摘要
目的探索非手术治疗联合健康教育对面部瘢痕疙瘩患者心理健康的影响。方法选择我院2023年1月至2024年4月收治的瘢痕疙瘩患者61例,采用非手术方法(如激光治疗、药物注射、放射治疗、护理教育等)进行干预,分别在治疗前、治疗中、治疗后1个月,采用半结构式访谈方式,运用广泛性焦虑障碍量表(GAD-7)、抑郁筛查量表(PHQ-9)、修订版温哥华瘢痕评定量表(MVSS)、社会影响量表(SIS)、自我效能感量表(GSES)及健康知识知晓率量表,分别对患者的焦虑和抑郁程度、瘢痕状态、社会层面影响、自我效能感及健康知识知晓情况进行评估分析。结果患者在治疗过程中经历了从自卑、焦虑到逐渐恢复自信、积极面对生活的心理转变,GAD-7、PHQ-9、MVSS、SIS各项评分均显著低于治疗前(P<0.05),GSES评分及健康知识知晓率显著高于治疗前(P<0.05),且治疗后指标改善幅度优于治疗中(P<0.05)。结论非手术治疗联合健康教育通过“外观改善-认知重建-社会适应”的递进式作用,既优化面部外观,又改善心理状态,为临床制定针对性心理干预策略提供理论依据。
Objective To evaluate the psychological outcomes associated with non-surgical treatment combined with health education in patients with facial keloids.Methods A prospective longitudinal cohort study was conducted with 61 consecutively enrolled patients undergoing multimodal non-surgical therapy,including procedural modalities(laser therapy,intralesional corticosteroid injections,radiation therapy and patient education)between January 2023 and April 2024.A triphasic assessment protocol was implemented,featuring semi-structured interviews via Generalized Anxiety Disorder-7(GAD-7),Patient Health Questionnaire-9(PHQ-9),Modified Vancouver Scar Scale(MVSS),Social Impact Scale(SIS),General Self-Efficacy Scale(GSES)and Health Literacy Inventory at baseline,mid-treatment(week 4),and one-month post-treatment,to assess the degree of anxiety and depression,scar status,social influence,self-efficacy and health knowledge acquisition.Results During the treatment process,the patient experienced a psychological transformation from low self-esteem and anxiety to gradually regaining confidence and facing life positively.Scores of GAD-7,PHQ-9,MVSS and SIS were significantly lower after treatment(P<0.05).The score of GSES and rates of health knowledge acquisition were significantly higher than those before treatment(P<0.05).Conclusion The non-surgical treatment combined with health education exerts a progressive effect of“appearance improvement-cognitive reconstruction-social adaptation”,which not only optimizes facial appearance but also improves psychological status,providing a theoretical basis for clinical formulation of targeted psychological intervention strategies.
作者
杜林
张贞
朱琦
许玮
DU Lin;ZHANG Zhen;ZHU Qi;XU Wei(Department of Nursing,Department of Dermatology,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Department of Oral and Maxillofacial-Head and Neck Oncology;Outpatient Triage Department,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China;Department of Ophthalmology,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China Shanghai Ninth People’s Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)
出处
《组织工程与重建外科》
2025年第6期538-542,共5页
Journal of Tissue Engineering and Reconstructive Surgery
基金
上海交通大学医学院附属第九人民医院护理科研院级基金(JYHL2022MS19)。
关键词
瘢痕疙瘩
非手术治疗
健康教育
心理健康
Keloid
Non-surgical treatment
Health education
Psychological health
