正念音乐训练对急性心肌梗死患者介入术后心理应激反应及睡眠质量的影响

Effects of mindfulness music training on psychological stress response and sleep quality in patients with acute myocardial infarction after percutaneous coronary intervention

目的探讨正念音乐训练对急性心肌梗死(AMI)行介入治疗(PCI)患者术后的心理应激反应和睡眠质量的影响。方法选择安康市中心医院2018年1月至2019年1月收治的200例AMI行PCI治疗者,采用随机数表法分为对照组和观察组,每组100例,对照组接受常规护理,观察组则接受常规护理+正念音乐训练。术后1d和7d分别采用汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)评价两组患者术后焦虑、抑郁不良心理应激改善情况,采用视觉模拟评分(VAS)评价疼痛程度,采用匹兹堡睡眠质量指数(PSQI)评价睡眠质量,采用心肌梗死多维度量表(MIDAS)评价生活质量情况。结果两组患者术后1d的HAMA、HAMD评分、VAS评分、PSQI评分、MIDAS评分比较差异均无统计学意义(P>0.05);观察组和对照组患者术后7d的HAMA评分[(17.06±1.84)分vs(21.05±2.08)分]、HAMD评分[(16.03±1.75)分vs(19.27±2.02)分]、VAS评分[(1.52±0.38)分vs(2.64±0.62)分]、PSQI评分[(7.61±0.84)分vs(11.57±1.26)分]、MIDAS评分[(22.14±2.38)分vs(34.27±3.51)分]比较,观察组均明显低于对照组,差异均有统计学意义(P<0.05)。结论正念音乐训练可改善AMI行PCI治疗者的焦虑、抑郁等不良心理应激,减轻疼痛程度,改善睡眠质量及生活质量。

Objective To explore effects of mindfulness music training on psychological stress response and sleep quality in patients with acute myocardial infarction (AMI) after percutaneous coronary intervention (PCI). Methods A total of 200 AMI patients undergoing PCI who were admitted to Ankang Central Hospital from January 2018 to January 2019 were enrolled and divided into control group and observation group according to random number table, with 100 patients in each group. The patients in the control group were given routine nursing, while those in the observation group were given routine nursing and mindfulness music training. At 1 d and 7 d after surgery, Hamilton Anxiety Scale (HAMA) and Hamilton Depression Scale (HAMD) were performed to evaluate improvement of postoperative anxiety and depression in both groups. The visual analogue scale (VAS) score was used to evaluate pain degree. Pittsburgh Sleep Quality Index (PSQI) was performed to evaluate sleep quality. The quality of life was assessed by Myocardial Infarction Dimensional Assessment Scale (MIDAS). Results At 1 d after surgery, there was no significant difference in HAMA, HAMD, VAS, PSQI or MIDAS scores between the two groups (P>0.05). At 7 d after surgery, scores of HAMA, HAMD, VAS, PSQI, and MIDAS were (17.06±1.84) points,(16.03±1.75) points,(1.52±0.38) points,(7.61±0.84) points,(22.14±2.38) points in the observation group, significantly lower than (21.05±2.08) points,(19.27±2.02) points,(2.64± 0.62) points,(11.57±1.26) points,(34.27±3.51) points in the control group (P<0.05). Conclusion Mindfulness music training can improve anxiety, depression and other adverse psychological stress of AMI patients undergoing PCI, reduce pain stress, as well as improve sleep quality and quality of life.