| Objective(s):1.The study was to investigate the psychological status,social support level and medical coping style of non-psychiatric inpatients in general hospital,analyze the correlation between psychological status and social support level and medical coping style,and the influencing factors of psychological problems,so as to provide a basis for the establishment of graded psychological intervention mode for non-psychiatric inpatients in general hospitals.2.Learn the excellent experiences from Huaxi hospital of Sichuan university.To explore and formulate the graded psychological intervention model for non-psychiatric inpatients in general hospital,and to evaluate the effectiveness of graded psychological nursing on the mental health,social support level and medical coping style of non-psychiatric inpatients through clinical implementation,so as to provide non-psychiatric departments of general hospitals with operational,systematic,scientific mode and method.Methods:1.The first part,a random sampling method was used to select 445 non-psychiatric inpatients as respondents from January 2019 to July 2019.According to the planning requirements of the "sunshine hospital" project,four non-psychiatric departments of cerebrovascular disease,gynecology,oncology and cardiology in the affiliated hospital of Kunming Medical University were selected as the pilot departments to carry out a current investigation.The construction project of "sunshine hospital" was initiated by Huaxi hospital of Sichuan university,which established a three-level management system of hospital,set up a three-level clinical psychological service team,and carried out grading treatment and bedside intervention according to the degree of inpatients.Within 24 hours after admission,to investigate 445 by using Huaxi Emotion Index(HEI),Social Support Rating Scale(SSRS),Medical Coping Modes Questionnaire(MCMQ)and self-made general data questionnaire,to evaluate their psychological status,social support level and medical coping style.2.In the second part,124 non-psychiatric inpatients with psychological problems were taken as the research subjects,and the graded psychological intervention was carried out.The subjects were randomly divided into the control group and the experimental group.The control group was given routine psychological care;The experimental was given graded psychological intervention model according to the severity of psychological problems.After the intervention,the two group patients were evaluated by HEI,MCMQ and SSRS scales again,compared the similarities and differences of the scales before and after the graded psychological intervention.Using SPSS22.0 statistical software for statistical analysis,the statistical methods included Pearson correlation,binary logistic regression analysis,samples t test,independent sample t test analysis of variance,chi-square test,non parametric test Wilcoxon paired test and Mann-Whitney U test.Statistical indicators include mean,standard deviation,quartile,composition ratio,rate,median and quartile spacing were used for data description,P<0.05 indicating statistical significance(a=0.05).Results:1.Among the 445 non-psychiatric inpatients,124 had psychological problems and the incidence of psychological problems was 27.87%.From high to low,the positive rate of Huaxi Emotion Index for inpatients in different departments was gynaecology(43,40.57%),Cardiology(27,27.55%),Cerebrovasculardisease(31,24.60%),Oncology(23,20%).Bad state of mind mainly was anxiety symptoms and the main manifestation was the worry about the disease.2.From high to low,the levels of social support of non-psychiatric inpatients was 67 cases(15.06%),370 cases(83.15%)and 8 cases(1.80%);All dimensions of medical coping style were lower than the norm(P<0.05).3.Pearson correlation analysis showed that the occurrence of psychological problems was negatively correlated with the total score of social support,objective support,subjective support and utilization of support(P<0.05),It was negatively correlated with face dimension of medical copying style(P<0.05),Positively correlated with yield dimension(P<0.05),and there was no correlation between avoidance dimension and psychological problems(P>0.05).4.Univariate analysis showed that there were significant statistically differences among different departments,gender,age,per capita family monthly income,occupation,medical payment method,personality,sleep quality(P<0.05).The results of multivariate analysis showed that medical payment method,gender,personality and sleep quality were the main influencing factors.5.Based on the construction project of "sunshine hospital",an expert team was set up and the graded psychological intervention model was preliminarily constructed.The results of the clinical trial showed that compared with the control group,the psychological assessment score of the experimental group significantly decreased and the level of social support improved,and the level of medical response significantly improved,with statistically significant differences(P<0.05).Conclusion(s):1.Psychological problems of non-psychiatric inpatients in general hospitals were more common.2.The social support of non-psychiatric inpatients was at a medium level,which was negatively correlated with the occurrence of psychological problems,indicating that the higher the level of social support,the better the psychological status and the lower the incidence and severity of psychological problems.Medical staff should attach importance to communication with patients and help them establish a good social support system with families and communities,so that patients can feel understanding,care and support,so as to improve their psychological state.3.The occurrence of psychological problems in non-psychiatric inpatients was negatively correlated with the face dimension and positively correlated with the yield dimension.Clinical workers should guide and encourage patients to actively face the disease,family and society,should take the initiative to express their wishes and seek appropriate help,and avoid adopting passive coping styles such as surrender and escape,so as to regulate patients' bad emotions.4.The mental health status of non-psychiatric inpatients is affected by many factors which mainly were medical payment method,gender,personality and sleep quality,indicating that medical workers should carry out targeted intervention according to patients' gender,personality and sleep quality when providing mental health services.5.The graded psychological intervention model adopted in this study can effectively improve the mental health level of non-psychiatric inpatients,reduce the degree of psychological problems and alleviate negative emotions of patients.It also can increase the level of social support.Meanwhile,this model can effectively promote positive coping styles and reduce the negative coping styles of avoiding and yielding in patients.Therefore,the graded psychological intervention model had important clinical significance and was worthy to be popularized and applied in non-psychiatric inpatients in general hospitals. |
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