正念认知疗法对老年慢性心力衰竭伴衰弱患者心理及心功能康复的影响

Effect of Mindfulness-based Cognitive Therapy on Psychological and Cardiac Rehabilitation in Elderly Patients with Chronic Heart Failure and Frailty

目的:分析正念认知疗法对老年慢性心力衰竭伴衰弱患者的影响。方法:选取2022年1月—2023年6月在福建中医药大学附属第三人民医院就诊的149例老年慢性心力衰竭伴衰弱患者作为研究对象,随机分为对照组(n=74)、治疗组(n=75)。对照组进行常规护理,治疗组在对照组基础上给予正念认知疗法。比较两组的护理满意度、心功能、心理状态、生活质量。结果:治疗组总有效率为96.00%,高于对照组的81.08%,差异有统计学意义(P<0.05)。干预后,两组左心室收缩期末内径(LVESD)、左心室舒张期末内径(LVEDD)、左房内径(LAD)均低于干预前,左心室射血分数(LVEF)均高于干预前,治疗组LVESD、LVEDD、LAD均低于对照组,LVEF高于对照组,差异均有统计学意义(P<0.05)。干预后,两组简明健康状况调查表(SF-36)各项评分均高于干预前,且治疗组均高于对照组,差异均有统计学意义(P<0.05)。干预后,两组抑郁自评量表(SDS)及焦虑自评量表(SAS)评分均低于干预前,且治疗组均低于对照组,差异均有统计学意义(P<0.05)。结论:正念认知疗法对老年慢性心力衰竭伴衰弱患者的改善效果显著,有助于改善心理状态,提高心功能及生活质量。

Objective:To analyze the influence of mindfulness-based cognitive therapy on elderly patients with chronic heart failure and frailty.Method:A total of 149 elderly patients with chronic heart failure and frailty treated in the Third Affiliated People's Hospital of Fujian University of Traditional Chinese Medicine from January 2022 to June 2023 were selected as the study objects,and randomly divided into control group(n=74)and treatment group(n=75).The control group received routine care,and the treatment group received mindfulness-based cognitive therapy on the basis of the control group.Nursing satisfaction,heart function,mental state and quality of life were compared between the two groups.Result:The total effective rate of the treatment group was 96.00%,which was higher than 81.08%of the control group,the difference was statistically significant(P<0.05).After intervention,left ventricular end-systolic diameter(LVESD),left ventricular end-diastolic diameter(LVEDD)and left atrial diameter(LAD)in both groups were lower than those before intervention,left ventricular ejection fraction(LVEF)were higher than those before intervention,and LVESD,LVEDD and LAD in treatment group were lower than those in control group,LVEF was higher than that in control group,the differences were statistically significant(P<0.05).After intervention,the scores of the MOS item short form health survey(SF-36)in both groups were higher than those before intervention,and those in the treatment group were higher than those in the control group,the differences were statistically significant(P<0.05).After intervention,the scores of self-rating depression scale(SDS)and self-rating anxiety scale(SAS)in both groups were lower than those before intervention,and those in the treatment group were lower than those in the control group,the differences were statistically significant(P<0.05).Conclusion:Mindfulness-based cognitive therapy has a significant effect on elderly patients with chronic heart failure and frailty,which is helpful to improve mental state,heart function and quality of life.