问题解决疗法在卒中后抑郁患者护理中的应用

Effect of problem-solving therapy in treating post-stroke depression

目的观察问题解决疗法在治疗卒中后抑郁的效果。资料与方法卒中后抑郁患者120例随机分为对照组(59例)与干预组(61例),所有患者均每日晨服氟西汀1片,对照组采取一般护理,干预组采用问题解决疗法进行护理;采用汉密尔顿抑郁量表(HAMD)评估患者治疗前后的抑郁程度。使用HAMD减分率评价患者治疗4周后疗效。结果治疗前,两组患者HAMD分数差异无统计学意义(P>0.05);治疗后第1、4周,干预组患者HAMD分数比治疗前及对照组均显著降低(P<0.05)。干预组中,治疗后第4周HAMD分数比第1周显著降低(P<0.05),对照组中,第4周较治疗前HAMD评分差异有统计学意义(P<0.05)。与对照组比较,干预组治疗后4周卒中后抑郁痊愈率、好转率、总有效率均显著增加(P<0.01)。结论问题解决疗法联合氟西汀治疗可有效降低卒中后抑郁HAMD评分。

Objective To find out the effect of problem-solving therapy in the treatment of post stroke depression. Method120 patients with post stroke depression were randomly divided into an experimental group（ n = 61） and a control group（ n= 59）. Both groups were required to take one tablet of Fluoxetine daily. The control group were administered with conventional care while the experimental group were cared with problem-solving therapy. The Hamilton depression scale（ HAMD） was used to measure the degree of depression in the subjects before and after intervention. Score reduction rate of the HAMD was used to evaluate the effect of treatment as obtained 4 weeks after intervention. Findings Before intervention,no significant difference was found in the HAMD scores between two groups（ P〉0. 05）. The HAMD scores of the experimental group obtained 1 week and 4 weeks after intervention were lower than those before intervention and those of the control group（ P〈0. 05）. The HAMD scores of the experimental group obtained 4 weeks after intervention were significantly lower than the scores obtained in the first week（ P〈0. 05）. The HAMD scores of the control group as obtained 4 weeks after intervention were significantly different from those obtained before intervention（ P〈0. 05）. there were significant differences at the 1 week and 4 week after strokes（ P〈0. 05）. Conclusion Problem-solving therapy plus Fluoxetine can result in significant lower HAMD scores of post stroke depression.