摘要
目的探讨注意偏向训练对冠状动脉介入治疗术后过渡期焦虑患者心境状态及疾病不确定感的影响。方法82例冠状动脉介入治疗术后过渡期焦虑患者按随机数字法分为对照组28例、逃离负性组27例和趋向正向组27例。对照组给予常规心理疏导，逃离负性组和趋向正向组在此基础上给予点探测任务的注意偏向训练（2组均为每次200个试次的目标探测任务训练，10~15 min/次，2次/周，共4周；其中逃离负性组中探测点两侧的负性词语和中性词语概率分别为20%和80%，趋向正向组中探测点两侧的正性词语和中性词语概率分别为100%和0）。采用Stroop试验、焦虑自评量表（SAS）、正负性认知偏向量表（APNIS）、心境状态量表（POMS）和疾病不确定感量表（IUS）对3组患者进行评测。结果干预后，对照组焦虑明显缓解占21.4%（6/28），逃离负性组焦虑明显缓解占70.4%（19/27），趋向正向组焦虑明显缓解占44.4%（12/27），差异有统计学意义（χ2=8.15，P=0.003）。干预前，3组SAS、POMS、Stroop试验结果、APNIS和IUS评分比较差异无统计学意义（P〉0.05）。干预后，逃离负性组中SAS、POMS评测的消极情绪维度评分（紧张-焦虑、忧郁-沮丧、疲惫-惰性、困惑-迷惑）和IUS评分低于对照组，差异有统计学意义（Q=3.79~7.58，均P〈0.01）；趋向正向组中SAS、IUS评分低于对照组，POMS评测的积极情绪维度评分（活力-好动）高于对照组，差异有统计学意义（Q=3.11、4.34、6.12，P〈0.05）。逃离负性组中SAS、POMS变化（紧张-焦虑、忧郁-沮丧、疲惫-惰性、困惑-迷惑、活力-好动）优于趋向正向组，差异有统计学意义（Q=3.09~4.04，P〈0.05），2组间IUS差异无统计学意义（P〉0.05）。结论注意偏向训练可改善冠状动脉介入治疗术后过渡期患者的焦虑症状，降低疾病不确定感；逃离负性的注意偏向训练在降低患者负性情绪，缓解焦虑症状效果优于趋向正性训练。
ObjectiveTo investigate the effects of attentional bias training on mood and disease uncertainty in anxious patients with coronary artery intervention treatment during transition period.MethodsA total of 82 anxious patients with coronary artery intervention treatment during transition period were assigned into control group （28 cases）, escape-negative-training group（27 cases） and positive-direction-training group （27 cases） by random digits table method. Patients in control group only received routine psychological counseling, while patients in escape-negative-training group and positive-direction-training group also received spot-type attentional bias training（200 trails/time,10-15 minutes/time,2 times/week, all 4 weeks in the two groups; the negative and neutral words between the probe points were 20% and 80% in escape-negative-training group,and positive and neutral words between the probe points were 100% and 0 in positive-direction-training group）. All the patients were evaluated by Stroop test, Self- evaluation of Anxiety Scale （SAS）, Attention to Positive and Negative Information Scale （APNIS）, Profile Of Mood States （POMS） and Illness Uncertainty Scale （IUS）.ResultsAfter intervention, 21.4% （6/28） was alleviated in the control group, while respective 70.4%（19/27） and 44.4%（12/27） in escape-negative-training group and positive-direction-training group （χ2=8.15, P=0.003）. There were no significant differences in SAS, POMS, Stroop test, APNIS and IUS among three groups （P〉0.05）. After intervention, the SAS, negative emotion scores in POMS （tension-anxiety, depression-dejection, fatigue-inertia, baffling - confusion） and IUS were lower in escape-negative-training group than those in control group（Q=3.79-7.58, all P〈0.01）; and the SAS and IUS were lower in positive-direction-training group than those in control group, while positive emotion scores in POMS （vigor-activity） higher than those in control group （Q respective was 3.11, 4.34, 6.12, all P〈0.05）. The SAS, POMS （tension-anxiety, depression-dejection, fatigue-inertia, baffling-confusion, vigor-activity） were more improved in escape-negative-training group than those in positive-direction-training group （Q = 3.09-4.04, all P〈0.05）, while no difference in IUS （P〉0.05）.ConclusionsAttentional bias training could improve the anxiety symptoms and reduce illness uncertainty in anxious patients with coronary artery intervention treatment during transition period. Escape-negative-training is more effective in reducing patients′ negative mood and alleviating anxiety symptoms than the positive-direction-training
作者
董春凤
王艾英
杜蕊
王秀梅
杨茜
Dong Chunfeng Wang Aiying Du Rui Wang Xiumei Yang Qian(Department of Cardiology, Tangshan Gongren Hospital, Tangshan 063000,Chin)
出处
《中国实用护理杂志》
2017年第1期16-20,共5页
Chinese Journal of Practical Nursing
基金
河北省医学科学研究重点课题计划（20150954）
关键词
冠状动脉疾病
焦虑
注意偏向训练
情绪
Coronary artery disease
Anxiety
Attentional bias training
Mood
