2021 年第 5 期 第 16 卷

急性期A型主动脉夹层患者情绪反应及Roy适应模式临床管理效果分析

Analysis of emotional response and Roy adaptation model clinical managing effect on type A aortic dissection patients in acute stage

作者：乔杰赵婵蔡华玲

英文作者：Qiao Jie Zhao Chan Cai Hualing

单位：首都医科大学附属北京安贞医院特需医疗科100029

英文单位：Department of Special Medicine Beijing Anzhen Hospital Capital Medical University Beijing 100029 China

关键词：主动脉夹层；Roy适应模式；情绪反应

英文关键词：Aorticdissection;Royadaptationmodel;Emotionalresponse

• 摘要：

• 目的 分析急性期A型主动脉夹层（AD）患者情绪反应及Roy适应模式临床管理效果。方法 选取2016年6月至2018年6月在首都医科大学附属北京安贞医院住院诊断为急性期A型AD患者102例，按照入院先后顺序，单数纳入对照组（51例），双数纳入观察组（51例）。入院时所有患者均采用正性负性情绪量表（PANAS）、情绪表达性量表（EES）测定患者急性期情绪反应。对照组采用常规临床干预，观察组采用常规临床干预联合Roy适应模式临床管理，分别于2组患者入院当天及术后3 d应用视觉模拟量表（VAS）、焦虑自评量表（SAS）、抑郁自评量表（SDS）、世界卫生组织生存质量测定量表简表评价疼痛感、负性情绪和生存质量。结果 所有急性期AD患者PANAS正性情绪评分为（26.1±2.5）分，负性情绪评分为（25.7±3.6）分，且EES总分［（65±7）分］高于其量表总分理论中值（51分）。干预后观察组VAS、SAS、SDS评分均明显低于对照组［（2.56±0.79）分比（4.68±0.23）分、（47±4）分比（48±6）分、（48±6）分比（49±5）分］，生存质量评分均明显高于对照组（均P＜0.05）。结论 急性期A型AD患者存在负面情绪反应。采用Roy适应模式临床管理，可改善负面情绪，降低疼痛程度，提升患者生存质量。

• Objective To analyze the emotional response and Roy adaptation model clinical managing effect on patients with type A aortic dissection (AD) in acute stage. Methods From June 2016 to June 2018, 102 patients with type A AD in acute stage admitted to Beijing Anzhen Hospital, Capital Medical University were enrolled. According to the order of admission, the singular numbers were included in the control group (51 cases) and the even numbers were included in the observation group (51 cases). On admission, the positive and negative affect scale (PANAS) and emotional expression scale (EES) were used to measure the patients′ emotional response in acute stage. The control group was given routine clinical intervention and observation group was given routine clinical intervention combined with Roy adaptation model clinical management. Visual analogue scale (VAS), self-rating anxiety scale (SAS), self-rating depression scale (SDS) and World Health Organization quality of life-BREF were used to evaluate pain, negative emotion and quality of life on the day of admission and 3 d after operation. Results The positive emotional of PANAS was (26.1±2.5) and the negative emotional was (25.7±3.6), the total score of emotional expression （65±7） of AD patients in acute stage was higher than the theoretical median score (51). After intervention, the VAS, SAS and SDS scores in the observation group were significantly lower than those in the control group［（2.56±0.79） vs （4.68±0.23）, （47±4） vs （48±6）, （48±6） vs （49±5）］, and the quality of life score in the observation group was significantly higher than that in the control group (all P＜0.05). Conclusions There is negative emotional response in patients with type A AD in acute stage. Roy adaptation model can improve negative emotions, reduce pain degree and improve the quality of life of patients.