综合心理干预对慢性心力衰竭患者焦虑与抑郁状态的影响

Effect of comprehensive psychological intervention on anxiety and depression in patients with chronic heart failure

目的：探讨以团体认知行为干预为主的综合性心理干预措施对慢性心力衰竭患者的焦虑及抑郁状态的效果。方法选取2012年1月—2013年12月收治的100例慢性心力衰竭患者为研究对象，采用随机数字表法将患者分为干预组和对照组各50例。对照组患者在住院期间实施常规护理，干预组在此基础上进行团体认知行为干预为主的综合心理干预。采用焦虑自评量表（ SAS）和抑郁自评量表（ SDS）比较两组患者的焦虑和抑郁情况。结果基线时，总体焦虑发生率为25％，其中轻度11例，中度10例，重度4例；总体抑郁发生率为39％，其中轻度19例，中度14例，重度6例。对照组和干预组干预后SAS及SDS得分均优于干预前，干预组分别为（36．90±8．465），（27．53±7．162）分，较对照组的（40．91±8．019），（36．78±10．562）分改善更明显，且差异有统计学意义（t分别为9．244，10．335；P＜0．01）。结论团体认知行为干预为主的综合心理干预策略能有效地缓解和改善慢性心力衰竭患者的焦虑、抑郁情绪。

Objective To investigate the effect of group cognitive behavioral therapy on anxiety and depression in patients with chronic heart failure （ CHF ） .Methods One hundred patients with CHF were recruited from January 2012 to December 2013 in cardiovascular department , and were divided into the intervention group and the control group , with 50 patients each .Comprehensive intervention including routine heart failure care and group cognitive behavioral therapy combined with other therapies was adopted on the patients in the intervention group .The Self-rating Anxiety Scale （ SAS ） and the Self-rating Depression Scale （ SDS） were used to compare the difference of anxiety and depression between groups .Results At the baseline, the incidence of anxiety was 25%, within which 11 patients had mild anxiety , and 10 patients had moderate anxiety, and 4 patients had severe anxiety.The incidence of depression was 39%, within which 19 patients had mild depression , and 14 patients had moderate depression , and 6 patients had severe depression .The score of SAS and SDS in the intervention group after intervention were （36.90 ±8.465） and （27.53 ±7.162）, respectively, which were significantly lower than （40.91 ±8.019） and （36.78 ±10.562） in the control group （t=9.244,10.335, respectively;P〈0.01）.Conclusions Group cognitive behavioral therapy can effectively relieve the anxiety and depression in patients with chronic heart failure .