CAT与HAD对慢性阻塞性肺疾病稳定期患者认知度干预后焦虑和抑郁状态评价临床研究

A clinical study of the CAT and HAD to evaluate the anxiety and depression after cognitive intervention in stable COPD patients

目的分析慢性阻塞性肺疾病(COPD)稳定期合并焦虑、抑郁患者的发病率,应用慢性阻塞性肺疾病评估测试量表(CAT)与医院焦虑/抑郁自评量表(HAD),评价认知度干预在COPD稳定期合并焦虑、抑郁患者中的应用。方法对河北省退役军人总医院220例COPD稳定期患者进行焦虑和抑郁(HAD)评估,了解患者焦虑、抑郁发生率;其中101例合并焦虑抑郁,经纳入排除标准共90例符合入组条件,将其依照随机表法分为2组,对照组、试验组,各45例,对照组给予常规护理,试验组在此基础上给予认知度干预,干预后2周对患者进行CAT量表、HAD量表评估,以及比较干预前后CAT量表、HAD量表的变化。结果220例COPD稳定期患者,焦虑抑郁发生率45.9%,其中12.3%单合并焦虑,4.1%单合并抑郁,29.5%同时合并焦虑、抑郁。经2周护理干预,试验组、对照组CAT评分均较之于前有明显下降(t=5.808、2.953,P值均<0.05),HAD评分均较之于前有明显下降(P值均<0.05);同时2组干预后CAT评分对比,试验组低于对照组(t=2.191,P<0.05),干预后HAD评分对比,试验组低于对照组(t=13.481、11.504,P值均<0.05)。结论COPD稳定期患者中存在较高的抑郁及焦虑情绪障碍。因此,采用CAT、HAD对COPD稳定期患者的焦虑、抑郁状态早期识别并予以认知度护理具有重要意义。

Objective To analysis the incidence of stable chronic obstructive pulmonary disese(COPD)with anxiety and depression.To evaluate the application of cognitive intervention in patients stable COPD patients with anxiety and depression by chronic obstructive pulmonary disease assessment test(CAT)scale and hospital lanxiety and depression scale(HAD).Methods Anxiety and depression(HAD scale)were evaluated in 220 patients with COPD in our hospital,to investigate the incidence of anxiety and depression in COPD patients.A total of 101 patients suffered from anxiety and depression in 220 patients of stable COPD.A total of 90 cases were included in the exclusion criteria,we randomly divide the COPD patents with anxiety and depression into two groups:control group and experimental group,45 cases in each group.The control group was given conventional nursing,and the experimental group was given cognitive intervention based on the control group.To analyze and compared the differences between the two groups for changes of CAT scale,HAD scale after 2 weeks.Results Among the 220 stable COPD patients,45.9%of them had anxiety and(or)depression.12.3%of them were only accompanied by anxiety,4.1%only with depression,and 29.5%with anxiety and depression.After 2 weeks of nursing intervention,the CAT scores of the experimental group and the control group were significantly lower than before(t=5.808,2.953,both P<0.05),HAD scores were significantly lower than before(all P<0.05),at the same time,the cat score of the experimental group was lower than that of the control group(t=2.191,P<0.05),after intervention,the had score of the experimental group was lower than that of the control group(t=13.481,11.504,both P<0.05).Conclusions There is a high prevalence rate of depression/anxiety symptom in patients with stable COPD.Thus,cognitive intervention is quite important for those detected stable COPD patients by CAT scale and HAD scale.