沈春丽

[摘要] 目的 探討心智觉知四步骤干预护理法在老年强迫症患者中的积极效果评价。 方法 选取湖州市第三人民医院老年精神科2017年8月～2018年4月收治的74例老年强迫症患者，按照随机数字法分为两组，每组37例，仅接受常规药物治疗及护理者为对照组，在对照组基础上结合心智觉知四步骤干预护理法者为观察组，比较不同护理方法对患者的积极影响，观察指标包括压力知觉量表评分（CPSS）、强迫症状评分（YBOCS）及生活质量评分（GQOLI-74）。 结果 观察组干预12周后的CPSS评分（26.50±2.22）分、强迫量表（6.12±4.35）分、强迫思维（3.20±1.88）分、强迫行为评分（2.95±1.75）分低于对照组，躯体功能（58.99±5.99）分、心理功能（55.75±5.68）分、社会关系（55.58±5.69）分及物质生活评分（50.75±5.88）分高于对照组，差异均有统计学意义（均P<0.05）。 结论 心智觉知四步骤干预方法应用于老年强迫症患者中的价值确切可靠，能明显改善患者的心理状态与生活质量。

[关键词] 心智觉知四步骤;老年强迫症;强迫症状评分;生活质量;负面情绪

[中图分类号] R471          [文献标识码] B          [文章编号] 1673-9701（2020）18-0175-04

Positive efficacy of mindfulness four-step intervention nursing method on elderly patients with obsessive-compulsive disorder

SHEN Chunli

Department of Geriatric Psychiatry， Ward Eight， Huzhou Third Peoples Hospital in Zhejiang Province， Huzhou   313000， China

[Abstract] Objective To explore the positive efficacy evaluation of mindfulness four-step intervention nursing method on elderly patients with obsessive-compulsive disorder. Methods Seventy-four elderly patients with obsessive-compulsive disorder admitted in the department of geriatric psychiatry of the Third Peoples Hospital of Huzhou from August 2017 to April 2018 were selected and divided into the control group （n=37） and the observation group（n=37） according to the random number method. Those who only received conventional drug treatment and nursing were taken as the control group， and those who combined the mindfulness four-step intervention nursing method on the basis of the control group were taken as the observation group. The positive efficacies of different nursing methods on the patients were compared. The observation indexes included Chinese perceived stress scale（CPSS）， the Yale-Brown obsessive-compulsive scale and generic quality of life inventory 74. Results The CPSS score（26.50±2.22）， obsessive-compulsive scale score（6.12±4.35）， obsessive-compulsive thinking score（3.20±1.88） and obsessive-compulsive behavior score （2.95±1.75） of the observation group after twelve weeks of intervention were lower than those of the control group， while the physical function score （58.99±5.99）， psychological function score （55.75±5.68）， social relationship score （55.58±5.69） and material life score （50.75±5.88） of the observation group were higher than those of the control group，and the differences were statistically significant（all P<0.05）. Conclusion The mindfulness four-step intervention nursing method is of definite and reliable value in the elderly patients with obsessive-compulsive disorder， and obviously improves the psychological state and life quality of the patients.

[Key words] Mindfulness four-step; Obsessive-compulsive disorder of the elderly; Yale-Brown obsessive-compulsive scale; Life quality; Negative emotion

强迫症是一种以强迫观念、强迫行为为主要特征的神经症状，具有病情易迁延的特点，影响患者的社会功能[1]。该疾病为一种全球性疾病，全国发病率约为0.05%～0.2%，终身患病率为1.9%～3.3%，成人强迫症的发病率高于青少年，且以女性居多，日益受到临床重视[2]。当前临床主要采用药物对症治疗，但治疗效果不佳，如何提高强迫症患者的治疗效果，是当前临床急需解决的问题。为保证治疗效果，临床提出需在用药同时结合实施护理干预，其中心智觉知为一种特殊集中注意力方法，可通过有意识观察评价身体内部、外部出现的刺激时心理体验，综合利用心智觉知及认知疗法以改善强迫症。……