The Effect Of Cognitive Behavioral Intervention On The Psychological Stress In Patients Undergoing Video Urodynamic Examination

Objective1To investigate the level of anxiety and its influencing factors in the patients undergoing Video urodynamic examination and analyse the correlation between the level of anxiety and medical coping strategy, and provide practical theory for the application of Cognitive behavioral intervention and improving the quality of clinical nursing.2To study the effect of cognitive behavioral intervention on patients undergoing Video urodynamic examination, and to explore whether Cognitive behavioral interve-ntion can effectively reduce the psychological stress reaction and improve the coping capacity of patients and to supply theory basis for improving the quality of clinical nursing.Methods1One hundred patients who had undergone Video urodynamic examination (VUE)in the first affiliated hospital of Zhengzhou university from April to September in2012were chosen as the qualitative research objects by purpose sampling method, And all the subjects were divided into control group (50patients) and intervention group (50patients) according to number of parity in the medical record number. The control group was given the routine nursing measures. On this basis, the intervention group was also given cognitive behavior intervention (including the psychological intervention rational-emotive therapy and progressive muscle relaxation) once a day,30-40min every time, and each patient did2interventions in all. To estimate the general condition, anxiety medical reply, evaluation of patients according the self-design scales(the general condition questionnaire)、Self-rating Anxiety Scale (S AS)、Medical Coping Modes Questionnaire (MCMQ) when the patients making an appointment, and recorded the heart rate and blood pressure under physiological stress response. value of pain measurement and Numerical Rating Scale (NRS) when to do examination and X-ray exposure. Analyze the effects of cognitive behavior intervention for patients with psychological stress reaction of intervention effect.And observe the corresponding index of the control group underlying physiological stress response.2The data was analyzed by SPSS17.0on computer. Statistical description included:chi-square, Fisher exact probability, Single samplet-test, non-parametric test, The Mann-Whitney U test.Statistical analysis included:Spearman correlation analysis, repeated measures analysis of variance.Results1The SAS score (58.83±3.67) of VUE was more than the domestic norm (50)(P<0.001), difference is statistically significant; The patients with mild anxiety accounted for65%(65cases),and the patients with Moderate Anxiety accounted for35%(35cases).The MCMQ score was:"confrontation"(18.03±0.97),"avoidance"(13.91±1.342), and"resignation"(10.93±1.103). The SAS score had positive correlate-vity with "avoidance" and "resignation", and the coefficient correlation were0.74and0.615(P<0.01). The coefficient correlation between SAS score and "confrontation" were0.095(P=0.346>0.05), and nonlinearity.2The SAS score, MCMQ score, NRS score, and heart rate show remarkable statistical significance in different time point (the patients to make an appointment, ten minutes before the examination and Ten minutes after the examination). Without considering coping, the SAS score, MCMQ score, NRS score, and heart rate of intervention group reduced with the time.The difference is statistically significant (P<0.001), and the SAS score,MCMQ score,NRS score, and heart rate of intervention group are lower than the control group (P<0.001). And interaction is exist in time effect and group effect (P<0.001).3The systolic pressure and diastolic pressure at different time (the patients when making an appointment, ten minutes before the examination and ten minutes after the examination) show that the time effect is statistically significant(P<0.001). Without considering coping, the blood pressure reduced with the time. The diastolic pressure of intervention group is lower than the control group, and group effect is statistically significant(P<0.001), and without considering the time factor, the diastolic pressure is different. The systolic pressure of intervention group is lower than the control group, the group effect is statistically significant (P<0.05),and without considering the time factor, the systolic pressure is different.And interaction is exist in time effect and group (P<0.001).4The NRS score, examination time, and X-ray exposure time of intervention group are lower than the control group significantly. And interaction is exist in time effect and group effect(P<0.001),and the difference between the groups is statistically significant (P<0.001).Conclusions1Patients undergoing Video urodynamic examination have different degrees of anxiety reaction, and tend to"avoidance"and "resignation". The trait anxiety had positive correlativity with "avoidance" and "resignation".2The SAS score, the "avoidance""resignation" coping style of MCMQ, NRS score, heart rate, and pain score of intervention group are lower than the control group,which shows that cognitive behavioral intervention can improve psychological stress reaction of patients undergoing video urodynamic examination effectively, reduce the anxiety level, and help patients improve the "confrontation" coping style, increase pain threshold, enhance pain tolerance level, and provide patients equilibrium state of physiology and psychology for examination. It is beneficial to monitor reliable and real inspection result.3The Cognitive behavioral intervention is to the benefit of reducing time of examination and time of X-ray exposure, helpful to complete the examination and ensure the safety of patients, and improve efficiency and quality of nursing, and provide effective nursing path for nursing study.