理性情绪行为疗法在居家慢性阻塞性肺疾病伴抑郁状态病人中的应用效果

Application effect of rational emotional behavior therapy for home chronic obstructive pulmonary disease patients with depression

[目的]探讨理性情绪行为疗法在居家慢性阻塞性肺疾病(COPD)伴抑郁状态病人中的应用效果。[方法]选取2016年12月—2017年6月青岛市某三级甲等医院出院后的居家伴抑郁状态的COPD病人72例,随机分为观察组36例和对照组36例,其中观察组用理性情绪行为疗法进行6周的心理干预,对照组进行常规电话随访。应用抑郁自评量表、匹兹堡睡眠质量指数量表、COPD自我效能量表、总体幸福感量表、6分钟步行试验评价干预效果。[结果]干预前两组病人的抑郁、睡眠质量、自我效能、总体幸福感评分和6分钟步行距离差异无统计学意义(P>0.05);干预后观察组抑郁、睡眠质量评分低于对照组,自我效能、总体幸福感评分和6分钟步行距离高于对照组(P<0.05)。[结论]运用理性情绪行为疗法对居家COPD伴抑郁状态的病人进行干预,可帮助病人建立合理的认知模式,缓解抑郁情绪,改善睡眠质量,提高自我效能、总体幸福感和运动能力。

Objective:To explore the application effect of rational emotive behavior therapy on home chronic obstructive pulmonary disease(COPD) patients complicated with depression.Methods:A total of 72 home COPD patients with depression were selected from December 2016 to June 2017 after discharging from a third grade A hospital in Qingdao,were randomly divided into the experimental group(36 cases) and the control group(36 cases).The patients in experimental group were given rational emotive behavior therapy for 6 weeks,while the patients in control group were given conventional telephone follow-up.The Self-Rating Depression Scale(SDS),Pittsburgh Sleep Quality Index(PSQI),COPD Self-Efficacy Scale(CSES),General Well-Being Schedule(GWB),6-minute walk test(6MWT) were used to evaluate the effect of rational emotive behavior therapy.Results:There were no significant differences in the scores of SDS、PSQI、CSES、GWB and 6MWD between the two groups before intervention( P >0.05).After intervention,the SDS and PSQI scores in experimental group were significantly lower than those in control group,the CSES、GWB scores and 6MWD in experimental group were significantly higher than those in control group,and the difference was statistically significant( P <0.05 for all).Conclusions:Rational emotive behavior therapy for home COPD patients with depression can help patients to establish a reasonable cognitive model to relieve depression,improve sleep quality,improve self-efficacy,overall well-being and exercise capacity.