认知技巧心理康复治疗对颅脑创伤患者心理推理能力和社会功能缺陷的影响
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摘要
目的:探讨认知技巧心理康复治疗对颅脑创伤患者心理推理能力和社会功能缺陷等的影响。方法:以2015年10月-2017年2月我院收治的90例颅脑创伤(外伤后6个月以上的稳定期颅脑创伤)患者为对象,盲法随机分为对照组和观察组各45例,对照组实施常规康复治疗,观察组在对照组基础上另实施认知技巧心理康复治疗,比较治疗前后两组意外创伤病人早期心理他评量表评分,采用眼区情绪识别测验、心理推理能力故事图片任务(TOM-PST)和社会功能缺陷筛选量表(SDSS)评分分别评估治疗前后两组心理推理能力和社会功能缺陷,比较治疗前后两组认知功能[威斯康星卡片分类测验(WCST)]。结果:与治疗前相较,两组治疗后焦虑、抑郁、退缩评分、SDSS评分明显降低,眼区情绪识别测验总分、TOM-PST评分、WSCT测试中概念化水平百分数明显升高,WSCT测试中的总时间及错误思考时间明显缩短(t_(观察组)=-20.725、-14.523、-14.703、73.360、58.612、12.942、-20.623、-28.294,t_(对照组)=-11.887、-6.378、-6.305、41.116、33.729、6.533、-11.136、-14.449,F_(观察组)=23.567,F_(对照组)=14.058;P<0.01),且治疗后观察组的各项指标变化较对照组明显(t=-10.118,-6.388,-7.420,29.206,16.668,8.210,12.501,16.567,5.562,-6.054,-10.495;P<0.01)。结论:认知技巧心理康复治疗对颅脑创伤患者的临床积极作用明显,不仅可有效缓解患者不良情绪,且明显改善其心理推理能力、社会功能缺陷及认知功能。
Objective:To explore the effect of cognitive skill psychological rehabilitation therapy on the mental reasoning ability and social disability of patients with craniocerebral trauma Methods:A total of 90 patients with craniocerebral trauma(stable craniocerebral trauma at 6 months or longer after trauma)who were treated in our hospital from October 2015 to February 2017 were selected as subjects,and they were randomly divided into the control group and the observation group,45 cases in each group.The control group were given routine rehabilitation therapy while the observation group were given cognitive skill psychological rehabilitation therapy.Scores of early psychological nurse-administered rating scale for patients with accidental traumas were compared between the two groups before and after treatment.The mental reasoning ability and social disability of the two groups were evaluated with the eye emotion discrimination task,Theory of Mind-Picture Sequencing Task(TOM-PST)and social disability screening scale(SDSS)before and after treatment.The cognitive function[Wisconsin Card Sorting Test(WCST)]was compared between the two groups before and after treatment.Results:After treatment,scores of anxiety,depression and withdrawal and SDSS scores were significantly decreased,while the total score of eye emotion discrimination task,TOM-PST scores and the percentage of conceptualization level in WSCT were significantly increased,the total time of WSCT and error thinking time were significantly shortened in the two groups(t_(observation group)=-20.725,-14.523,-14.703,73.360,58.612,12.942,-20.623,-28.294,t_(control group)=-11.887,-6.378,-6.305,41.116,33.729,6.533,-11.136,-14.449,F_(observation group)=23.567,F_(control group)=14.058,P<0.01).Changes of above-mentioned indexes in the observation group after treatment were more obvious than those in the control group(t=-10.118,-6.388-7.420,29.206,16.668,8.210,12.501,16.567,5.562,-6.054,-10.495;P<0.01).Conclusion:Cognitive skill psychological rehabilitation therapy has a positive effect on patients with craniocerebral trauma.It not only can relieve negative emotions but also can significantly improve the psychological reasoning ability,social disability and cognitive function in patients.
Objective:To explore the effect of cognitive skill psychological rehabilitation therapy on the mental reasoning ability and social disability of patients with craniocerebral trauma Methods:A total of 90 patients with craniocerebral trauma(stable craniocerebral trauma at 6 months or longer after trauma)who were treated in our hospital from October 2015 to February 2017 were selected as subjects,and they were randomly divided into the control group and the observation group,45 cases in each group.The control group were given routine rehabilitation therapy while the observation group were given cognitive skill psychological rehabilitation therapy.Scores of early psychological nurse-administered rating scale for patients with accidental traumas were compared between the two groups before and after treatment.The mental reasoning ability and social disability of the two groups were evaluated with the eye emotion discrimination task,Theory of Mind-Picture Sequencing Task(TOM-PST)and social disability screening scale(SDSS)before and after treatment.The cognitive function[Wisconsin Card Sorting Test(WCST)]was compared between the two groups before and after treatment.Results:After treatment,scores of anxiety,depression and withdrawal and SDSS scores were significantly decreased,while the total score of eye emotion discrimination task,TOM-PST scores and the percentage of conceptualization level in WSCT were significantly increased,the total time of WSCT and error thinking time were significantly shortened in the two groups(t_(observation group)=-20.725,-14.523,-14.703,73.360,58.612,12.942,-20.623,-28.294,t_(control group)=-11.887,-6.378,-6.305,41.116,33.729,6.533,-11.136,-14.449,F_(observation group)=23.567,F_(control group)=14.058,P<0.01).Changes of above-mentioned indexes in the observation group after treatment were more obvious than those in the control group(t=-10.118,-6.388-7.420,29.206,16.668,8.210,12.501,16.567,5.562,-6.054,-10.495;P<0.01).Conclusion:Cognitive skill psychological rehabilitation therapy has a positive effect on patients with craniocerebral trauma.It not only can relieve negative emotions but also can significantly improve the psychological reasoning ability,social disability and cognitive function in patients.
