基于PERMA模式的脑卒中积极心理干预方案的构建与应用

Development and Application of a Positive Psychology Intervention Program for Stroke Patients Based on the PERMA Model

摘要: 目的：构建基于情绪–投入–人际关系–意义–成就(PERMA)模式的脑卒中积极心理干预方案，并评价该方案的应用效果。方法：以PERMA模式为理论框架，在文献回顾的基础上，结合专家函询、小组讨论构建基于PERMA模式的脑卒中积极心理干预方案。于2023年10月~2024年4月，采用便利抽样法选取上海市某三级医院神经内科脑卒中患者作为研究对象，对照组(n = 32)采用常规康复治疗护理及心理指导，干预组(n = 30)在对照组的基础上采用基于PERMA模式的脑卒中积极心理干预方案，评估指标包括两组社会疏离、症状负担和主观幸福感。结果：本轮研究经两轮专家函询，专家的熟悉程度为0.78；专家的判断系数为0.86；专家权威系数为0.83，专家评价结果可靠。两轮肯德尔和谐系数分别为0.108、0.094 (P < 0.001)。最终形成的基于PERMA模式的脑卒中积极心理干预框架，包含4个一级指标，17个二级指标，67个三级指标。研究团队根据三级指标架构，形成干预方案终稿。方案应用后，干预组的社会疏离、症状负担和主观幸福感得分均高于对照组，差异具有统计学意义(t = −2.425, −2.072, 3.282; P < 0.05)。结论：应用基于PERMA模式的脑卒中积极心理干预方案能有效减轻脑卒中患者症状负担，提高患者幸福体验，缓解社会疏离症状。

Abstract: Objective: To develop a positive psychological intervention program for stroke patients based on the PERMA (Positive Emotion, Engagement, Relationships, Meaning, Achievement) model and evaluate its application effects. Methods: Using the PERMA model as the theoretical framework, a positive psychological intervention program for stroke was developed through a literature review and two rounds of expert consultation. Convenience sampling was used to select stroke patients from the neurology department of a tertiary hospital in Shanghai. Ultimately, 32 patients were assigned to the control group and 30 to the intervention group. The control group received routine rehabilitation therapy, nursing care, and psychological guidance, while the intervention group received the PERMA-based positive psychological intervention in addition to the control group’s treatment. Social isolation, symptom burden, and subjective well-being were compared between the two groups. Results: This study conducted two rounds of expert consultation. The expert familiarity coefficient was 0.78, the judgment coefficient was 0.86, and the authority coefficient was 0.83, indicating reliable expert evaluation results. The Kendall’s W coefficients for the two rounds were 0.108 and 0.094, respectively (P < 0.001). The final PERMA model-based positive psychological intervention framework for stroke patients comprised 4 first-level indicators, 17 second-level indicators, and 67 third-level indicators. Based on this three-tier indicator structure, the research team finalized the intervention protocol. After implementation, the intervention group demonstrated significantly higher scores than the control group in social isolation, symptom burden, and subjective well-being (t = −2.425, −2.072, 3.282, respectively; P < 0.05). Conclusion: The application of the PERMA-based positive psychological intervention program effectively alleviates symptom burden, enhances well-being, and reduces social isolation in stroke patients.