《中国康复理论与实践》

《中国康复理论与实践》 ›› 2008, Vol. 14 ›› Issue (11): 1045-1047.

• 临床研究 • 上一篇    下一篇

自我效能理论在脑卒中偏瘫伴心理障碍患者康复训练中的应用

杨文清; 郭克锋; 王志江; 朱银星   

  1. 第四军医大学唐都医院康复医学科,陕西西安市 710038
  • 收稿日期:2228-08-19 出版日期:2008-11-01 发布日期:2008-11-01

Application of Self-Efficacy Theory in Rehabilitation for Hemiplegics with Psychological Disorder after Stroke

YANG Wen-qing, GUO Ke-feng, WANG Zhi-jiang, et al   

  1. Department of Rehabilitation Medicine, Tangdu Hospital, Fourth Military Medical University, Xi'an 710038, Shaanxi, China
  • Received:2228-08-19 Published:2008-11-01 Online:2008-11-01

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摘要： 目的探讨自我效能理论在脑卒中偏瘫伴心理障碍患者康复训练中的作用和意义。方法将26例脑卒中偏瘫伴心理障碍患者随机分为综合治疗组13例(在常规运动疗法训练中增加自我效能的方法)、常规运动疗法组13例,分别在治疗前、治疗后1个月和3个月采用一般自我效能感量表(GSES)进行自我效能评价,采用Fugl-Meyer评定法评定运动功能;在治疗前和治疗后1个月采用症状自评量表(SCL-90)对心理健康水平进行检测。结果两组患者入院时GSES评分无显著性差异(P>0.05)。综合治疗组1个月后GSES评分提高63%,与运动疗法组比较有非常显著性差异(P<0.01)。综合治疗组在治疗后3个月与1个月时自身前后相比增高幅度为10%。治疗前简化Fugl-Meyer评定评分两组患者无显著性差异,1个月后综合治疗组由(53.08±13.04)上升为(90.07±6.54),运动疗法组由(56.46±12.95)上升为(81.77±8.51),有显著性差异(F=85.53,P<0.05)。两组患者治疗前SCL-90各因子分没有显著性差异,治疗后综合治疗组抑郁、焦虑、强迫、敌对因子分与运动疗法组比较明显降低(P<0.01)。结论将自我效能理论应用于脑卒中偏瘫伴心理障碍患者的康复治疗,能充分调动其自身潜能,增加患者的信心,改善患者的情绪,提高训练效果,从而提高其生活质量。

关键词: 脑卒中, 偏瘫, 心理障碍, 自我效能, 康复

Abstract: Objective To investigate the effect of self-efficacy theory in rehabilitation on stroke patients with hemiplegia complicated psychological disorder. Methods 26 cases were divided into the combined therapy group (13 cases, accepted physical therapy with self-efficacy) and the routine physical therapy group (13 cases). They were assessed with General self-efficacy scale (GSES), Fugl-Meyer Assessment before and 1, 3 months after treatment, as well as symptom checklist (SCL-90) before and 1 month after treatment. Results The scores of GSES raise 63% in the combined therapy group 1 month after treatment, obviously different from that of routine physical therapy (P<0.01).The score of Fugl-Meyer Assessment of the combined therapy group were increased from (53.08±13.04) to (90.07±6.54 ) and from (56.46±12.95) to (81.77±8.51)in the routine physical therapy group (F= 85.53,P<0.05). All the scores of depression, anxiety, compulsion, hostility in SCL-90 were markedly lower in the combined therapy group than in the routine physical therapy group(P<0.01). Conclusion Utilization of self-efficacy theory in rehabilitation can improve the emotion and effect of rehabilitation.

Key words: stroke, hemiplegia, psychological disorder, self-efficacy, rehabilitation