基于信息-动机-行为技巧模型的认知行为疗法对前庭功能障碍患者负性情绪的影响

Effects of cognitive behavioral therapy based on the Information-Motivation-Behavioral Skills model on negative emotions in patients with vestibular dysfunction

目的探讨基于信息-动机-行为技巧(IMB)模型的认知行为疗法对前庭功能障碍患者焦虑、抑郁等负性情绪的影响。方法纳入本院2021年3月—2023年9月收治的154例前庭功能障碍患者,使用简单随机抽样法分别纳入观察组(n=77)、对照组(n=77)。2组均接受常规治疗和干预,观察组加用基于IMB模型的认知行为疗法干预。比较2组干预前后抑郁-焦虑-压力自评量表(DASS-21)、眩晕残障量表(DHI)、前庭康复获益问卷(VRBQ)、跌倒风险问卷(FRQ)、自我护理能力量表(ESCA)评分和平衡功能变化。结果2组干预4周后DASS-21中抑郁、焦虑、压力维度评分均较干预前下降,且观察组干预4周后评分均较对照组更低,差异有统计学意义(P<0.05)。2组干预4周后DHI中躯体、情感、功能维度评分均较干预前下降,且观察组干预4周后评分均较对照组更低,差异有统计学意义(P<0.05)。2组干预4周后VRBQ、FRQ评分均较干预前下降,ESCA评分均较干预前升高,观察组干预4周后VRBQ、FRQ评分均较对照组更低,其ESCA评分较对照组更高,差异有统计学意义(P<0.05)。2组干预4周后平衡功能均较干预前改善,观察组干预4周后平衡功能优于对照组,差异有统计学意义(P<0.05)。结论基于IMB模型的认知行为疗法能够帮助前庭功能障碍患者改善焦虑、抑郁等负性情绪,同时促进患者临床症状的好转和自护能力的提升,进而实现康复质量的提高。

Objective To investigate the effects of cognitive behavioral therapy based on the Information-Motivation-Behavioral Skills(IMB)model on anxiety,depression,and other negative emotions in patients with vestibular dysfunction.Methods A total of 154 patients with vestibular dysfunction admitted to our hospital from March 2021 to September 2023 were enrolled and randomly divided into observation group(n=77)and control group(n=77)using simple random sampling.Both groups received routine treatment and intervention,while the observation group received additional cognitive behavioral therapy based on the IMB model.The Depression Anxiety Stress Scales-21(DASS-21),Dizziness Handicap Inventory(DHI),Vestibular Rehabilitation Benefit Questionnaire(VRBQ),Falls Risk Questionnaire(FRQ),Exercise of Self-Care Agency Scale(ESCA)scores,and changes in balance function were compared between the two groups before and after the intervention.Results After 4 weeks of intervention,the depression,anxiety,and stress scores in both groups decreased compared to pre-intervention,and the observation group showed lower scores than the control group after 4 weeks of intervention(P<0.05).The physical,emotional,functional scores decreased in both groups after 4 weeks of intervention;the observation group had lower scores than the control group at 4 weeks(P<0.05).The VRBQ and FRQ scores decreased,while the ESCA scores increased in both groups after 4 weeks of intervention;the observation group had lower VRBQ and FRQ scores and a higher ESCA score compared to the control group at 4 weeks(P<0.05).Balance function improved in both groups after 4 weeks of intervention,with the observation group showing better balance function than the control group(P<0.05).Conclusion Cognitive behavioral therapy based on the IMB model can help patients with vestibular dysfunction improve negative emotions such as anxiety and depression,and promote the improvement of clinical symptoms and self-care ability,thereby enhancing the quality of rehabilitation.