Preliminary Application Of Acceptance And Commitment Therapy In Psychological Nursing Of Post-stroke Insomniac With Anxiety And Depression

ObjectivesThis study attempted to apply ACT to construct the psychological nursing programs preliminarily for post-stroke insomniac with anxiety and depression,and preliminarily explore its application effect,and analyze other influence factors of the psychological flexibility for such patients.MethodsBased on the theory and practice of acceptance and commitment therapy and psychological nursing,the psychological nursing program of acceptance and commitment therapy has been initially constructed.65 cases of insomniac with anxiety and depression were selected from the stroke inpatient in grade three-A hospital in Beijing from December 2018 to April 2019 as the research objects.Using before and after self-control study,the psychological nursing was performed with ACT,the study lasted for 7 times in total,once every time for 40 minutes.A series of data about patients were collected before and after psychological nursing,such as demographic questionnaires,the summary of Pittsburgh sleep quality index(PSQI),Athens Insomnia Scale(AIS),Acceptance and Action Questionnaire-Ⅱ(AAQ-Ⅱ),Cognitive Fusion Questionnaires(CFQ),Self-Rating Depression Scale(SDS)and Self-Rating Anxiety Scale(SAS).SPSS 21.0 was used for data processing.The measurement data were expressed as(x±s)and paired sample t-test was used.The influence factors were analyzed by single factor analysis with homogeneity of variance,and P<0.05 was considered as statistically significant.Results1.The level of psychological flexibility:The differences of patients between before and after psychological nursing,were statistically significant(P<0.05)in the level of psychological flexibility.After psychological nursing,the scores of AAQ-Ⅱand CFQ were decreased significantly,that is,psychological flexibility was improved.2.The level of anxiety and depression:The differences of patients between before and after psychological nursing,were statistically significant(P<0.05)in the level of anxiety and depression.After psychological nursing,the scores of SAS and SDS were decreased significantly,that is,the anxiety and depression of patients was alleviated.3.The summary of insomnia symptoms:The differences of patients between before and after psychological nursing,were statistically significant(P<0.05)in the level of the insomnia symptoms for patients.After psychological nursing,the scores of PSQI and AIS were decreased,insomnia was improved;4.Influence factors of patients’ psychological flexibility:"Age" and "First stroke or non-first stroke" had an impact on the effect of acceptance and action(P<0.05).“Suffer other diseases or not" had an effect on cognitive dissociation(P<0.05).Gender,marital status,education level,occupation,family per capita monthly income,residence status,residence place,type of care,duration of stroke,number of hospital admissions for stroke,and medical payment method had no statistical significance on psychological flexibility(P>0.05).Conclusions1.The psychological flexibility of post-stroke insomniac with anxiety and depression is at a low level,"Age","First stroke or non-first stroke" and "suffer other diseases or not" are the main influencing factors.2.ACT was applied to the psychological nursing in this study,desired effects were achieved preliminary.By improving the level of psychological flexibility to improve alleviate anxiety,depression and insomnia.3."ACT-Psychological nursing→Psychological flexibility→Alleviate negative emotions(anxiety,depression,etc.)→Improve adverse symptoms(such as insomnia)",it can be used as a new train of thought,to explore the psychological nursing and training nurses application technology of ACT simply,it will be more professional psychological nursing to be used widely in clinical.