陈涛 石瑾 周叶

摘 要 目的：評价团体心理干预在社区失智失能老人照护者中的应用效果，探索促进社区居家养老服务开展的照护者心理干预方法。方法：选取2019年4月-2020年7月居住在上海长桥街道的108例失智失能老人的照护者进行团体心理干预，其中男性42人，平均年龄为（60.53±11.51）岁；女性66人，平均年龄为（56±10.24）岁。采用90项症状自评量表（SCL-90）、总体幸福量表（GWB）调查团体心理干预前后照护者的情绪和幸福感。结果：干预后SCL-90总均分为（113.15±14.22）分，明显低于干预前（132.98±10.06）分，差异有统计学意义（P<0.05）。干预后SCL-90各因子得分均明显低于干预前，差异均有统计学意义（P<0.05）。干预前后总体GWB得分分别为（43.3±3.4）分和（75.7±4.2）分，差异均有统计学意义（P<0.05）。结论：在社区开展团体心理干预能有效改善失智失能老人照护者的负性情绪，提高其心理健康水平和幸福感。

关键词 失智失能老人；照护者；社区；团体心理干预

中图分类号：R395 文献标志码：A 文章编号：1006-1533（2021）10-0052-04

*基金项目：上海市中西医结合学会社区医学与健康管理研究项目（SQ10）

Evaluation of the application effect of the group psychological intervention in the community caregivers of the mentally retarded and disabled elderly people

CHEN Tao1， SHI Jin2， ZHOU Ye3（1.Nursing Department of Changqiao Community Health Service Center of Xuhui District， Shanghai 200231， China； 2. Outpatient Office of Changqiao Community Health Service Center of Xuhui District， Shanghai 200231， China； 3.General Practice Wards of Changqiao Community Health Service Center of Xuhui District， Shanghai 200231， China ）

ABSTRACT Objective： To evaluate the application effect of the group psychological intervention in the caregivers of the mentally retarded and disabled elderly people in the community， so as to find out the psychological intervention methods for the caregivers to promote the development of community home-based care services. Methods： From April 2019 to July 2020， 108 caregivers of the elderly people with dementia and disabilities who lived in Changqiao Community were selected for the group psychological intervention， among them， there were 42 males with an average age of （60.53±11.51） years and 66 females with an average age of （56±10.24） years. 90-item symptom checklist（SCL-90） and general well-being scale（GWB） were used to investigate the emotion and happiness of the caregivers before and after the group psychological intervention. Results： The total mean score of SCL-90 after the intervention was （113.15±14.22）， which was significantly lower than that before （132.98±10.06）， and the difference was statistically significant（P<0.05）. The scores of SCL-90 factors after the intervention were significantly lower than those before the intervention， and the differences were statistically significant（P<0.05）. The overall GWB scores before and after the intervention were （43.3±3.4） and （75.7±4.2）， respectively， and the differences were statistically significant（P<0.05）. Conclusion： The group psychological intervention in the community can effectively improve the negative emotions of the caregivers of the mentally retarded and disabled elderly， and improve their mental health level and happiness.

KEY WORDS mentally retarded and disabled elderly people； caregiver； community； group psychological intervention

据文献统计我国失智失能老人的数量占世界总病例数的四分之一，且每年都有新发病例，约30万左右，预计到2050年失智失能老人数量将达到2 000万人以上。截至2015年，我国完全失能和部分失能的老人达4 063万人，占总体老年人口的18.3%[1]。失智失能老人给照顾者及其家庭带来了沉重的打击与精神负担，照护者由于照料老人导致常年生活节奏变快，脱离社交圈，日积月累使其出现社交孤立、焦虑、压抑、失望、孤独等负性情绪，进而导致躯体与心理两种因素相互影响，形成恶性循环。居家养老服务是社会化难题，已经引起社会的广泛关注[2]。

上海长桥社区合理利用社区公共卫生资源，发展社区精神卫生服务建设，为失智失能老人照护者搭建团体心理干预社区服务平台，使照护者及时了解自己的心理健康状况，帮助其进行适当的自我调适，增加其心理幸福感，提高失智失能老人家庭的生活质量[3]。……