目的 探讨幸福PERMA（positive emotion,engagement,relationships,meaning,and accomplishment）模型配合健康教育在臂丛神经损伤后慢性疼痛控制中的应用效果。方法 选取2021年6月—2025年6月本院收治的88例臂丛神经损伤后慢性疼痛患者,采用随机数表法分为两组各44例。对照组实施常规疼痛管理与健康教育,研究组实施PERMA模型配合健康教育,两组均持续干预8周。比较两组干预前和干预2周、4周、6周、8周后的疼痛数字评分法（numerical rating scale,NRS）评分;比较两组干预前和干预8周后自我护理能力测定量表（exercise of self-care agency scale,ESCA）维度评分及总分、焦虑自评量表（self-rating anxiety scale,SAS）评分、抑郁自评量表（self-rating depression scale,SDS）评分、疼痛灾难化量表（pain catastrophizing scale,PCS）评分、总体幸福感量表（general well-being schedule,GWB）维度评分及总分。结果 研究组在干预2、4、6、8周各时间点的NRS评分均显著低于对照组;研究组的健康知识水平、自我护理技能、自护责任感和自我概念维度ESCA评分及总分均高于对照组;研究组SAS、SDS和PCS评分均显著低于对照组;研究组对健康的担心、精力、对生活的满足和兴趣、忧郁或愉快、对情感和行为的控制及松弛与紧张维度评分和总分均高于对照组。结论 幸福PERMA模型配合健康教育可有效缓解臂丛神经损伤后慢性疼痛,改善患者心理状态,提升自我管理能力,值得临床推广应用。
Abstract
Objective To explore the application effect of happiness PERMA (positive emotion, engagement, relationships, meaning, and accomplishment) model combined with health education in the control of chronic pain after brachial plexus nerve injury. Methods A total of 88 patients with chronic pain after brachial plexus nerve injury in the hospital were enrolled between June 2021 and June 2025. According to random number table method, they were divided into control group (routine pain management and health education) and study group (happiness PERMA model combined with health education), 44 cases in each group. All patients were intervened for 8 weeks. The scores of numerical rating scale (NRS) before intervention and after 2, 4, 6 and 8 weeks of intervention, scores and total score of exercise of self-care agency scale (ESCA), scores of self-rating anxiety scale (SAS), self-rating depression scale (SDS) and pain catastrophizing scale (PCS), scores and total scores of general well-being schedule (GWB) before intervention and after 8 weeks of intervention were compared between the two groups. Results After 2, 4, 6 and 8 weeks of intervention, NRS scores in study group were significantly lower than those in control group. After intervention, scores and total score of ESCA (health knowledge level, self-care skills, self-care responsibility, self-concept) were higher than those in control group, scores of SAS, SDS and PCS were significantly lower than those in control group, scores and total score of GWB (concern for health, energy, satisfaction and interest in life, depression or pleasure, control of emotions and behaviors, relaxation and tension) were higher than those in control group. Conclusion The happiness PERMA model combined with health education can effectively alleviate chronic pain after brachial plexus nerve injury, improve psychological state and self-management ability, which is worthy of clinical promotion and application.
关键词
臂丛神经损伤 /
慢性疼痛控制 /
幸福PERMA模型 /
健康教育 /
自我管理能力 /
主观幸福感
Key words
brachial plexus nerve injury /
chronic pain control /
happiness PERMA model /
health education /
self-management ability /
subjective well-being
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基金
北京市医管中心培育计划项目“基于rs-fMRI技术探究背根入髓区毁损术治疗臂丛神经撕脱伤后疼痛的中枢机制”（PX2025011）; 北京积水潭医院科研基金“信息化激励式心理护理+延续护理对BPA后NP患者心理及疼痛的影响”（HL-202409）
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