The Application Of Cognitive Behavioral Intervention In The Continuous Nursing Of Outpatients With Temporomandibular Disorder

Objective:To explore the effect of cognitive-behavioral intervention in the continuous nursing of patients with temporomandibular joint disorder in outpatient department on improving patients psychological status,disease efficacy and satisfaction,and to provide relevant reference for clinical nursing intervention measures.Methods:This study was divided into two parts.(1)Questionnaire survey stage:108 patients with TMJ disorder were randomly selected from the outpatient clinic of oral and maxillofacial surgery in three top three hospitals in Guizhou Province from December 2017 to June 2018 by using convenient sampling method.The self-designed general information questionnaire,simple coping style questionnaire(SCSQ),self-assessment Anxiety Scale(SAS),adult psychological stress scale were used Table(APSS)was used to investigate and evaluate the patients to understand their condition,general situation and psychological state.(2)Cognitive behavioral intervention:from June 2018 to December 2018,108 patients with TMD were randomly divided into experimental group and control group,54 in each group.The control group was given routine outpatient education and nursing.On this basis,the experimental group was given continuous nursing of cognitive behavior intervention through wechat interactive platform,nurse outpatient continuous nursing,telephone follow-up,health lecture and other ways.At 2,4 and 6 months after the intervention,the patients were assessed by SCSQ,SAS and APSS,and the patients were investigated by outpatient follow-up and telephone follow-up;(3)Application Epidata3.0 Software input data,check and sort out the data,and then use SPSS22.0The software analyzed the psychological status,disease efficacy and satisfaction index of the two groups,and made the bar chart of SCSQ questionnaire,SAS scale and APSS scale scores of the two groups at different time points by using Excel 2007.The data of age,course of disease,score of SCSQ,SAS and APSS were normal distribution,It is described by mean±standard deviation(x±s).The counting data were described by rate(%)or composition ratio(%).Group t test andc~2 test were used for group comparison,and Fisher exact probability method was used for those who did not meetc~2 the test conditions.For the quantitative data of repeated measurement design,repeated measurement analysis of variance was used.For the data of repeated measurement design with multiple classification variables of disease efficacy and satisfaction,the generalized estimation equation model was used.Inspection level?=0.05,P?0.05,The difference was statistically significant.Results:after 2,4 and 6 months of continuous nursing,the results of ANOVA showed that the scores of SCSQ coping tendency,SAS and APSS were compared between the two groups,The difference between the groups was statistically significant(P<0.05).The difference was statistically significant(P<0.05).The interaction between and within the group was statistically significant(P<0.05).The results showed that there was a significant difference between different groups and different time points(P<0.05).Compared with the control group,the disease efficacy of the experimental group(?=0.753,95%CI:0.099-1.406)?Satisfaction(?=0.551,95%CI:0.015-1.118).The score was higher;based on the score of disease efficacy and satisfaction 6 months after the intervention,the disease efficacy and satisfaction of the two groups increased with the extension of the intervention time(P<0.05).Conclusion:1.The continuous nursing of patients with TMD in outpatient department for 2,4 and 6 months is helpful to improve their coping tendency,improve their positive coping style,and reduce their anxiety and psychological pressure;2.The continuous nursing of patients with TMD in outpatient department for 2,4 and 6months is helpful to improve their disease effect;3.The continuous nursing of patients with TMD in outpatient department for 2,4 and 6 months is helpful to improve their disease effect;3 The continuous nursing for 2,4 and 6 months is helpful to improve the patients'satisfaction.