引文
[1]刘源,王蓉.热量限制在颅脑创伤中的应用进展[J].神经疾病与精神卫生,2016,16(5):583-585
[2]王岚,王学义.创伤后应激障碍发生自杀的研究进展[J].神经疾病与精神卫生,2016,16(2):197-201
[3]李祖晟,陈洪武,金鑫,等.伤前应激性生活事件对脑震荡患者生活质量及情绪症状的影响[J].中华行为医学与脑科学杂志,2015,24(5):447-450
[4]杨利芹,高盼.精神分裂症儿童与正常儿童父母的心理理论能力比较[J].中国健康心理学杂志,2015,27(3):339-342
[5]钟慧,汪凯,朱春燕,等.集体心理治疗改善早发性精神分裂症患者心理推理能力损伤的效果[J].中国心理卫生杂志,2017,31(4):263-267
[6]李翠燕.心理护理用于颅脑外伤术后恢复期患者中对其负性心理的改善效果研究[J].重庆医学,2017,27(A02):402-403
[7]Owen A M.Functional neuroimaging after severe anoxic brain injury in children may reveal preserved,yet covert,cognitive function[J].Human Brain Mapping,2017,38(10):4832-4832櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏
[8]翟建霞.意外创伤者早期心理他评量表及常模的研制[D].上海:第二军医大学,2009
[9]孙会艳.脑外伤后认知功能障碍评价的法医学初步研究[D].苏州:苏州大学,2016
[10]宋美,王冉,王学义.应激所致远期认知功能损害的研究进展[J].神经疾病与精神卫生,2015,15(5):512-514
[11]齐军慧,刘靖,李雪,等.孤独症儿童社会交往能力发展与执行功能和心理推理能力的关系[J].中国心理卫生杂志,2017,31(3):219-224
[12]董晓敏,李爱萍,吴立红,等.早期综合康复干预颅脑外伤的多中心临床研究[J].中华物理医学与康复杂志,2015,37(7):513-517
[13]吴玲玲,孙建芳,孙洁瑾,等.早期认知行为干预对颅脑损伤病人心理的影响[J].护理研究,2015,18(35):4373-4376
[14]杨亚婷,周染云,张敏,等.颅脑损伤患者康复期心理护理研究进展[J].护理管理杂志,2015,23(7):486-487
[15]张登科,徐水琴,苏巧荣,等.脑外伤患者心理推理能力缺陷的认知性和技巧性干预:一项12周随机单盲对照试验[J].中国心理卫生杂志,2012,26(12):906-912
[16]李静.颅脑损伤患者康复期不良心理情绪干预效果观察[J].按摩与康复医学,2015,18(22):89-90
[2]王岚,王学义.创伤后应激障碍发生自杀的研究进展[J].神经疾病与精神卫生,2016,16(2):197-201
[3]李祖晟,陈洪武,金鑫,等.伤前应激性生活事件对脑震荡患者生活质量及情绪症状的影响[J].中华行为医学与脑科学杂志,2015,24(5):447-450
[4]杨利芹,高盼.精神分裂症儿童与正常儿童父母的心理理论能力比较[J].中国健康心理学杂志,2015,27(3):339-342
[5]钟慧,汪凯,朱春燕,等.集体心理治疗改善早发性精神分裂症患者心理推理能力损伤的效果[J].中国心理卫生杂志,2017,31(4):263-267
[6]李翠燕.心理护理用于颅脑外伤术后恢复期患者中对其负性心理的改善效果研究[J].重庆医学,2017,27(A02):402-403
[7]Owen A M.Functional neuroimaging after severe anoxic brain injury in children may reveal preserved,yet covert,cognitive function[J].Human Brain Mapping,2017,38(10):4832-4832櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏櫏
[8]翟建霞.意外创伤者早期心理他评量表及常模的研制[D].上海:第二军医大学,2009
[9]孙会艳.脑外伤后认知功能障碍评价的法医学初步研究[D].苏州:苏州大学,2016
[10]宋美,王冉,王学义.应激所致远期认知功能损害的研究进展[J].神经疾病与精神卫生,2015,15(5):512-514
[11]齐军慧,刘靖,李雪,等.孤独症儿童社会交往能力发展与执行功能和心理推理能力的关系[J].中国心理卫生杂志,2017,31(3):219-224
[12]董晓敏,李爱萍,吴立红,等.早期综合康复干预颅脑外伤的多中心临床研究[J].中华物理医学与康复杂志,2015,37(7):513-517
[13]吴玲玲,孙建芳,孙洁瑾,等.早期认知行为干预对颅脑损伤病人心理的影响[J].护理研究,2015,18(35):4373-4376
[14]杨亚婷,周染云,张敏,等.颅脑损伤患者康复期心理护理研究进展[J].护理管理杂志,2015,23(7):486-487
[15]张登科,徐水琴,苏巧荣,等.脑外伤患者心理推理能力缺陷的认知性和技巧性干预:一项12周随机单盲对照试验[J].中国心理卫生杂志,2012,26(12):906-912
[16]李静.颅脑损伤患者康复期不良心理情绪干预效果观察[J].按摩与康复医学,2015,18(22):89-90