心理护理及健康教育对冠心病合并抑郁、焦虑患者的效果

Effect of psychological nursing and health education in coronary heart disease patients with depression and anxiety

目的探讨心理护理及健康教育干预对伴有抑郁、焦虑的冠心病患者的影响。方法将我院2017年4月~2019年4月期间收治的伴有抑郁、焦虑的冠心病患者100例随机分组:开展心理疏导及健康教育干预(观察组,n=50)与施以常规护理(对照组,n=50)。比较两组患者的认知及自我效能评分、焦虑及抑郁评分、心功能指标水平、生活质量评分。结果干预前,两组的认知评分、自我效能评分、HAMA评分和HAMD评分经测验无差异(P>0.05),干预后,认知评分、自我效能评分均有提升,HAMA评分和HAMD评分均有降低,且观察组变化程度较对照组更为显著(P<0.05);两组干预前,心功能指标BNP、LVEF及冠状动脉IMR经测定无差异(P>0.05),干预后,BNP均有降低,LVEF、冠状动脉IMR均有升高,观察组变化程度更为明显(P<0.05)。两组干预前,ADL评分经测验无差异(P>0.05),干预后,测定值明显提升,观察组提升程度更为显著(P<0.05)。结论对伴有抑郁、焦虑的冠心病患者开展心理疏导及健康教育干预,可提升认知水平,增强自我效能感,改善冠心病症状,消除负性情绪,增强心功能,提高生活质量。

Objective To explore the effect of psychological counseling and health education intervention on prognosis of coronary heart disease patients with depression and anxiety. Methods 100 coronary heart disease patients with depression and anxiety were selected and divide into two groups :psychological counseling and health education intervention(observation group,n=50)and routine nursing(control group,n=50). Cognitive and self-efficacy score,anxiety and depression score,cardiac function index level and quality of life score were compared between two groups. Results Before the intervention,there was no difference in the scores of cognitive,self-efficacy,HAMA and HAMD between the two groups(P>0.05). After the intervention,the scores of cognitive,self-efficacy,HAMA,HAMD and ADL were all improved in both of two groups,and the degree of improvement in the observation group was more significant than those in the control group(P<0.05). Before the intervention,the BNP,LVEF and coronary IMR were not different(P>0.05),after the intervention,BNP,LVEF and IMR were all improved in both of two groups,and the degree of improvement in the observation group was more significant than those in the control group(P<0.05). Conclusion The psychological counseling and health education intervention can improve cognitive level,enhance self-efficacy,improve symptoms of coronary heart disease,eliminate negative emotions,enhance heart function and improve life in the coronary heart disease patients with depression and anxiety.