Psychotherapy In Chronic Hepatitis B Patients' Rehabilitation

ObjectiveTo acssess the mental and behavioral state of patients with chronic hepatitis B(CHB), and to investigate the contributing factors on quality of life in the patients;To implement psychotherapy on patients with CHB and to compare the effects between psychotherapy plus medication and only medication,So can provide experimental and theoretical thereunder for clinical psychology.Object and methods1 .To study the status of mental and behavioral state, 152 in-patient volunteers with CHB in Jinan infectious hospital participated in the study,by contrast with the medicos and nurses in the hospital.2.The psychotherapy group included 50 patients, matched with the other 40 ones (control group) in state of illness and demology data. All objects were asked to answer the psychological rating scales(SCL-90,CLDQ,MCMQ,SAS,SDS) and were tested liver function(ALT, AST, TBIL, DBIL, ALB) befor and after being treated.3.Each patients in Intervention group was put out a handbook of health educationand and was diagnosed the core mental problem before psychotherapy , then they were given 2-12 interviews being in hospital. The control group accepted only medication.4.Evaluate the effect of the curative effect of psychotherapy.results1 .The mental and behavioral state of patients with CHB:The results of SCL-90 showed that there was significant different between the patients and the norm except F6 and F8,and was significant different between the patients and the students and nurses.The patients had higher SAS and SDS scores than the norm. The results of MCMQ showed a lower confronce score and higher Acceptance-Resignation and avoidance scores contrast to the norm.By semi-structrured interview, the CHB patients were classified into 9 types: psychological balanced> roles conflicted^ anxious type^ depressive type> intimate relationship conflicted n victim of disease n economic pressed ^ uninformed and fearless n CHB labeled.2. The relativity analysis of quality of life:The patients, were splited into positive group whose everage scores of SCL-90 were more then 0.44(norm) and negtive group whose scores less then 0.44.The study revealed that the former had a higher CLDQ score than the latter. The scores of SCL-90 were found to be negtively correlated with scores of CLDQ for all domains and there were negative correlation between the scores of negative coping styles(avoidance and acceptance-resignation)and CLDQ.3.The effects of psychological intervention:There were non-significant different between the intervention group and the control group in SCL-90 ^ SAS> SDS> MCMQ% CLDQ and liver function before psychological intervention.However after psychointerention ,the intervention group patients had significantly decreased scores of SCL-90 compared with the controls eccept F5 and F8,as well as the scores of SAS and SAS. The former had a higher confronce score and lower avoidance and acceptance-resignation scores then the latter.The former had significantly increased scores of CLDQ for all domains eccept AS and lower score in ALI\ AST^ ALB than the latter. Conclusion1.Patients with CHB have extensively and visible psycho - social problems and negative coping style ,which reveal that besides medication, psychological intervention should be applicated to the patients.2. The psycosomatic symptoms and negative coping styles of patients with CHB can influence the quality of life. To improve the quality of life of CHB by Psychologycal intervention, emphasis shoud be placed on easing the psycosomatic symptoms and improving the coping styles.3.Not only psychological and behavioral status but also quality of life and liver function of the intervention group improved more than the control group after psychotherapy.That means psychotherapy as a supportive treatment to regular therapy had a satisfactory effect.