继续动机性访谈对脑梗死后抑郁患者的影响

Effects of Continuing Motivational Interview in Patients with Depression after Cerebral Infarction

目的：探讨继续动机性访谈联合居家护理对脑梗死后抑郁出院患者服药依从性和生活质量的影响。方法：收集2015年9月-2016年9月我院脑梗死后抑郁出院患者80例,随机分为观察组和对照组各40例,两组患者出院时均接受常规出院指导,对照组给予居家护理干预,观察组在对照组的基础上联合应用继续动机性访谈干预;比较两组患者出院6月后服药依从性的改变,对患者进行汉密尔顿抑郁量表（HAMD）评分,采用健康状况问卷量表（SF-36）对患者进行生命质量评估,分析并比较其结果的差异性。结果：观察组出院6月后对疾病的认知程度（t=9.747,P〈0.05）、不良习惯改变情况（t=9.826,P〈0.05）、自我护理能力（t=9.577,P〈0.05）、情绪控制能力（t=8.889,P〈0.05）均明显优于对照组;观察组出院6月后药物依从率（95.0%）较对照组（72.5%）明显上升（χ~2=5.878,P〈0.05）;观察组HAMD评分（t=9.791,P〈0.05）和HAMA评分（t=9.682,P〈0.05）明显优于对照组;观察组SF-36各维度评分均明显高于对照组（t=9.850,7.230,4.398,7.850,8.854,9.591,8.867,8.769;P〈0.05）。结论：出院后继续动机性访谈能帮助患者及家属获得最佳院外延续性护理方案,通过提高患者对疾病的认知程度、不良习惯改变情况、自我护理能力、情绪控制能力,能明显提高居家护理质量,进而达到改善脑梗死后抑郁出院患者服药依从性和生活质量的目的。

Objective：To explore the effects of continuing motivational interview combined with home nursing on medication compliance and quality of life in patients with depression after cerebral infarction.Methods：80 cases of discharged patients with depression after cerebral infarction from September 2015 to September 2016 in our hospital were collected for the study and randomly divided into the observation group and the control group with 40 cases in each group.The patients in the two groups were given routine discharge guidance when discharged,and the control group was given home nursing intervention and the observation group was given the combined application of continuing motivational interview intervention and home nursing invention.The changes of medication compliance were compared between the two groups after 6 months of discharge and the Hamilton Depression Scale（HAMD）score was made to patients.And the health status questionnaire（SF-36）was used to evaluate the quality of life.Results：At 6 months after discharge,the levels of cognition（t=9.747,P〈0.05）,adverse habits（t=9.826,P〈0.05）,self-care ability（t= 9.577,P〈0.05）and emotional control ability（t=8.889,P〈0.05）of the observation group were significantly better than those of the control group.The rate of drug compliance（95.0%）in the observation group was significantly increased compared with that in the control group（72.5%）after 6 months of discharge（χ~2=5.878,P〈0.05）.The HAMD score（t=9.791,P〈0.05）and HAMA score（t=9.682,P〈0.05）of the observation group were significantly better than those of the control group.The scores of SF-36 in the observation group were significantly higher than those in the control group（t=9.850,7.230,4.398,7.850,8.854,9.591,8.867,8.769;P〈0.05）.Conclusion：Continuing motivational interview after discharge can help patients and their families get the best outpatient continuous care programs,and can significantly improve the quality of home nursing to improve the medication compliance and quality of life in patients with depression after cerebral infarction by improving the patient＇s cognition of the disease,the changes of bad habits,self-care ability and emotional control.