摘要
目的：探讨以正念为基础的认知行为训练对脑梗死肩手综合征患者自我感觉负担及自我效能的影响。方法投掷硬币进行随机分组将65例脑梗死后肩手综合征患者随机分为对照组（ n＝32）和干预组（n＝33），对照组给予常规手法进行康复，干预组在此基础上给予连续6周的以正念为基础的认知行为训练；两组患者均采用巴式指数（BI）、自我感受负担量表（SPBS）、一般自我效能感量表（GSES）、正念注意觉知量表（MAAS）及生命质量简表（SF-36）进行干预前及干预后6周的评估。结果干预前，两组患者Barthel、SPBS、GSES、MAAS评分及SF-36评分差异无统计学意义（P＞0．05）；干预后，干预组Barthel、GSES及MAAS评分分别为（72．4±11．6），（7．3±1．3），（79．9±11．8）分，均高于对照组，而SPBS评分（38．2±5．7）分低于对照组（47．3±6．6）分，差异具有统计学意义（t值分别为3．38，6．50，5．41，5．72；P＜0．05）；干预组患者SF-36各维度评分高于对照组，差异有统计学意义（P＜0．05），且MAAS评分与SF-36评测的一般健康、活力、社会功能、情感职能、精神健康等维度评分呈正相关，差异有统计学意义（P＜0．05）。结论以正念为基础的认知行为训练降低了脑梗死肩手综合征患者自我感觉负担，提高患者自我效能水平，改善患者生存质量。
Objective To investigate the effects of mindfulness cognitive behavioral training on self -perception burden and self-efficacy of patients with shoulder-hand syndrome （ SHS ） after brain infarction . Methods A total of 65 cases with SHS were randomly divided by coin-tossing into two groups：control group （n=32） and experimental group （n =33）.Patients in control group received routine rehabilitation , while patients in experimental group were given mindfulness cognitive behavioral training for 6 weeks consecutively based on routine rehabilitation;both groups of patients were evaluated using Barthel index （BI）, self-perceived burden scale （ SPB ） , general self-efficacy scale （ GSES ） , mindful attention awareness scale （ MAAS ） and quality of life short-form 36（SF-36） before and after 6 weeks of intervention.Results There was no significant difference in the scores of BI,SPB,GSES,MAAS and SF-36 between two groups before the intervention （P〉0.05）.After the intervention, scores of BI,GSES and MAAS in experimental group were （72.4 ±11.6）, （7.3 ±1.3）,（79.9 ±11.8） respectively,which all higher than that of control group significantly （t=3.38, 6.50,5.41;P〈0.05）, while the score of SPBS was （38.2 ±5.7） lower than that of control group （47.3 ± 6.6） significantly （t=5.72;P〈0.05）; The scores of SF-36 for each dimension of experimental group were higher than that of control group significantly （P〈0.05）.Furthermore, MAAS score was correlated positively with scores of general health , vitality, social function , emotional function , mental health in SF-36 with significant difference （ P〈0.05 ） .Conclusions The cognitive behavioral training based on mindfulness can weaken the self-perceived burden and strengthen self-efficacy of patients with SHS after brain infarction greatly , so as to improve the life quality of patients .
出处
《中华现代护理杂志》
2016年第12期1664-1669,共6页
Chinese Journal of Modern Nursing
基金
河北省科技厅课题（13277776D）
关键词
脑梗死
肩手综合征
自我效能
自我感觉负担
正念认知行为训练
Brain infarction
Shoulder-hand syndrome
Self-efficacy
Self-perceived burden
Mindfulness cognitive behavioral training
