摘要目的:探讨支持-表达性团体干预方案对早期慢性肾脏病（CKD）患者恐惧疾病进展和自我感受负担的影响。方法:选取2018年5月至2020年7月在上海交通大学医学院附属仁济医院肾内科治疗的176例早期CKD患者，按照随机数字表法将其分为研究组88例，对照组88例。研究组失访12例，对照组失访14例，最终研究组76例、对照组74例纳入统计分析。对照组给予常规护理，研究组在常规护理基础上给予基于支持-表达性团体干预方案的护理措施。采用恐惧疾病进展量表（FoP）、自我感受负担量表（SPBS）分别于干预前、干预后12周评价干预效果。结果:干预前2组患者FoP及SPBS中各维度评分以及总分比较差异无统计学意义（ P>0.05）。干预后研究组情感反应、自主性丧失、伙伴关系/家庭、应对焦虑维度评分及FoP总分分别为（35.79 ± 5.82）、（18.52 ± 3.16）、（16.23 ± 2.27）、（21.57 ± 2.92）、（110.81 ± 17.12）分，低于对照组的（47.61 ± 7.13）、（24.61 ± 3.97）、（24.52 ± 3.71）、（31.67 ± 3.87）、（147.32 ± 21.72）分，差异有统计学意义（ t值为-18.07~-10.41，均 P<0.05）。干预后研究组身体因素、情感因素维度评分及SPBS总分分别为（10.15 ± 1.82）、（10.17 ± 1.86）、（24.01 ± 4.25）分，低于对照组的（15.87 ± 2.57）、（16.81 ± 3.14）、（36.39 ± 6.32）分，差异有统计学意义（ t=-15.76、-15.92、-14.11，均 P<0.05）。 结论:支持-表达性团体干预方案能够有效改善早期CKD患者对疾病进展的恐惧程度，缓解患者自我感受负担。

abstractsObjective:To explore the impact of supportive-expressive group therapy on the fear of disease progression and self-perceived burden of patients with early chronic kidney disease (CKD).Methods:A total of 150 early CKD patients in the Nephrology Department of Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine from May 2018 to July 2020 were selected and divided into research group with 88 cases and control group with 88 cases by random number table method. There were 12 cases were lost in the research group, 14 cases were lost in the control group. 76 cases in the research group and 74 cases in the control group were involved in the statistical analysis. The control group was treated with routine nursing while the research group was treated with nursing measures based on supportive-expressive group therapy as well as routine nursing. The effect of intervention was assessed by Fear of disease Progression (FoP) Questionnaire and Self-Perceived Burden Scale (SPBS) before and 12 weeks after the intervention.Results:There was no significant difference in the scores of FoP and Self Perceived Burden Scale (SPBS) between the two groups before the intervention ( P>0.05). After intervention, the scores of emotional reactions, loss of autonomy, partnership/family, anxiety response and the total score of FoP in the research group were (35.79 ± 5.82), (18.52 ± 3.16), (16.23 ± 2.27), (21.57 ± 2.92), (110.81 ± 17.12) respectively, which were lower than those in the control group (47.61 ± 7.13), (24.61 ± 3.97), (24.52 ± 3.71), (31.67 ± 3.87), (147.32 ± 21.72), and the differences were statistically significant ( t values were -18.07 - -10.41, all P<0.05). After intervention, the scores of physical factors, emotional factors and the total score of SPBS in the research group were (10.15 ± 1.82), (10.17 ± 1.86), (24.01 ± 4.25), which were lower than those in the control group (15.87 ± 2.57), (16.81 ± 3.14), (36.39 ± 6.32), and the differences were statistically significant ( t values were -15.76, -15.92, -14.11, all P<0.05). Conclusions:Supportive-expressive group therapy can effectively reduce the early CKD patients′ fear of disease progression and relieve their self-perceived burden.