价值取向综合干预对老年抑郁症患者生活质量及主观幸福感的影响

Effect of comprehensive value-oriented intervention on quality of life and subjective well-being of elderly patients with depression

目的探讨价值取向综合干预措施对老年抑郁症患者生活质量及主观幸福感的影响。方法选择2018年1月至2019年9月新乡医学院第二附属医院收治的86例老年抑郁症患者为研究对象,根据治疗方法将患者分为观察组(n=44)和对照组(n=42)。对照组患者根据病情接受相应的常规药物治疗。观察组患者在对照组常规治疗基础上进行价值取向综合干预,包括一般性心理干预、认知干预、正念治疗、价值取向治疗,干预周期为3个月。分别于干预前、干预3个月时,采用简易应对方式问卷(SCSQ-19)评估患者在日常生活中遇到问题时所采取的态度和措施,包括积极应对和消极应对2个维度;采用世界卫生组织生存质量测定量表简表(WHOQOL-BREF)评估患者的生存质量,包含总体生存质量及生理功能、心理功能、环境领域和社会关系4个领域;采用纽芬兰纪念大学幸福度量表(MUNSH)评估患者的主观幸福感,包含正性情感和负性情感2个维度。结果对照组患者干预3个月时的积极应对和消极应对维度评分与干预前比较差异无统计学意义(P>0.05);观察组患者干预3个月时的积极应对维度评分显著高于干预前,消极应对维度评分显著低于干预前(P<0.05);干预3个月时,观察组患者的积极应对维度评分显著高于对照组,消极应对维度评分显著低于对照组(P<0.05)。对照组患者干预3个月后的总体生存质量及生理功能、心理功能、社会关系、环境领域评分与干预前比较差异无统计学意义(P>0.05);观察组患者干预3个月时的总体生存质量及生理功能、心理功能、社会关系、环境领域评分均显著高于干预前;干预3个月时,观察组患者的总体生存质量及生理功能、心理功能、社会关系、环境领域评分均显著高于对照组(P<0.05)。对照组患者干预前与干预3个月的正性情感评分、负性情感评分、MUNSH总分比较差异无统计学意义(P>0.05);观察组患者干预3个月的正性情感评分、MUNSH总分均显著高于干预前,负性情感评分显著低于干预前(P<0.05);观察组患者干预3个月的正性情感评分、MUNSH总分显著高于对照组,负性情感评分显著低于对照组(P<0.05)。结论在常规药物治疗的基础上,价值取向综合干预能帮助老年抑郁症患者正确应对抑郁情绪,显著提高其生活质量和主观幸福感。

Objective To explore the effect of comprehensive value-oriented intervention on quality of life and subjective well-being of elderly patients with depression.Methods A total of 86 elderly patients with depression admitted to the Second Affiliated Hospital of Xinxiang Medical University from January 2018 to September 2019 were selected as the research objects,and they were divided into the observation group(n=44)and the control group(n=42)according to the treatment method.The patients in the control group received corresponding conventional drug treatment according to their condition.The patients in the observation group were given comprehensive value-oriented intervention on the basis of conventional treatment in the control group,including general psychological intervention,cognitive intervention,mindfulness therapy and value-oriented therapy;the treatment cycle was 3 months.Before intervention and at 3 months after intervention,the attitudes and measures taken by the elderly patients when they encountered problems in daily life were evaluated by the simplified coping style questionnaire(SCSQ-19),including positive coping dimension and passive coping dimension;the quality of life of patients was evaluated by the World Health Organization's quality of life scale(WHOQOL-BREF),including overall quality of life and physiological function domain,psychological function domain,environment domain and social relation domain;the subjective well-being of the patients was evaluated by the Memorial University of Newfoundland Scale of Happiness(MUNSH),including dimensions of positive affect and negative affect.Results There was no significant difference in the scores of positive coping dimension and negative coping dimension of patients in the control group at 3 months of intervention compared with those before intervention(P>0.05);the positive coping dimension score of the patients in the observation group at 3 months of intervention was significantly higher than that before intervention,and the negative coping dimension scores was significantly lower than that before intervention(P<0.05);at 3 months of intervention,the positive coping dimension score of patients in the observation group was significantly higher than that in the control group,and the negative coping dimension score was significantly lower than that in the control group(P<0.05).There was no significant difference in the overall quality of life and physiological function,psychological function,environment domain and social relation domain scores of patients in the control group at 3 months of intervention compared with those before intervention(P>0.05);the overall quality of life and physiological function,psychological function,environment domain and social relation domain scores of patients in the observation group at 3 months of intervention were significantly higher than those before intervention(P<0.05);at 3 months of intervention,the overall quality of life and physiological function,psychological function,environment and social relation domain scores of patients in the observation group were significantly higher than those in the control group(P<0.05).There was no significant difference in the positive emotion score,negative emotion score and MUNSH total score of patients in the control group at 3 months of intervention compared with those before intervention(P>0.05);the positive emotion score and MUNSH total score of patients in the observation group at 3 months of intervention were significantly higher than those in the control group,and the negative emotion score was significantly lower than that in the control group(P<0.05).Conclusion On the basis of conventional drug therapy,comprehen sive value-oriented intervention can help elderly depression patients to cope with depression correctly,and significantly improve their quality of life and subjective well-being.