者自身对疾病的理解和感知，仅停留在指导和治疗措施上，目前国内对肝硬化患者的疾病感知状况的研究甚少，若能在治疗中对肝硬化患者的疾病感知采取有效的干预措施，则可以提高及改善患者的疾病感知及自我护理水平，从而改善患者的生活质量，进而改善患者的预后。本研究旨在探讨心理护理干预对肝硬化患者的自我疾病感知和生活质量的影响，分析其在促进肝硬化患者恢复中的作用，现报道如下。……