心理干预对急性冠脉综合征患者介入治疗前后负性情绪和生存质量的影响

Impact of Psychological Intervention on Negative Emotion and Life Quality in Acute Coronary Syndrome Patients Undergoing Percutaneous Coronary Intervention

目的探讨心理干预对急性冠脉综合征(ACS)患者介入治疗前后负性情绪和生存质量的影响。方法选择2008年1月至2010年12月住院的ACS患者80例。按随机数字表法分成试验组40例,对照组40例,采取症状自评表(SCL-90),抑郁自评量表(SDS),焦虑自评量表(SAS),生存质量量表(ARES-S)进行心理状态和生命质量的追踪评估,并根据初期的评估结果对试验组进行有针对性的心理干预,并对干预结果进行分析,评定2组之间的差别。结果 ACS患者介入治疗前的心理健康状况较差,焦虑、抑郁情况明显、生命质量明显下降;试验组干预前各评定结果分别为SDS(54.6±7.4)分、SAS(53.6±5.2)分、SCL-90评分中焦虑(2.4±0.6)分、CARES-SF(28.4±12.4)分。干预1个月后,患者无论在心理状态和生命质量上均较干预前有显著改善,各量表评分分别为SDS(41.8±7.5)分、SAS(42.6±5.5)分、SCL-90评分中焦虑(1.6±0.4)分、CARES-SF(35.5±12.7)分,前后分值比较差异均有统计学意义(P<0.01或P<0.05)。而对照组干预前后上述分值比较差异无统计学意义。因此,试验组在心理干预后负性情绪(抑郁、焦虑、敌对、恐惧)明显减少(前两者P<0.01,后两者P<0.05),生存质量明显提高。结论心理干预能有效地改善ACS患者的负性情绪和心理压力,有利于提高生存质量和度过围手术期。

Objective To observe the impact of psychological intervention on negative emotion and life quality in acute coronary syndrome（ACS） patients undergoing percutaneous coronary intervention.Methods Eighty ACS patients hospitalized in our hospital between January 2008 and December 2010 were randomly divided into experimental group（n=40） and control group（n=40）.Psychological status and life quality were assessed by self-assessment form（SCL-90）,self-rating depression scale（SDS）,self-rating anxiety scale（SAS） and life quality scale（ARES-S）.The targeted psychological intervention was given according to the initial assessment results and intervention results were analyzed to investigate the differences between the two groups.Results Patients had poor mental health with anxiety,depression and decreased life quality before percutaneous coronary intervention.The SDS,SAS,SCL-90 score（anxiety）and CARES-SF scores were 54.6±7.4,53.6±5.2,2.4±0.6 and 28.4±12.4,respectively.At 1 month after psychological intervention,psychological status and life quality of patients significantly improved.The SDS,SAS,SCL-90 and CARES-SF scores were 41.8±7.5,42.6±5.5,1.6±0.4 and 35.5±12.7,respectively.These scores were significantly different before and after intervention（P0.01 or P0.05）.Negative emotions（depression,anxiety,hostility and fear） in experimental group significantly decreased after psychological intervention（P0.01 or P0.05）.Conclusion Psychological intervention can effectively relieve negative emotion and psychological stress and help to improve life quality throughout the perioperative period in ACS patients undergoing percutaneous coronary intervention.