潘稚芬　潘亚慧　周勇　李国荣　潘亦天

[關键词] 肺结核;应激;短期正念训练;SCL-90量表;MCMQ量表;满意度

[中图分类号] R395.6          [文献标识码] B          [文章编号] 1673-9701（2021）23-0087-05

The effect of short-term mindfulness training on the psychological state of tuberculosis inpatients under stress

PAN Zhifen1   PAN Yahui2   ZHOU Yong2   LI Guorong2   PAN Yitian3

1.Department of Tuberculosis，Affiliated Hospital of Jiaxing University，The First Hospital of Jiaxing，Jiaxing   314000，China; 2.Department of Psychiatry，Kangci Hospital of Jiaxing City in Zhejiang Province，Jiaxing   314500，China; 3.Class 1 of Medical Treatment， Huanggang Vocational College of Science and Technology，Huanggang   438000，China

[Abstract] Objective To explore the effect of short-term mindfulness training on the psychological state of tuberculosis patients under stress. Methods Seventy-eight pulmonary tuberculosis patients hospitalized in the tuberculosis area of the Jiaxing No.1 Hospital from January 20， to March 20， 2020， were retrospectively analyzed. According to the random number table method， the patients were divided into the control group and the observation group， with 39 cases in each group. The control group was given routine diagnosis and treatment， and the observation group was given short-term mindfulness training intervention on the basis of routine diagnosis and treatment. The changes in psychological status， medical coping styles， and satisfaction with diagnosis and treatment before and after intervention between the two groups were compared. Results Compared with before the intervention， the scores of the self-rating symptom scale （SCL-90） decreased after the intervention， and the anxiety， terror factors， and total scores of the observation group decreased more significantly than the control group（P<0.05）. Before intervention， there was no significant difference in the scores of the MCMQ between the two groups（P>0.05）. There are significant differences in the scores of the MCMQ dimensions in the observation group before and after the intervention（P<0.05）. The control group only had differences in avoidance dimensions before and after the intervention（P<0.05）. After the intervention， the satisfaction in the observation group was 94.871%，which was significantly higher than that of 66.67% in the control group （P<0.05）. The satisfaction in the observation group after the intervention was significantly higher than that before the intervention， and the difference was significant （P<0.05）. The satisfaction in the control group before and after the intervention was not significantly different （P>0.05）. Conclusion Early identification of mental stress from the outside and short-term mindfulness training can help improve the psychological conditions and coping styles of tuberculosis patients under stress， promote patient recovery， and improve diagnosis and treatment satisfaction.

[Key words] Tuberculosis; Stress; Short-term mindfulness training; SCL-90 scale; MCMQ scale; Satisfaction

呼吸道传染病如重症急性呼吸综合征[传染性非典型肺炎（Severe acute respiratory syndrome，SARS[1]）、中东呼吸综合征冠状病毒（Middle east respiratory syndrome coronavirus，MERS[2]）以及近期的新型冠状病毒肺炎（COVID-19）[3]等]，因其急性传染性及诊治上的不确定性，已严重威胁着人民群众的健康安全，在心理学上已认定为创伤应激性事件[4]。

肺结核患者与急性呼吸道传染病患者均有乏力、发热、干咳等症状，而且已知传播途径也相似[5]。应小燕等[6]研究显示，肺结核患者因疾病本身的传染性，隔离的环境、长期的服药疗程等因素容易诱发孤独、焦虑、抑郁、恐惧等心理问题。而在急性呼吸道传染病疫情防控期间，因发热、咳嗽等疑似新冠肺炎[7]就诊的结核病患者，更因一时无法快速识别自己罹患的是急性呼吸道传染病还是慢性传染病肺结核而陷入一种紧张、焦虑的应激状态。这种来自外部疾病刺激导致的精神压力使就诊的肺结核患者心理发生一系列的“变态”反应。这类因急性应激刺激引发加重的焦虑、抑郁、恐惧等心理创伤比较隐蔽，且不易识别，更得不到重视和处置，容易引发非理性行为，对社会的稳定和秩序造成威胁。

正念练习强调个体要聚焦当下，只关注此时此刻的身体感受、想法与情绪状态，而对当下经历采取不反应的态度，进而缓解个体沉溺于负性认知与情绪改变的症状[8]。多项研究[8-9]表明，正念训练对住院诊疗过程中解除危机刺激、改善患者负性情绪状态、增强自信、接纳自己有积极作用。……