认知行为疗法联合治疗性沟通对ESD术后患者心理及治疗依从性的效果

doi:10.20223/j.cnki.1000-8535.2025.12.016

摘要/Abstract

摘要： 目的探究认知行为疗法联合治疗性沟通在对内镜黏膜下剥离（ESD）术患者心理及治疗依从性的效果。方法前瞻性选取2023年3月至2025年3月鹰潭市一八四医院收治的122例行ESD术的患者作为研究对象,采用随机数字表法将患者分为A、B组,B组56例患者采取治疗性沟通干预,A组66例患者采用认知行为疗法联合治疗性沟通干预,两组均连续干预2个月。比较两组患者干预前后焦虑自评量表（SAS）、抑郁自评量表（SDS）评分、心理弹性量表（CD-RISC）评分、Herth希望指数量表（HHI）评分差异,对比两组干预依从性。结果干预后,两组SAS、SDS评分均下降且A组低于B组（t分别为12.096、10.326,P<0.05）;干预后,两组CD-RISC量表各项评分均提高且A组高于B组（t分别为18.483、12.060、13.622,P<0.05）;干预后,两组HHI量表各项评分均上升且A组高于B组（t分别为1.289、11.568、12.527、13.794,P<0.05）;A组患者总依从率96.97%（64/66）高于B组80.36%（45/56）（χ²=8.782,P<0.05）。结论认知行为疗法联合治疗性沟通在ESD术患者中干预效果理想,能够明显改善患者负性情绪,提高心理弹性及对疾病康复的希望水平,有效提升依从性。

关键词: 认知行为疗法, 治疗性沟通, 内镜黏膜下剥离术, 效果

Abstract: Objective To explore the effect of cognitive behavioral therapy combined with therapeutic communication on psychological health and therapy compliance of patients undergoing endoscopic submucosal dissection（ESD）．Methods Prospectively,122 patients who underwent ESD at Yingtan 184 Hospital from March 2023 to March 2025 were selected as the research subjects．These patients were randomly divided into Group A and Group B using the random number table method,and 56 patients in group B were treated with therapeutic communication,66 patients in group A were treated with cognitive behavioral therapy combined with therapeutic communication,and both groups were continuously intervened for 2 months．The scores of Self-Rating Anxiety Scale（SAS）,Self-Rating Depression Scale（SDS）,Connor-Davidson Resilience Scale（CD-RISC）and Herth Hope Index（HHI）were compared between the two groups before and after treatment．Therapy compliance between the two groups was compared．Results After treatment,the SAS and SDS scores of the two groups were decreased,and the scores of group A was lower than that of group B（t=12.096,10.326,P<0.05）after the intervention,the scores of the CD-RISC scale of the two groups were improved,and the score of group A was higher than that of group B（t=18.483,12.060,13.622,P<0.05）．After intervention,the scores of HHI scale in both groups increased and score of group A was higher than that of group B（t=11.289,11.568,12.527,13.794,P<0.05）．The total compliance rate of patients in group A was 96.97%（64/66）,which was significantly higher than 80.36%（45/56）in group B（χ²=8.782,P<0.05）．Conclusions Cognitive-behavioral therapy combined with therapeutic communication has an ideal effect in ESD patients,which can significantly improve patients' negative emotions,psychological resilience and hope for disease recovery,and also therapy compliance．

Key words: cognitive behavioral therapy, therapeutic communication, endoscopic submucosal dissection, efficacy

朱小英, 姜连金, 洪丽华, 陈戈珍, 黄晓美, 黄军翠. 认知行为疗法联合治疗性沟通对ESD术后患者心理及治疗依从性的效果[J]. 广州医药, 2025, 56(12): 1730-1735.

ZHU Xiaoying, JIANG Lianjin, HONG Lihua, CHEN Gezhen, HUANG Xiaomei, HUANG Juncui. Effect of cognitive behavioral therapy combined with therapeutic communication on psychological health and therapy compliance of ESD patients[J]. Guangzhou Medical Journal, 2025, 56(12): 1730-1735.

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