认知-行为团体心理咨询对老年冠心病患者抑郁和焦虑及服药依从性的影响研究

Effects of cognitive-behavioral group psychotherapy on depression, anxiety and medication adherence in aged patients with coronary heart disease

目的探讨认知-行为团体心理咨询与老年冠心病患者抑郁、焦虑负性情绪及服药依从性的作用。方法对青海省某两个社区伴有轻中度抑郁、焦虑80例老年冠心病患者，运用随机数字表法分为干预组（40例）和对照组（40例）。对照组给予常规护理。干预组在对照组基础上给予8周认知-行为团体心理咨询治疗，干预前、干预后、干预第3个月、干预后第6个月，采用Zung抑郁自评量表、焦虑自评量表及Morisky自我报告式的依从性量表，对两组老年性冠心病患者焦虑、抑郁情绪和服药依从性进行调查。结果观察组老年冠心病患者抑郁、焦虑情绪及服药依从性的改善程度高于对照组（F＝22.805、48.058、128.058，均P〈0.05）。干预后不同时间点干预组抑郁、焦虑情绪得分均低于对照组，服药依从性得分高于对照组，差异有统计学意义（均P〈0.012）。结论认知-行为团体心理咨询可减轻老年冠心病患者的抑郁、焦虑情绪，改善服药依从性。

ObjectiveTo assess the effects of cognitive-behavioral group psychotherapy on depression, anxiety and medication adherence in elderly patients with coronary heart disease.MethodsEighty patients from two communities in Qinghai province were randomly divided into intervention group （n=40） and control group （n=40）. In addition to regular care for both groups, patients in the intervention group also received cognitive-behavioral group psychotherapy.Depression, anxiety and medication adherence were measured with the Zung Self-Rating Depression Scale （SDS）, the Zung Self-Rating Anxiety Scale （SAS） and the eight-item Morisky Medication Adherence Scale （MMAS-8）, respectively, at baseline, immediately after intervention, at 3 months after intervention, and at 6 months after intervention.ResultsThe repeated-measures ANOVA showed that improvement in depression, anxiety and medication adherence before and after intervention in the intervention group was greater than in the control group （F=22.805, 48.058, 128.058, all P〈0.05）. Scores for depression and anxiety were lower and scores for medication adherence were higher （all P〈0.05） in the intervention group than in the control group at all the time points after intervention.ConclusionsCognitive-behavioral group psychotherapy can alleviate depression and anxiety, and improve medication adherence in elderly patients with coronary heart disease.