护理干预对慢性阻塞性肺疾病伴抑郁患者预后及生活质量的影响

Effect of nursing intervention on prognosis and life quality for COPD combined depression patients

目的探讨护理干预对慢性阻塞性肺疾病(COPD)伴抑郁患者预后及生活质量的影响。方法将132例合并抑郁的COPD患者随机分为干预组和对照组各66例。对照组采用常规护理方法,干预组在此基础上实施护理干预,包括心理干预、行为干预、呼吸功能康复训练等。4个月后采用汉密尔顿抑郁量表(HAMD)评价两组患者抑郁改善情况,采用圣乔治呼吸问卷(SGRQ)评价患者生活质量。随访1年,统计两组患者急性发作次数。结果经过护理干预,干预组患者肺功能、抑郁程度、生活质量较干预前发生明显改变,差异均有统计学意义(P<0.01),和对照组比较FEV1、FEV1/FVC、HAMD量表评分以及SGRQ问卷中的疾病影响部分和总分两项指标均有统计学意义(P<0.05或0.01)。对照组护理前后,除FEV1差异有统计学意义外(P<0.01),其余各项指标均与护理前没有显著性差异(P>0.05)。随访1年,两组COPD急性发作次数比较差异有统计学意义(P<0.01)。结论对于COPD合并抑郁的患者,实施有针对性的护理干预,能有效减轻抑郁症状、改善肺功能、减少急性发作次数、提高患者的生活质量。

Objective To explore the effect of nursing intervention on prognosis and life quality for chronic obstructive pulmonary disease（COPD） combined depression patients.Methods A hundred and thirty-two cases of COPD patients with depression were randomized into intervention group and control group with 66 cases respectively.The control group received routine nursing care,while the intervention group was implemented nursing intervention on the basis of routine nursing care,which included psychological intervention,behavior intervention and respiratory rehabilitation training.After 4 months,the depression situation of two group＇s patients was assessed using Hamilton Depression Scale（HAMD）,and quality of life was evaluated using St George＇s Respiratory Questionnaire（SGRQ）.The acute outbreak frequency of two groups was calculated after follow-up for 1 year.Results After nursing intervention,patients＇ pulmonary function,the degree of depression and life quality of the intervention group changed significantly,as compared with those before the intervention,the differences were statistically significant（P 〈 0.01）.Compared with the control group FEV1,FEV1/FVC,HAMD score,two indicators of disease part and total score in SGRQ questionnaire of the intervention group were significantly different（P 〈0.05 or 0.01）.In control group,except the difference between FEV1statistically significant before and after care（P 0.01）,other indicators showed no significant difference（P 〉0.05）.After 1 year of follow-up,acute outbreak frequencies of two groups were significantly different（P 〈 0.01）.Conclusions For COPD patients with depression,the implementation of targeted nursing intervention can effectively reduce symptoms of depression,promote lung function,improve the living quality and reduce the frequency of acute outbreak.