蔡芳 周敏 周晓倩

[摘要]目的：探究基于网络平台的结构式心理护理对烧伤后瘢痕整形患者创伤后康复及不良情緒的影响。方法：将120例烧伤后瘢痕整形患者采用计算机单盲随机分组分为观察组（n=61）与对照组（n=59）。对照组患者给予常规护理，观察组在其基础上给予基于网络平台的结构式心理护理。比较两组患者入院时、出院后1个月的创伤后成长能力[改良版创伤后成长评定量表（Posttraumatic growth inventory，PTGI）]、不良情绪[状态特质焦虑量表（State-trait anxiety inventory，STAI）、贝克抑郁问卷（Beck's depression inventory，BDI）]、体象接受[体象障碍自评量表（Body image rating scale，BIRS）、伤残接受度量表（Acceptance of disability scale，ADS）]变化，并记录其出院前1d的外观满意度及并发症发生情况。结果：出院后1个月，两组患者PTGI量表（人际关系、新可能性、个人能力、精神改变、享受生活）各维度评分及总分、ADS量表较入院时均有显著上升，而STAI量表（状态焦虑、特质焦虑）中各分量表评分及BDI量表、BIRS量表评分均较入院时显著下降，且观察组上述指标变化幅度更大，差异有统计学意义（P<0.05）。出院后1个月，观察组总满意率为93.44%，高于对照组的79.66%，差异有统计学意义（P<0.05）。观察组并发症发生率为8.20%低于对照组的16.95%，组间比较差异无统计学意义（χ2=2.101，P>0.05）。结论：基于网络平台的结构式心理护理可提高烧伤后瘢痕整形患者创伤后成长能力，缓解其不良情绪，且还可有利于自我体象接受度的提高，对整形满意度较好，适合广泛推广及应用。

[关键词]网络平台;结构式心理护理;烧伤;瘢痕整形;创伤后成长;不良情绪;满意度

[中图分类号]R473    [文献标志码]B    [文章编号]1008-6455（2021）07-0154-04

Effect of Structured Psychological Nursing Based on Network Platform on Rehabilitation and Negative Emotion of Patients with Burn Scar Plastic Surgery

CAI Fang，ZHOU Min，ZHOU Xiao-qian

（Department of Plastic Surgery and Burns，West China Hospital，Sichuan University，Chengdu 610000，Sichuan，China）

Abstract： Objective  To explore the effects of structured psychological nursing based on network platform on rehabilitation and negative emotion of patients with burn scar plastic surgery. Methods  A total of 120 patients with burns were divided into the observation group （n=61） and the control group （n=59） by computer single-blind randomized grouping. Patients in control group were given routine nursing， and the observation group was given structural psychological nursing based on network platform on this basis. The post-traumatic growth ability [Modified posttraumatic growth inventory （PTGI）]， unhealthy emotion [State-trait anxiety inventory （STAI）， Becks depression inventory （BDI）] and body image acceptance [Body image rating scale （BIRS）， Acceptance of disability scale （ADS）] were compared between the two groups at admission and at one month after discharge， and the appearance satisfaction and occurrence of complications were recorded at 1d before discharge. Results  At one month after discharge， the scores of dimensions and total score of of PTGI scale （interpersonal relationship， new possibilities， personal abilities， mental changes， enjoyment of life） and score of ADS scale of the two groups were increased significantly compared with those at admission， the differences were statistically significant （P<0.05）. While the scores of subscales of STAI scale （state anxiety， trait anxiety） and scores of BDI scale and BIRS scale were significantly decreased compared with those at admission （P<0.05）. And the observation group were better than the control group （P<0.05）. At one month after discharge， the total satisfaction rate in the observation group was higher than that in the control group （93.44% vs 79.66%， P<0.05）. The complication rate of the observation group was 8.20%， which was lower than that of the control group（16.95%）， there was no significant difference between the two groups （χ2=2.101， P>0.05）. Conclusion  Structured psychological nursing based on network platform for patients with burn scar plastic surgery can improve the post-traumatic growth ability and relieve the unhealthy emotion， and can also improve the acceptance of self-body image. It has good satisfaction with plastic surgery， and is suitable for wide promotion and application.

Key words： network platform; structural psychological nursing; burn; scar plastic surgery; posttraumatic growth; negative emotion; satisfaction

烧伤是指因热力引起的组织损伤，发生于皮肤或黏膜，严重者可伤及皮下组织及黏膜下组织，进而造成体液渗出、强烈疼痛、创面感染等情况发生，影响其生活质量[1]。……