| Objective 1 To explore the dynamic change and influencing factors of acceptance of disability and quality of life on patients with burns under the latent growth curve modeling.2 Based on the stress model of focus solution and the characteristics of burn patients,a group psychological intervention scheme suitable for burn patients was constructed.3 To explore the effect of focused solution brief group(SFBT)psychological intervention scheme on the acceptability of disability in burn patients’ quality of life.Methods 1 A convenient sampling methods was used to extract 216 patients with burns in the rehabilitation treatment stage from October 2016 to July 2017 in a burn centre in Fujian province.The general condition table,ADS-R and BSHS-B were conducted on the patients at the time of diagnosis,and 1、3、6 months after discharged.Latent growth curve modeling was constructed to assess the feature of outcome growth trajectory and related influencing factors.2 Guided by SFBT theories,a short-term group psychological intervention program focusing on solutions was preliminarily constructed.Then two rounds consultation were conducted among 12 experts in Fujian province using Delphi technique.3 Using convenient sampling method,50 cases of burn patients in the rehabilitation period of Fujian burn centre from January 2018 to November 2018 were selected,and were divided into intervention group and control group with 25 cases respectively by non-synchronous control method.Finally,53 cases were followed up.The control groups received the normal model(routine treatment+routine nursing+ routine rehabilitation),and the intervention groups completed the fourth phase of the SFBT group psychological intervention program based on the routine model.The two groups of patients were followed up for the wound healing period,the fourth week and the eighth week using the general data questionnaire,ADS-R and BSHS-B scales.The t-test,χ2test,Mann-Whitney U test were used to compare baseline data,acceptance of disability and quality of life.The time effect and interaction effect levels of the intervention factors for acceptance of disability and quality of life were analyzed by using the simple effect analysis of two-factor repeated measurement ANOVA.Results 1 The average ADS-R and BSHS-B were 101.68 and 72.99 at baseline,and both of them showed an increasing trend,and the increasing rate gradually slowed down during the follow-up period.The intercept,slope and quadratic slope factor of ADS-R were statistically significant,indicating they varied across individuals(P<0.01),the variances of both latent intercept and quadratic slope factor of BSHS(P<0.01).Gender,reasons of burns,payment and education level did not showed significant effect on both intercept and slope factor(P>0.05),while severity of burns and complications had significant negative effect on intercept factor of BSHS(P<0.05).The level of ADS-R showed significant predictive effect on the BSHS during the follow-up(P<0.001).2 After two rounds of consultation by experts,the importance of each index was assigned an average value of 4.44~4.97,CV was 0.02~0.10,and Kendall’s W was 0.146~0.205(all P <0.001),indicating that the score of the index by the expert group was consistent and the reliability of the consultation result was good.Finally,the 4 phases SFBT group psychological intervention program was formed.3 The results of clinical empirical analysis show that:(1)During the wound healing period,the total score of ADS-R,BSHS-B and the scores of each dimension were not statistically significant(P>0.05),but were comparable between the two groups.Then,as time went by,the scores of ADS-R,BSHS-B in the control group decreased and then increased.After the implementation of SFBT group psychotherapy,the average level of the two groups increased,and their overall level was higher than that of the control group.(2)Acceptance of disability repetitive measure analysis of variance showed that the ADS-R total score and each dimension score exist interaction(P<0.05),the time factors on the effect of disability acceptance by grouping different between fixed set of factor analysis,further intervention group the index score ADS-R at various time points to compare all have significant difference(P<0.001),suggesting compared with control group,SFBT group psychological intervention can improve the ADS-R of burn patients better level of fixed time factor analysis,results show that the role of SFBT group psychological intervention gradually increased over time.(3)Quality of life of repeated measurement variance analysis shows that the time factor in BSHS-B score of basic ability of hand function emotional sex and heat sensitive dimension the main effect of statistically significant(P<0.05),prompted with the passage of time,the two models are different levels of the emotional life ability hand function in patients with sex and heat sensitive level of hand function The interaction between scores in the emotional and interpersonal dimensions was significant(P<0.05).Further analysis of the factors between the two groups showed that the simple effect test of scores in the emotional and interpersonal dimensions measured at week 4 was significant in both groups(P<0.05).However,no statistical significance was found in the two dimensions at week 8(P>0.05).The analysis of fixed time factors showed that the hand function and emotional dimension scores of BSHSB were statistically significant(P<0.05),but the interpersonal dimension scores were not significantly different(P>0.05).Conclusion 1 The changes in quality of life and acceptance of disability in burn patients are not a simple linear increase,but a trend of increasing curve,and the rate of increase gradually slows down.According to the characteristics of their trajectories,clinicians can carry out post-hospital follow-up work to help patients regain their self,accept the status of disability,improve their quality of life,and hope to return to society smoothly.2 A short-term focused group psychological intervention program with burn characteristics was constructed to provide patients with guiding information to resolve psychological crisis,improve the coping ability of burn patients in the process of physical and mental rehabilitation,and finally return to society and family smoothly.3 The SFBT group intervention program can be used in patients with burn rehabilitation period to help them redefine the target structure,enhance family support and interpersonal interaction experience,tap their potential,and optimize problem strategies to promote self-acceptance and improve quality of life. |
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