线上结构式团体认知行为治疗对抗疫一线护士抑郁情绪的干预作用

Effect of internet-based structured group cognitive behavior therapy on depression of anti-epidemic frontline nurses

目的:探讨线上结构式团体认知行为治疗(I-GCBT)对抗疫一线护士抑郁情绪的干预作用。方法:对抗疫一线工作的220名护士进行问卷调查及患者健康问卷抑郁症状群量表(PHQ-9)评估;对有抑郁情绪的121名护士按照随机数字表法分为研究组60例与对照组61例;两组在线上心理健康教育(共3场,每场1 h)的基础上,联合进行I-GCBT(每周1次,每次1.5 h,共12次)对研究组进行干预。干预6及12周末采用PHQ-9对两组护士的抑郁情绪进行评估。结果:①干预后研究组54名、对照组53名护士完成12周观察,两组一般资料差异无统计学意义。②干预6及12周研究组PHQ-9评分明显低于对照组(P均<0.01);重复测量方差分析显示:在PHQ-9评分上时间效应、组别效应及交互效应显著(P均<0.01);③对于轻度抑郁者,在PHQ-9评分上时间效应及交互作用具有显著统计意义(P均<0.01);组别效应不显著;对于中度及以上抑郁者,在PHQ-9评分上组别效应、时间效应及交互作用均具有显著统计学意义(P均<0.01)。结论:I-GCBT联合心理健康教育对中度以上抑郁情绪的抗疫一线护士的有积极的作用。

Objective:To explore the therapeutic effect of internet-based structured group cognitive behavior therapy on depression of anti-epidemic front-line nurses.Method:A total of 220 nurses were enroled in this study,121 nurses with moderate depression and above were randomly divided into study group(n=60)and control group(n=61).Both groups were given online mental health education three times(1 hour each).The study group received online mental health education combined with Internet-based structured Group Cognitive Behavior Therapy(I-GCBT).The depressive mood of the two groups of anti-epidemic front-line nurses was evaluated by the Patient Health Questionnaire Depression Symptom Group Scale(PHQ-9)before intervention,6 weeks and 12 weeks after intervention.Results:①There were 54 nurses in the study group and 53 nurses in the control group at end of intervention;no significant difference in demographic information between the two groups was found(P<0.05).②The study group demonstrated lower PHQ-9 score than the control group after the intervention(P<0.05).The repeated measurs analysis of variance results presented significant group effect,time effect and interaction effect on PHQ-9 score(Ftime=289.027,Fgroup=8.966,Finteraction=17.578;all P<0.05).③For the nurses with mild depression,on PHQ-9 scores there was no significant group effect(Fgroup=0.124,P>0.05)but significant time effect and interaction effect(Ftime=519.539,Finteraction=9.387,all P<0.05).For the nurses with moderate depression or above,on PHQ-9 scores there were significant group effect,time effect and interaction effect(Ftime=169.265,Fgroup=4.698,Finteraction=29.211,all P<0.05).Conclusion:I-GCBT combined with online mental health education has a positive effect on anti-epidemic nurses with moderate depression or above,but the effect on mild depression is not obvious.