Application of cognitive behavioral intervention in stroke patients with constipation
CONG Nan1 ZHANG Yi1 GUO Chuang2
1.Department of Neurosurgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing 100073, China;
2.Ward 3, Department of Orthopedics, the First Affiliated Hospital, Heilongjiang University of Chinese Medicine, Heilongjiang Province, Harbin 150040, China
Abstract:Objective To explore the effect of cognitive behavior intervention in patients with stroke and constipation. Methods Sixty patients with stroke and constipation who were hospitalized in the Department of Neurosurgery of Peking Union Medical College Hospital from January 2018 to December 2019 were selected as the research objects. The study subjects were randomly divided into two groups according to the order of hospitalization, with 30 cases in each group. The control group was given conventional treatment and nursing for constipation, and the experimental group was given cognitive behavioral intervention on the basis of conventional treatment and nursing for constipation. The improvement of constipation symptoms in the two groups of stroke patients with constipation before intervention and after 7 and 14 d of intervention were compared. Results The differences in the time, inter-group, and interaction of stroke patients between the two groups were highly statistically significant (P < 0.01). Further pairwise comparison, intra-group comparison: the constipation score of stroke patients after intervention for 7, 14 d were lower than that before intervention, and the differences were statistically significant (P < 0.05); comparison between groups: after 7, 14 d of the intervention, the constipation score of stroke patients in the experimental group was lower than the control group, and the difference was statistically significant (P < 0.05). The effective rate of the experimental group was significantly higher than that of the control group, and the difference was statistically significant (P < 0.05). The differences in the time, inter-group, and interaction of stroke patients between the two groups were highly statistically significant (P < 0.01). Further pairwise comparison, intra-group comparison: the Barthel index (BI) score of stroke patients after 7 and 14 d of intervention were higher than those before intervention, and the differences were statistically significant (P < 0.05); comparison between groups: after 7, 14 d of the interventional, the BI score of stroke patients in the experimental group was higher than the control group, and the difference was statistically significant (P < 0.05). Conclusion Cognitive behavioral intervention can improve the symptoms of constipation in stroke patients, improve its clinical effects, and further improve the quality of life of patients.
[1] 刘鸣,刘峻峰,吴波.脑血管病分类分型进展与解读[J].中华神经科杂志,2017,50(3):163-167.
[2] 李小寒.基础护理学[M].5版.北京:人民出版社,2015:311-315.
[3] Lim SF,Childs C. Asystematic review of the effective-ness of bowel management strategies for constipation in adults with stroke [J]. Int J Nurs Stud,2013,50(7):1004-1010.
[4] 李清,梁丽花,李丽,等.住院高血压伴失眠患者实施认知行为疗法干预的效果探讨[J].当代护士:下旬刊,2013, 11(5):39-40.
[5] 中华医学会神经病学分会脑血管病学组,急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中国全科医学,2011,14(12):4013-4017.
[6] 中华医学会神经病学分会神经康复学组,中华医学会神经病学分会脑血管病学组,卫生部脑卒中筛查与防治工程委员会办公室.中国脑卒中康复治疗指南(2011完全版)[J].中国康复理论与实践,2012,18(4):301-318.
[7] 中华人民共和国卫生部,中国人民解放军总后勤部卫生部.临床护理实践指南2011版[M].北京:人民军医出版社,2011.
[8] 张苑榆,宁雪莲,林丽珍,等.认知行为干预对老年习惯性便秘的应用研究[J].护理管理,2015,12(19):106-107.
[9] 中华医学会外科学分会肛肠外科学组.便秘症状及疗效评估[J].中华胃肠外科杂志,2005,8(4):355.
[10] 凡国华,徐兴祥,闵凌峰,等.腹部按摩联合辨证施膳治疗肺癌患者化疗后便秘的临床疗效[J].中华肺部疾病杂志:电子版,2017,10(4):445.
[11] 程荣,王晶心,刘红瑞,等.中医综合护理对老年获得性肺炎患者肺功能及生活指数的影响[J].四川中医,2015,33(8):182-183.
[12] 李艳秋,王丽芹,郭闯.百会穴埋线配合认知行为干预对卒中后便秘患者的影响[J].现代生物医学进展,2018, 18(13):2579-2582.
[13] Cai W,Wang L,Guo L,et al. Correlation analysis between post-stroke constipation and brain injury [J]. Nan Fang Yi Ke Da Xue Xue Bao,2013,33(1):117-120.
[14] Wu Q,Liang S,Wang YS. Study on Constipation Symptoms in Elderly Patients with Stroke and Cognitive Impairment during Recovery Period [J]. Geriatric Healthcare,2016,15(5):56-59.
[15] 王丽,王静新,张晓梅,等.脑卒中后便秘与认知障碍的相关性研究及护理策略[J].中国实用护理杂志,2013, 29(5):20-23.
[16] Wang L,Zhou JG,Yang XH,et al. Cognitive Behavioral Intervention in Patients with Post-Stroke Constipation [J]. J Nur Sci,2014,29(3):39-42.
[17] 李慧,姜亚芳.脑卒中患者早期康复护理干预措施的研究进展[J].中华护理杂志,2010,45(2):187-189.
[18] 徐慧英,李爱萍.创伤性顾脑损伤的康复治疗进展[J].中国康复医学杂志,2011,26(5):489-491.
[19] 罗思欢,辛静丽,孙静娜.认知行为综合干预对药源性便秘效果的研究[J].临床护理杂志,2016,15(4):41-42.
[20] 唐茜茜,王剑桥,吴丽.认知行为干预对胸腰椎术后患者便秘的影响[J].当代护士:中旬刊,2018,25(23):50-51.
[21] 王莉亚,张卫红,毛淑芳.认知行为干预及熊戏改良操在糖尿病便秘患者中的应用效果[J].护理实践与研究,2017,14(24):1-2.
[22] 蒙桂琴,汪莉,傅雪梅.指叩百会穴联合认知行为干预对脑卒中后便秘的影响[J].护理研究,2015,29(12):4257-4258.
[23] 张静,火静兰.长期住院精神病患者便秘的护理进展[J].当代护士:下旬刊,2015,10(7):4-6.
[24] Ferwerda M,Van BS,Van MH,et al. A tailored-guided Internet-based cognitive-behavioral intervention for patients with rheumatoid arthritis as an adjunct to standard rheumato-logicalcare:results of a randomized controlled trial [J]. Pain,2017,15(5):868-878.
[25] 杜桦,樊少磊,李依婷,等.认知行为干预对脑卒中住院病人疾病不确定感的影响[J].护理研究,2012,26(4A):1487-1488.