王丽萍;

• 1:郑州市第九人民医院

摘要(Abstract)：

目的探讨颅脑损伤伴骨盆骨折患者自我感受负担与正念水平的相关性,指导患者心理状态的调节,以改善预后情况。方法选取2019-02—2020-02郑州市第九人民医院88例颅脑损伤伴骨盆骨折患者为研究对象,观察所有患者术后3个月的自我感受负担[通过自我感受负担量表(SPBS)评估]与正念水平[通过正念注意觉知量表(MAAS)评估]状况,根据自我感受负担程度分组后对比组间基线资料及正念水平,分析颅脑损伤伴骨盆骨折患者自我感受负担与正念水平的关系,探讨正念水平对自我感受负担的影响。结果 88例颅脑损伤伴骨盆骨折患者均存在自我感受负担,重度、中度、轻度、无自我感受负担分别为13例、21例、54例、0例,中重度自我感受负担患者占38.64%(34/88);中重度组正念水平低于对照组,差异有统计学意义(P<0.05),其他基线资料比较差异无统计学意义(P>0.05);经双变量Pearson直线相关性检验显示,颅脑损伤伴骨盆骨折患者SPBS总分、MAAS评分呈负相关(r<0,P<0.001);经单项Logistic回归分析并建立多元回归模型,分析正念水平与自我感受负担的关系,结果显示正念水平低下是颅脑损伤伴骨盆骨折患者自我感受负担加重的影响因素(OR>1,P<0.05)。结论颅脑损伤伴骨盆骨折患者普遍存在不同程度的自我感受负担,且多集中为中重度,可能受正念水平低下的影响,临床应重视颅脑损伤伴骨盆骨折患者的早期正念干预,可能对降低患者自我感受负担程度有积极意义。

关键词(KeyWords)： 颅脑损伤;骨盆骨折;自我感受负担;正念水平;相关性

Abstract:

Keywords:

基金项目(Foundation): 河南省医学科技攻关计划联合共建项目（编号：LHGJ20191130）

作者(Authors): 王丽萍;

