成杰,陈璐,马晴,郑思琪,王钰涵,王云龙.改良关注和解释疗法对脑卒中偏瘫患者疲劳及睡眠质量的影响[J].四川精神卫生杂志,2024,37(5):427-432.Cheng Jie,Chen Lu,Ma Qing,Zheng Siqi,Wang Yuhan,Wang Yunlong,Effect of modified attention and interpretation therapy on fatigue and sleep quality in patients with post-stroke hemiplegia[J].SICHUAN MENTAL HEALTH,2024,37(5):427-432
改良关注和解释疗法对脑卒中偏瘫患者疲劳及睡眠质量的影响
Effect of modified attention and interpretation therapy on fatigue and sleep quality in patients with post-stroke hemiplegia
投稿时间:2023-01-18  
DOI:10.11886/scjsws20230118002
中文关键词:  关注和解释疗法  脑卒中偏瘫  疲劳  睡眠
英文关键词:Attention and interpretation therapy  Post-stroke hemiplegia  Fatigue  Sleep
基金项目:2022年度河北省医学科学研究课题计划项目(项目名称:二元支持应对干预对脑卒中偏瘫患者及配偶焦虑抑郁及家庭功能的影响,项目编号:20221544)
作者单位邮编
成杰 华北理工大学护理与康复学院河北 唐山 063000 063000
陈璐 华北理工大学护理与康复学院河北 唐山 063000 063000
马晴 华北理工大学护理与康复学院河北 唐山 063000 063000
郑思琪 华北理工大学护理与康复学院河北 唐山 063000 063000
王钰涵 华北理工大学护理与康复学院河北 唐山 063000 063000
王云龙 华北理工大学护理与康复学院河北 唐山 063000 063000
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中文摘要:
      背景 脑卒中偏瘫患者普遍存在疲劳及睡眠障碍,关注和解释疗法(AIT)能增加患者的心理灵活性,从而减轻患者压力,改善其情绪管理能力和身心适应的能力。但目前缺少关于AIT在脑卒中偏瘫患者中应用的研究报道。目的 探讨改良AIT对脑卒中偏瘫患者疲劳和睡眠质量的改善效果,为此类患者的身心康复护理提供参考。方法 选取2021年8月1日—2022年6月30日在华北理工大学附属医院康复医学科住院治疗的、符合《中国急性缺血性脑卒中诊治指南2018》和《中国脑出血诊治指南(2019)》诊断标准的120例脑卒中偏瘫患者为研究对象,采用随机数字表法分为研究组与对照组各60例。对照组接受基于慢病轨迹模式的护理干预,研究组接受改良AIT,两组干预时长均为8周。在基线期、干预4周和8周后,采用中文版卒中神经疲劳指数(NFI-Stroke)量表和匹兹堡睡眠质量指数量表(PSQI)对患者进行评定。结果 重复测量方差分析结果显示,研究组和对照组PSQI总评分、睡眠质量、入睡时间、睡眠时间、睡眠效率、睡眠障碍及日间功能障碍维度评分的组间效应、时间效应和交互效应均有统计学意义(F组间=4.281、5.598、8.814、4.351、4.302、4.091、7.608,F时间=122.230、19.698、19.289、16.403、15.421、28.879、90.876,F交互=19.508、3.227、11.586、5.237、5.507、5.799、3.338,P均<0.05);两组NFI-Stroke总评分、身体维度评分及认知维度评分的组间效应、时间效应和交互效应均有统计学意义(F组间=7.140、5.466、5.547,F时间=362.192、309.817、70.888,F交互=21.079、13.430、13.354,P<0.05)。结论 改良AIT可能有助于缓解脑卒中偏瘫患者的疲劳状况,改善其睡眠质量。
英文摘要:
      Background Patients with post-stroke hemiplegia are likely to experience fatigue and sleep disorder. Attention and interpretation therapy (AIT) has been shown to promote psychological flexibility, thereby alleviating their stress, improving emotional management and somatopsychic adaptation. Currently, there is a lack of application of AIT in patients with post-stroke hemiplegia.Objective To explore the effect of modified AIT on fatigue and sleep quality in patients with post-stroke hemiplegia, so as to provide references for physical and mental rehabilitation nursing of post-stroke hemiplegia patients.Methods A total of 120 patients with post-stroke hemiplegia attending the rehabilitation medicine department of North China University of Science and Technology Affiliated Hospital from August 1, 2021 to June 30, 2022 and fulfilling the Chinese guidelines for diagnosis and treatment of acute ischemic stroke 2018 and the Chinese guidelines for diagnosis and treatment of acute intracerebral hemorrhage 2019 were enrolled. Patients were assigned into two groups using random number table methods, each with 60 cases. Control group was given chronic illness trajectory model-based nursing, while study group received modified AIT intervention. All participants were evaluated using the Chinese version of Neurological Fatigue Index for Stroke (NFI-Stroke) and Pittsburgh Sleep Quality Index (PSQI) at the baseline, after 4 weeks and 8 weeks of intervention.Results The repeated measures ANOVA on PSQI total score and scores on sleep quality, sleep time, sleep duration, sleep efficiency, sleep disturbance and daytime dysfunction revealed a significant group effect, time effect and interaction effect (Fgroup=4.281, 5.598, 8.814, 4.351, 4.302, 4.091, 7.608, Ftime=122.230, 19.698, 19.289, 16.403, 15.421, 28.879, 90.876, Finteraction=19.508, 3.227, 11.586, 5.237, 5.507, 5.799, 3.338, P<0.05). Significant group effect, time effect and interaction effect were reported on NFI-Stroke total score and scores on physical subscale and cognitive subscale (Fgroup=7.140, 5.466, 5.547, Ftime=362.192, 309.817, 70.888, Finteraction=21.079, 13.430, 13.354, P<0.05).Conclusion Modified AIT may help alleviate fatigue and improve sleep quality in patients with post-stroke hemiplegia.[Fundey by 2022 Medical Science Research Project of Hebei Province (numeber, 20221544)]
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