家庭行为认知干预用于COPD合并抑郁焦虑情绪患者的疗效

The effect of family behavior cognitive intervention on COPD patients with depression and anxiety

目的探讨家庭行为认知干预用于慢性阻塞性肺疾病(Chronic obstructive pulmonary disease,COPD)合并抑郁焦虑情绪患者的效果。方法选择2015年1月至12月在我院接受治疗的140例合并抑郁焦虑情绪的COPD患者,用随机数表法分为对照组和干预组,每组各70例。对照组给予常规的COPD护理干预,干预组在对照组的基础上给予家庭行为认知干预。结果干预前两组患者的焦虑自评量表(SAS)和抑郁自评量表(SDS)评分组间对比无明显差异(P>0.05),干预后两组患者的SAS和SDS评分均出现明显下降,且干预组患者的SAS和SDS评分低于对照组,上述差异均有统计学意义(P<0.05)。干预前两组患者的第1秒用力呼气量(FEVl)、第1秒用力呼气容积占预计值百分比(FEVl/FVC)和用力肺活量(FVC)等肺功能指标比较,差异无统计学意义(P>0.05),干预后两组患者的肺功能指标与干预前相比均明显改善,且干预组患者的肺功能指标明显优于对照组,差异有统计学意义(P<0.05)。干预前两组患者的圣乔治呼吸问卷(SGRQ)评分中症状部分、活动能力、疾病影响和总分组间差异无统计学意义(P>0.05),干预后两组患者的上述指标评分均明显下降,且干预组患者的评分低于对照组,生活质量更高,差异有统计学意义(P<0.05)。干预前两组患者缩唇呼吸、腹式呼吸和全身性呼吸体操等康复训练的依从性相近(P>0.05),干预后两组患者的依从性均出现提高,且干预组患者的依从性高于对照组,差异有统计学意义(P<0.05)。结论在常规护理干预措施的基础上增加家庭行为认知干预,可以更明显改善COPD合并抑郁焦虑情绪患者的不良情绪,提高康复训练依从性,从而提高肺功能和生活质量。

Objective To investigate the effect of family behavior cognitive intervention on COPD patients with depression and anxiety. Methods A total of 140 cases of COPD patients with depression and anxiety were selected and divided into the intervention group and the control group randomly, with 70 cases in each group. Patients in the con- trol group were performedwith the routine COPD nursing; based on this intervention, those in the intervention group were alsoperformedwith family behavior cognitive intervention. Results There were no significant differences of scores of SAS and SDS between the two groups before nursing intervention （P〉0.05） . The scores of SAS and SDS of the two groups after intervention were significantly lower thanthose of the two groups before intervention （ P〈0.05 ）, and the scores in the intervention group were significantly lower than those in the control group （P 〈 0.05 ） . There were no sig- nificant differences of indexes of pulmonary function such as FEVj, FEVj/FVC, FVC between the two groups before nursing intervention （P 〉 0.05 ） . Theindexes of pulmonary function mentioned above of the two groups after intervention were significantly better thanthose of the two groups before intervention, and the indexes in the intervention group were significantly better than those in the control group （ P 〈 0.05 ） . There were no significant differences of scores of symp- tom, activity, disease influence and total scores of SGRQ between the two groups before nursing intervention （P 〉 0.05 ） .The scores ofthe indexes above of SGRQ of the two groups after intervention were significantly lower thanthose of the two groups before intervention （ P〈0.05 ）, and the scores in the intervention group were significantly lower than those in the control group （ P 〈 0.05 ） . The compliance of the rehabilitation training, such as the reduction of lip breathing, abdominal breathing and systemic respiratory gymnastics between the two groups before nursing intervention were simi- lar （ P 〉 0.05 ） . The compliance of the two groups were both improved after nursing intervention, and the compliance of the intervention group was higher than that of the control group, the differences above were statistically significant （P 〈 0.05 ）. Conclusion The implementation of family cognitive behavioral intervention based on the routine nursing intervention measures can significantly improve the negative emotions such as depression and anxiety, the compliance of rehabilitation training and the pulmonary function and quality of life of patients with COPD.