目的:探讨氟西汀联合心理干预治疗心血管疾病患者伴焦虑抑郁症状的临床疗效。方法:选择伴有抑郁、焦虑情绪障碍的85例冠心病患者(心功能Ⅱ、Ⅲ级),并将其随机分成研究组和对照组。观察6w,对照组患者仅给予常规的治疗,研究组患者在常规治疗基础上给予氟西汀联合心理干预治疗。观察治疗前后两组患者采用汉密顿焦虑量表( Hamilton Anxiety Scale,HAMA) 评定焦虑症状,汉密顿抑郁量表( Hamilton Depression Scale,HAMD) 评定抑郁症状;并对治疗后心功能分级(NYHA)恢复到Ⅰ级的例数及左室射血分数进行分析评价。结果:治疗6 周 后,研究组均较对照组的汉密顿焦虑量表及汉密顿抑郁量表评分下降显著( P lt;0.01),研究组抗焦虑显效率为87.16%、抗抑郁显效率为82.26%,对照组分别为43.75%、45.36%,研究组均显著高于对照组( P lt;0.01);研究组患者的左室射血分数显著高于对照组 ( P lt;0.05),心功能分级(NYHA)恢复到Ⅰ级的例数显著高于对照组 ( P lt;0.05)。结论:氟西汀联合心理干预治疗不仅能改善心血管疾病伴焦虑抑郁患者的焦虑、抑郁情绪障碍,还能改善患者的心功能,疗效显著优于单用心血管药物治疗。
Objective To assess the effectiveness of psychological intervention on post-stoke depression. Methods Such databases as the JBI Database of Systematic Review (1980 to June, 2010), The Cochrane Library (1980 to June, 2010), PubMed (1966 to 2010), CINAHL(1982 to May, 2000), CBM (1978 to 2010), and CNKI (1979 to 2010) were searched to collect randomized controlled trials (RCTs). In accordance with the predefined inclusion and exclusion criteria, the quality of included studies was evaluated, and then meta-analyses were performed by using RevMan 5.0 software. Results A total of 33 RCTs were included. The results of meta-analyses showed: (1) Compared with the control group, the short-term effect of psychological intervention was more effective in decreasing depression score. The subgroup analysis showed that the intervention effects at the time of four weeks, six weeks, eight weeks, and 12 weeks were better than those of the control group. (2) The long-term effect of psychological intervention was more effective in decreasing depression score. The subgroup analyses showed that the intervention effects at the interval of eight weeks, 24 weeks, and 48 weeks were better than those of the control group. (3) The combined or single application of either cognitive-behavioral psychotherapy or supportive psychotherapy was more effective in decreasing depression score than the control group. However, there was no significant difference between the general psychological treatment group and the control group. (4) The subgroup analyses showed that the different qualities of the included studies were more effective than those of the control group. Conclusion Various psychological intervention is effective in decreasing the patient’s depression score, and cognitive-behavioral therapy and supportive psychotherapy, especially, can significantly improve the depression state and promote recovery.
肿瘤患者常常具有不适应情绪和行为反应,如焦虑、抑郁、悲伤、愤怒、恐惧等。针对这类患者的特征,我们对肿瘤科查房模式进行探讨,旨在缓解患者的不良情绪,提高肿瘤患者的治疗疗效,降低医疗风险。
目的:了解地震住院伤员的身心状态,进行针对性心理干预。方法:采用方便抽样,应用作者根据应激理论设计的应激身心反应调查表［1］,通过对地震伤员的观察和访谈,对在2008年5月12日至5月30日在四川大学华西医院住院的371名地震伤员进行身心状态的评估,并进行有针对性的心理干预。结果:①地震伤员灾后急性期心身应激反应较严重,其中出现频率最多的症状是睡眠困难,对突然的噪音或声音感到紧张害怕,心情沮丧,感到身体紧张,心情难以平静;②不同性别地震伤员身心反应存在一定差异,女性反应症状重于男性;③年龄在小于12岁、12～18岁和41～50岁年龄段地震伤员的身心反应与其他年龄段地震伤员的身心反应存在差异;④地震伤员的身心反应与其性别、年龄、文化、个人受伤情况有关。结论:地震伤员灾后身心反应严重,急性期给予针对性心理干预十分重要。
ObjectiveTo explore the application and effect of peer education combined with group psychological intervention in patients with spinal cord injury.Methodspatients with spinal cord injury admitted to the Rehabilitation Medicine Center of West China Hospital, Sichuan University from April to June 2019 were selected. According to the random number table method, the patients were randomly divided into the control group and the experimental group. The patients in the control group received routine psychological nursing intervention; while those in the experimental group were given routine psychological nursing intervention, supplemented by peer education and group psychological intervention. Before and 1 month after the intervention, the self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), the Short Form-36 (SF-36), and the compliance of rehabilitation treatment were compared between the two groups.ResultA total of 51 patients with spinal cord injury were admitted and 40 were eventually included, with 20 in each group. Before the intervention, there was no statistically significant difference between the two groups in SAS, SDS, SF-36 or rehabilitation treatment compliance (P>0.05). After the intervention, SAS [(28.60±3.30) points], SDS [(33.35±2.32) points], SF-36 [(86.60±4.56) points], and the rehabilitation treatment compliance [(83.28±5.07) %] in the experimental group were significantly improved compared with those in the control group [(34.75±6.17) points, (45.90±3.81) points, (80.90±5.19) points, (75.61±5.94) %; t=−3.932, −12.580, −3.694, 4.397, P<0.001]. After the intervention, SAS and SDS of the experimental group decreased compared with those before the intervention (P<0.05); while SF-36 and rehabilitation treatment compliance were higher than those before the intervention (P<0.05). Compared with those before the intervention, the SAS, SDS, SF-36 and rehabilitation treatment compliance of the control group after the intervention were not statistically significant (P>0.05).ConclusionGroup psychological intervention combined with peer education can effectively promote the psychological rehabilitation of patients with spinal cord injury and improve the curative effect and patients' quality of life.