护理 情绪干预对高血压治疗效果的影响

论文编号:HL186  论文字数:15316.页数:24

论文题目：情绪干预对高血压病治疗效果的影响
摘　要
 
 
 研究背景：高血压是心血管系统的常见病，多发病，是一种严重危害人们生命健康的心身疾病。心理及社会因素在其发生、发展的过程中起重要作用，并影响病人的预后。其病因是多方面的，包括生物遗传与代谢倾向，饮食习惯，生活方式和心理社会因素，其中精神紧张或情绪因素占重要地位。最常的情绪问题是病人的焦虑和抑郁。通过对高血压患者系统的心理护理（应用一般资料的问卷调查，心理疏导和放松疗法等情绪干预措施）观察降压效果。从而推测焦虑抑郁情绪可能是影响高血压患者预后的机制之一。针对高血压患者存在的情绪障碍，应加强和重视患者的心理治疗,通过有效的心理行为干预，可改善心理状况, 有助于降低血压, 提高生活质量。
 研究目的：探讨高血压患者的情绪与降压效果的关系。
 研究方法：对2005年6月至2007年6月收治的40例有情绪障碍的原发性高血压病病人为研究对象（选择符合选择符合WHO/ISH及我国新制订的高血压诊断标准的原发性高血压患者），其中男24例、女16例,平均年龄在38～68岁。病程最短3年,最长17年。本组临界性高血压4例,高血压急症1例,老年人高血压占15例。其中农民12例,工人10例,干部18例。文盲2例,小学3例,初中10例,高中15例,大专以上10例。排除继发性高血压和心、脑、肾严重并发症;将其随机分成两组，对照组和实验组各20例，对照组：常规降压治疗；实验组：在降压治疗的同时接受系统的心理护理。（应用一般资料的问卷调查，心理疏导和放松疗法等情绪干预措施）。心理学量表采用SCL-90，两组进行治疗4周。测试患者心理行为状况。通过两组患者的心理和生理指标的比较并运用统计学方法，观察和比较两组患者的降压效果。
 研究结果：两组治疗前SCL-90均与健康人存在差异，高血压患者存在的情绪障碍, 主要以焦虑为主, 有的患者焦虑、抑郁并存。治疗后, 实验组患者SCL-90的焦虑、抑郁分数明显少于对照组（P〈0.01），实验组降压效果较对照组更明显（P〈0.01），实验组治疗效果优于对照组。
 结论：1. 原发性高血压病的发生，发展和转归与心理社会因素有明显关系，患者存在的情绪障碍主要以焦虑为主, 有的患者焦虑、抑郁并存。对治疗效果有直接的影响。   2.针对高血压患者存在的情绪障碍，应加强和重视患者的心理治疗,通过有效的心理行为干预，可改善心理状况, 有助于降低血压, 提高生活质量。3.情绪干预对原发性高血压病疗效影响明显。
 
 关键词：高血压；护理干预；情绪；焦虑；抑郁
 论文类型：研究报告
 
 
 
 Title: The Influence of Emotional Interference on the effect of Hypertension Treatment

ABSTRACT
 
 
 Background: Hypertension is one of the commonest cardiovascular system diseases, which is to seriously hurt people  physically and mentally. Psychological and social elements are likely to matter at its beginning、 development and treatment. It may caused by genetic inheritance、metabolic orientaton、living habits and other emotional elements which mainly include anxiety and depression. Through systematic psychological nursing (making use of questionaire of common materials、psychological guidance and relaxation treatment,etc), the effect of hypertension treatment is observed, and it is speculated that anxiety and depression is one of the elements influencing the treatment of hypertension. Therefore, emphasis should be laid on the psychological treatment. It is suggested that the hypertension sufferers should be given effective psychological interference to reduce their blood pressure and improve their living quality.
 Objectives: To probe the relationship between the emotion of hypertension patients and the effect of its treatment
   Methods: Take 40 patients of primary hypertension with emotional disorder as the study objects. They were brought to hospital from June of 2005 to June of 2006, consisting of 24 men and 16 women sufferers with their ages ranging from 38 to 68. The shortest disease course lasts for 3 years and the longest 17 years. In this study group there are 4 critical hypertension and 1 acute hypertension, and the sufferers are made up of 15 old people, 12 farmers, 10 workers and 18 cadres, and with 2 illiterates, 3 graduating from primary school, 10 from junior secondary school, 15 from senior secondary school and 10 from colleges.The patients are excluded from secondary hypertension and serious complication of heart、 brain and kidney. They are divided into 2 groups at random: 20 cases in the contrast group and the experimental group respectively. The contrast group are given the routine hypertension treatment while the experimental group are additionally given systematical psychological nursing. The psychological check chart adopts SCL-90. The two groups are given 2 weeks’ treatment and the patients’ psychological behavior will be examined. Through the comparison of  the psychological and physical index between the two groups, plus statistical method, the effects of hypertension treatment of the two groups are observed and compared.
 Results: Before treatment, SCL-90 of the two groups differs from that of healthy ones and the hypertension sufferers have emotional disorder, which mainly refers to anxiety while additional depression in some cases. After treatment, the SCL-90 level of anxiety and depression of the experimental group is obviously less than that of the contrast group（P〈0.01）.The effect of hypertension treatment of the experimental group is better than that of the contrast group（P〈0.01）.
   Conclusion: 1.The beginning、development and change of primary hypertension is obviously related with psychological conditions. The sufferers’ emotional disorder is mainly anxiety while some have both anxiety and depression, which has direct influence on hypertension treatment. 2.In In view of the emotional disorder, emphasis should be laid on the psychotherapeutics. The positive psychological behavior interference can help to improve the sufferers’ mental condition, to bring down their blood pressure and to upgrade their living quality. 3.Emotional interference has an obvious effect on the primary hypertension treatment.

KEY WORDS: hypertension; nursing interference; emotion;anxiety;depression

TYPE OF THESIS: research report

目  录
摘　要 I
ABSTRACT III
目  录 V
1 绪论 1
1.1 背景及意义 1
1.2 研究目的及目标 2
1.3 关键词及定义 2
 1.4文献回顾…………………………………………………………………………….2
     1.4.1情绪因素对高血压病的影响………………………………………………..2
     1.4.2情绪干预对高血压病的治疗效果的影响…………………………………..3
2 研究设计 6
2.1 研究对象 6
2.2 研究方法与研究步骤 6
3 研究结果 11
3.1一般资料 11
 3.2治疗前后两组患者 SCL-90评定结果比较……………………………………...11
 3.3两组治疗前后血压（mmHg）比较……………………………………………….11
4 讨论 13
4.1 情绪障碍对高血压病的病情转归的影响 13
4.2 情绪干预对高血压病的治疗效果的影响 14
5 推论及建议 17
5.1 推论 17
5.2建议 17
致谢…………………………………………………………………………………………18
参考文献………………………………………………………………………………….....19