嚴(yán)敏鈴 曾冬梅

摘要 目的：探討運(yùn)動(dòng)治療聯(lián)合心理護(hù)理對(duì)慢性精神分裂癥患者睡眠和生命質(zhì)量的影響。方法：選取2017年1月至2019年1月福州神經(jīng)精神病防治院收治的慢性精神分裂癥患者80例作為研究對(duì)象，隨機(jī)分為對(duì)照組和觀察組，每組40例。對(duì)照組進(jìn)行常規(guī)護(hù)理，觀察組在對(duì)照組的基礎(chǔ)上進(jìn)行運(yùn)動(dòng)治療聯(lián)合心理護(hù)理。比較2組護(hù)理前后的睡眠質(zhì)量[匹茲堡睡眠質(zhì)量指數(shù)（PSQI）]及生命質(zhì)量[世界衛(wèi)生組織生命質(zhì)量評(píng)估簡表（WHOQOL-BREF）]評(píng)分。結(jié)果：護(hù)理后觀察組的PSQI評(píng)分顯著低于對(duì)照組，WHOQOL-BREF評(píng)分顯著高于對(duì)照組，差異有統(tǒng)計(jì)學(xué)意義（P<0.05）。結(jié)論：運(yùn)動(dòng)治療聯(lián)合心理護(hù)理可改善慢性精神分裂癥患者的睡眠質(zhì)量和生命質(zhì)量。

關(guān)鍵詞 慢性精神分裂癥;運(yùn)動(dòng)治療;心理護(hù)理;睡眠質(zhì)量;生命質(zhì)量

Abstract Objective：To explore the influence of exercise therapy combined with psychological nursing for sleep and life quality of patients with chronic schizophrenia.Methods：A total of 80 patients with chronic schizophrenia in Neuro-psychiatric Hospital of Fuzhou City from January 2017 to January 2019 were randomly divided into control group and observation group with 40 cases in each group.The control group were with routine nursing，the observation group were with exercise therapy combined with psychological nursing on the basis of control group.The scores of sleep quality[Pittsburgh Sleep Quality Index（PSQI）] and life quality[World Health Organization Quality of Life Scale-Brief Form Questionnaire（WHOQOL-BREF）] of two groups before and after the nursing were compared.Results：After treatment，compared with the control group，The PSQI score of observation group after the nursing was significantly lower than that of control group，and the WHOQOL-BREF score was significantly higher than that of control group，there were statistically significant differences（P<0.05）.Conclusion：The exercise therapy combined with psychological nursing can improve the sleep quality and life quality of patients with chronic schizophrenia.

Keywords Chronic schizophrenia;Life quality;Exercise therapy;Psychological nursing;Sleep quality

中圖分類號(hào)：R473.74 文獻(xiàn)標(biāo)識(shí)碼：A doi：10.3969/j.issn.2095-7130.2020.08.079

精神分裂癥屬于慢性病，嚴(yán)重危害到人們的身心健康[1]。抗精神病藥物是臨床治療精神分裂癥的主要手段，但部分患者睡眠和生命質(zhì)量較差，因此需對(duì)患者采取護(hù)理措施進(jìn)行干預(yù)。本研究探討運(yùn)動(dòng)治療聯(lián)合心理護(hù)理對(duì)精神分裂癥患者的護(hù)理作用，現(xiàn)報(bào)道如下。

1 資料與方法

1.1 一般資料 選取2017年1月至2019年1月福州神經(jīng)精神病防治院收治的慢性精神分裂癥患者80例作為研究對(duì)象，隨機(jī)分為對(duì)照組和觀察組，每組40例。對(duì)照組中男14例，女16例，年齡23～65歲，平均年齡（43.19±10.51）歲，病程3～15個(gè)月，平均病程（8.94±2.31）個(gè)月。觀察組中男12例，女18例，年齡22～64歲，平均年齡（42.87±10.48）歲，病程3～16個(gè)月，平均病程（9.13±2.29）個(gè)月。一般資料經(jīng)統(tǒng)計(jì)學(xué)分析，差異無統(tǒng)計(jì)學(xué)意義（P>0.05），具有可比性。本研究經(jīng)我院醫(yī)學(xué)倫理學(xué)委員會(huì)批準(zhǔn)。

1.2 納入標(biāo)準(zhǔn) 1）符合ICD-11精神與行為障礙（草案）中關(guān)于精神分裂癥的診斷標(biāo)準(zhǔn)，確診為精神分裂癥[2]者;2）年齡18～65歲者;3）病程至少3個(gè)月者;4）患者及家屬對(duì)治療方法、護(hù)理方法及研究目的知情同意，簽署知情同意書者。

1.3 排除標(biāo)準(zhǔn) 1）意識(shí)障礙者;2）語言功能障礙者;3）合并嚴(yán)重器質(zhì)性病變者;4）中途脫落研究者。

1.4 護(hù)理方法 對(duì)照組進(jìn)行常規(guī)護(hù)理。觀察組在常規(guī)護(hù)理基礎(chǔ)上進(jìn)行運(yùn)動(dòng)治療及心理護(hù)理。1）運(yùn)動(dòng)治療：為患者講解運(yùn)動(dòng)治療的要求、注意事項(xiàng)，每周運(yùn)動(dòng)3次，持續(xù)30 min/次左右。在運(yùn)動(dòng)期間，注意監(jiān)測(cè)患者的呼吸頻率、脈搏、心率等生命體征，并遵照循序漸進(jìn)的原則。2）心理護(hù)理：系統(tǒng)性地測(cè)評(píng)患者的心理狀況，再結(jié)合患者文化程度、年齡特點(diǎn)，選擇合適方式與患者溝通，引導(dǎo)其宣泄負(fù)性情緒。