参考文献(References)：

• [1]唐丽华.1例颅脑损伤合并血气胸及骨盆骨折患者的护理[J].中国实用神经疾病杂志，2015,18(21):144-145.
• [2]TAKATORI K,MATSUMOTO D,MIYAZAKI M,et al.The difference between self-perceived and chronological age in the elderly may correlate with general health,personality and the practice of good health behavior:Across-sectional study[J].Arch Gerontol Geriatr,2019,27(83):13-19.
• [3]REHMANN-SUTTER C.Self-perceived burden to others as a moral emotion in wishes to die.A conceptual analysis[J].Bioethics,2019,33(4):439-447.
• [4]REN H,LIU C,LI J,et al.Self-perceived Burden in the Young and Middle-aged Inpatients with Stroke:ACross-sectional Survey[J].Rehabil Nurs,2016,41(2):101-111.
• [5]CARLSSON M,WANBY P,BRUDIN L,et al.Older Swedish Adults with High Self-Perceived Health Show Optimal 25-Hydroxyvitamin D Levels Whereas Vitamin D Status Is Low in Patients with High Disease Burden[J].Nutrients,2016,8(11):717.
• [6]CHAN E Y,WANG Y.Mindfulness changes construal level:An experimental investigation[J].J Exp Psychol Gen,2019,148(9):1656-1664.
• [7]NICASTRO R,JERMANN F,BLUTEAU BLIN S,et al.Mindfulness Training for Adults with Attention-Deficit/Hyperactivity Disorder:Implementation of Mindful Awareness Practices in a French-Speaking Attention-Deficit/Hyperactivity Disorder Unit[J].J Altern Complement Med,2021,27(2):179-183.
• [8]WALDRON S M,GAUNTLETT-GILBERT J,MARKS E,et al.Dispositional Mindfulness and Its Relationship With Distress and Functioning in Adolescents With Chronic Pain and Low-Level Pain[J].J Pediatr Psychol,2018,43(9):1038-1046.
• [9]YEUNG N C Y,LU Q,MAK W W S.Self-perceived burden mediates the relationship between self-stigma and quality of life among Chinese American breast cancer survivors[J].Support Care Cancer,2019,27(9):3337-3345.
• [10]ENRIQUEZ C M,CHISHOLM K H,MADDEN L K,et al.Glasgow Coma Scale:Generating Clinical Standards[J].J neurosci nurs,2019,51(3):142-146.
• [11]WATERFIELD J,SIM J.Clinical assessment of pain by the visual analogue scale[J].Br J Ther Rehabil,2013,3(2):94-97.
• [12]MICHALOS A C.Encyclopedia of Quality of Life and Well-Being Research--Self-Perceived Burden Scale[M].Berlin Germany:Springer Netherlands,2014:252.
• [13]GOH H E,MARAIS I,IRELAND M J.A Rasch Model Analysis of the Mindful Attention Awareness Scale[J].Assessment,2017,24(3):387-398.
• [14]马建芬.心理护理干预对颅脑外伤患者焦虑状态的影响[J].中国实用神经疾病杂志，2014,17(8):137-138.
• [15]SOENDERGAARD P L,WOLFFBRANDT M M,BIER-ING-S?RENSEN F,et al.A manual-based family intervention for families living with the consequences of traumatic injury to the brain or spinal cord:a study protocol of a randomized controlled trial[J].Trials,2019,20(1):646.
• [16]ZHANG C,GAO R,TAI J,et al.The Relationship between Self-Perceived Burden and Posttraumatic Growth among Colorectal Cancer Patients:The Mediating Effects of Resilience[J].Biomed Res Int,2019,12:6840743.
• [17]KUO S C,CHOU W C,HOU M M,et al.Changes in and modifiable patient-and family caregiver-related factors associated with cancer patients’high self-perceived burden to others at the end of life:A longitudinal study[J].Eur J Cancer Care(Engl),2018,27(6):e12942.
• [18]张营丽，周艳华，李卓，等.正念冥想疗法干预阿尔茨海默病患者神经损伤及焦虑抑郁的效果分析[J].中国实用神经疾病杂志，2020,23(20):1813-1817.
• [19]BAXENDALE S,HEANEY D,RUGG-GUNN F,et al.Neuropsychological outcomes following traumatic brain injury[J].Pract Neurol,2019,19(6):476-482.
• [20]POTPARA T S,MIHAJLOVIC M,ZEC N,et al.Self-reported treatment burden in patients with atrial fibrillation:quantification,major determinants,and implications for integrated holistic management of the arrhythmia[J].Europace,2020,22(12):1788-1797.
• [21]李亚南，杜晓冰.老年慢性病患者的自我感受负担正念水平与生活质量的相关性分析[J].中国实用神经疾病杂志，2018,21(22):2540-2546.
• [22]HAUG L,WAZAKILI M,YOUNG S,et al.Longstanding pain and social strain:patients’and health care providers'experiences with fracture management by skeletal traction;a qualitative study from Malawi[J].Disabil Rehabil,2017,39(17):1714-1721.
• [23]SOLEM S,HAGEN R,WANG C E,et al.Metacognitions and Mindful Attention Awareness in Depression:A Comparison Of Currently Depressed,Previously Depressed and Never Depressed Individuals[J].Clin Psychol Psychother,2017,24(1):94-102.
• [24]CRAMER H,MEHLING W E,SAHA F J,et al.Postural awareness and its relation to pain:validation of an innovative instrument measuring awareness of body posture in patients with chronic pain[J].BMC Musculoskelet Disord,2018,19(1):109.
• [25]GRAHN KRONHED A C,ENTHOVEN P,SP?NGEUSA,et al.Mindfulness and Modified Medical Yoga as Intervention in Older Women with Osteoporotic Vertebral Fracture[J].J Altern Complement Med,2020,26(7):610-619.
• [26]WIELGOSZ J,GOLDBERG S B,KRAL T R A,et al.Mindfulness Meditation and Psychopathology[J].Ann Rev Clin Psychol,2019,14(15):285-316.
• [27]REHMANN-SUTTER C.Self-perceived burden to others as a moral emotion in wishes to die.A conceptual analysis[J].Bioethics,2019,33(4):439-447.
• [28]CRESWELL J D.Mindfulness Interventions[J].Ann Rev Psychol,2017,67(68):491-516.
• [29]BERK L,WARMENHOVEN F,STIEKEMA A P M,et al.Mindfulness-Based Intervention for People With Dementia and Their Partners:Results of a Mixed-Methods Study[J].Front Aging Neurosci,2019,24(11):92.
• [30]HOWARTH A,PERKINS-PORRAS L,SMITH J G,et al.Pilot study evaluating a brief mindfulness intervention for those with chronic pain:study protocol for a randomized controlled trial[J].Trials,2016,17(1):273.