团体认知行为疗法联合饮食干预对血液透析患者心理和残余肾功能的影响

Effects of cluster cognitive-behavioral therapy in combination with dietary intervention on psychology and residual renal function in hemodialysis patients

目的探讨团体认知行为疗法联合饮食干预对血液透析患者心理和残余肾功能的保护作用。方法将56例血液透析患者均分为对照组和观察组,各28例。对照组遵医嘱接受药物治疗、血液透析及健康教育;观察组在此基础上实施团体认知行为疗法联合饮食护理干预措施,具体包括进行负性自动想法、核心信念的识别及矫正,由营养师指导和制订个体化食谱。采用SCL-90症状自评量表、残余肾功能与尿量评价两组治疗前及治疗3个月后效果。结果两组抑郁、焦虑、躯体化症状、恐惧及其他分数,以及残余肾功能、尿量比较,差异有统计学意义(P<0.05,P<0.01)。结论团体认知行为疗法联合饮食干预可以有效地改善患者心理状态,改善患者的残余肾功能及尿量,提高生存质量。

Objective To explore the protective effects of cluster cognitive-behavioral therapy （C-CBT） in combination with dietary intervention on psychology and residual renal function （RRF） in hemodialysis patients.Methods Fifty-six hemodialysis patients were equally divided into a control group and an observation group.Patients in the control group were given medications,hemodialysis,and health education.Patients in the observation group additionally received C-CBT （recognition and correction of negative automatic thoughts and core beliefs） and individualized dietary intervention which was provided by a dietitian.The Symptom Checklist 90,RRF and urine volume were used to evaluate the effects after 3-month intervention.Results The scores of depression,anxiety,somatization,phobic anxiety,and additional items,as well as RRF and urine volume,had significant differences between the two groups（P＜0.05,P＜0.01）.Conclusion Cluster cognitive-behavioral therapy in combination with dietary intervention could effectively improve patient＇s mental health,RRF and urine volume.