Application of cognitive behavioural therapy and group games combined with relaxation training in psychological intervention for adolescent cleft lip and palate patients
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摘要:
目的 探讨认知行为疗法、团体游戏联合放松训练在青少年唇腭裂患者心理干预中的应用效果。 方法 选取2019年3月—2020年3月期间蚌埠医学院第一附属医院治疗的29例青少年唇腭裂患者作为研究对象,采用随机数字表法分为对照组和观察组,分别实施常规心理疏导及认知行为疗法、团体游戏联合放松训练的心理干预方法,比较2组患者干预前后心理状态、自我接纳水平和应对方式。 结果 实施干预后,观察组SCL-90评分为(192.88±24.03)分,明显低于干预前[(233.29±43.88)分],差异有统计学意义(P < 0.05),且观察组SCL-90评分低于对照组[(214.00±30.88)分,t=-2.072,P=0.048];在接纳自我方面,观察组总分及各因子分均高于对照组,其中观察组总分为(47.18±4.64)分,对照组为(36.08±3.18)分,2组比较差异有统计学意义(t=7.164,P < 0.001);在应对方式方面,观察组积极因子分[(13.52±1.19)分]高于对照组[(10.86±1.19)分, t=5.901,P < 0.001],消极因子分[(3.36±0.84)分]低于对照组[(5.62±0.96)分,t=-6.702,P < 0.001]。 结论 认知行为疗法、团体游戏联合放松训练可以改善青少年唇腭裂患者心理状态;可以帮助患者以积极的方式应对困难,促进自我接纳。 Abstract:Objective To explore the effect of cognitive behavioural therapy and group games combined with relaxation training in psychological intervention for adolescents with cleft lip and palate. Methods Twenty-nine adolescent cleft lip and palate patients treated in our department from March 2019 to March 2020 were selected as the research objects. The patients were divided into control and observation groups through the random-number table method. Conventional psychological counseling, cognitive behavioural therapy, and group games combined with relaxation training were conducted. The psychological state, self-acceptance level, and coping style of the patients in both groups were compared before and after intervention. Results After intervention, the SCORE of SCL-90 in the observation group (192.88±24.03) was significantly lower than that before intervention (233.29±43.88), and the difference was statistically significant (P < 0.05). The score of SCL-90 was lower than that of the control group (214.00±30.88, t=-2.072, P=0.048). In terms of self-acceptance, the total score and factor scores of the observation group were higher than those of the control group, and the total score (47.18±4.64) of the observation group was significantly higher than that of the control group (36.08±3.18, t=7.164, P < 0.001). In terms of coping style, the positive factor score (13.52±1.19) in the observation group was higher than that in the control group (10.86±1.19, t=5.901, P < 0.001), and the negative factor score (3.36±0.84) was lower than that in the control group (5.62±0.96, t=-6.702, P < 0.001). Conclusion Cognitive behaviour therapy and group games combined with relaxation training can improve the psychological state of adolescents with cleft lip and palate. It can help patients cope with difficulties in a positive way and promote self-acceptance, so it can be extensively used in clinical work. -
表 1 2组唇腭裂患者一般资料及唇腭裂种类比较(例)
组别 例数 年龄(x±s,岁) 性别 学历 唇腭裂种类 男性 女性 小学 初中 高中 唇裂 腭裂 唇腭裂 观察组 17 13.29±2.41 10 7 7 7 3 3 4 10 对照组 12 13.33±2.49 7 5 6 4 2 2 3 7 t值 0.042 P值 0.966 0.999a 0.885a 0.999a 注:a为采用Fisher精确检验。 表 2 2组唇腭裂患者干预前后SCL-90评分比较(x ±s,分)
组别 例数 干预前 干预后 t值 P值 观察组 17 233.29±43.88 192.88±24.03 5.900 < 0.001 对照组 12 224.92±32.67 214.00±30.88 3.653 0.004 t值 0.560 -2.072 P值 0.580 0.048 表 3 2组唇腭裂患者干预前后接纳自我评分比较(x ±s,分)
组别 例数 总分 自我接纳因子 自我评价因子 干预前 干预后 干预前 干预后 干预前 干预后 观察组 17 34.47±3.78 47.18±4.64a 17.76±1.92 23.76±2.22a 16.71±2.78 23.41±3.20a 对照组 12 34.00±2.34 36.08±3.18a 17.58±1.62 18.00±2.17 16.42±1.62 18.08±1.83a t值 0.382 7.164 0.266 6.940 0.323 5.179 P值 0.705 < 0.001 0.792 < 0.001 0.749 < 0.001 注:组内干预前后比较,aP < 0.05。 表 4 2组唇腭裂患者干预前后CODI评分比较(x ±s,分)
组别 例数 积极因子 t值 P值 消极因子 t值 P值 干预前 干预后 干预前 干预后 观察组 17 10.41±2.45 13.52±1.19 -6.447 < 0.001 6.42±0.76 3.36±0.84 -10.510 < 0.001 对照组 12 10.41±1.44 10.86±1.19 -1.993 0.072 6.38±0.76 5.62±0.96 2.831 0.016 t值 0.005 5.901 0.169 -6.702 P值 0.996 < 0.001 0.867 < 0.001 -
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