基于正念减压疗法的心理干预对冠心病支架植入患者负性情绪、服药依从性及生活质量的影响

Effects of psychological intervention based on mindfulness-based stress reduction on negative emotions,medication compliance and quality of life in patients with stent implantation of coronary heart disease

目的:探究基于正念减压疗法(MBSR)的心理干预对冠心病(CHD)支架植入患者负面情绪、服药依从性及生活质量的影响。方法:将我院2015年1月-2018年1月收治的120例CHD支架植入患者随机分为观察组(常规干预+基于MBSR的心理干预,n=60)与对照组(常规干预,n=60),比较两组负性情绪、服药依从性、生活质量、自我感受负担及服务满意度。结果:干预后,观察组躯体化(t=-6.61,P<0.05)、强迫症状(t=-5.65,P<0.05)、人际关系(t=-3.41,P<0.05)、抑郁(t=-5.54,P<0.05)、焦虑(t=-10.36,P<0.05)、恐怖(t=-5.01,P<0.05)及偏执(t=-3.70,P<0.05)均显著低于对照组;观察组服药依从性显著优于对照组(Hc=5.66,P<0.05);观察组干预后躯体活动受限程度(PL)(t=4.69,P<0.05)、心绞痛稳定状态(AS)(t=4.68,P<0.05)、心绞痛发作情况(AF)(t=4.58,P<0.05)、治疗满意度(TS)(t=3.89,P<0.05)、疾病认知程度(DP)(t=2.96,P<0.05)及总得分(t=6.52,P<0.05)均显著高于对照组;观察组干预后,身体负担(t=-9.37,P<0.05)、情感负担(t=-4.48,P<0.05)及总得分(t=-3.45,P<0.05)得分均显著低于对照组;观察组服务满意度显著高于对照组(t=5.44,P<0.05)。结论:基于MBSR的心理干预可有效减轻CHD支架植入患者负面情绪及身心感受负担,并提高患者服药依从性、生活质量及服务满意度。

Objective:To explore the effects of psychological intervention based on mindfulness-based stress reduction(MBSR)on negative emotions,medication compliance and quality of life in patients with stent implantation of coronary heart disease(CHD).Methods:A total of 120 cases of patients with CHD stent implantation admitted between January 2015 to January 2018 in our hospital were randomly divided into observation group(conventional intervention+psychological intervention based on MBSR,n=60)and control group(conventional intervention,n=60).Negative emotions,medication compliance,quality of life,self-perceived burden and servicing satisfaction were compared between the two groups.Results:After intervention,the scores of somatization(t=-6.61,P<0.05),obsessive-compulsive symptoms(t=-5.65,P<0.05),interpersonal relationships(t=-3.41,P<0.05),depression(t=-5.54,P<0.05),anxiety(t=-10.36,P<0.05),horror(t=-5.01,P<0.05)and paranoid(t=-3.70,P<0.05)and the total score(t=-3.80,P<0.05)in observation group were significantly lower than those in control group.The medication compliance in observation group was significantly better than that in control group(Hc=5.66,P<0.05).After intervention,the physical limitation(PL)(t=4.69,P<0.05),anginal stability(AS)(t=4.68,P<0.05),anginal frequency(AF)(t=4.58,P<0.05),treatment satisfaction(TS)(t=3.89,P<0.05),and disease awareness(DP)(t=2.96,P<0.05)and total score(t=6.52,P<0.05)in observation group were all significantly higher than those in control group.After intervention,the scores of physical burden(t=-9.37,P<0.05),emotional burden(t=-4.48,P<0.05)and the total score(t=-3.45,P<0.05)in observation group were significantly lower than those in control group.The servicing satisfaction in observation group was significantly higher than that in control group(t=5.44,P<0.05).Conclusion:Psychological intervention based on MBSR can effectively reduce the negative emotions and psychosomatic burden of patients with CHD stent implantation,and improve medicine compliance,quality of life and servicing satisfaction.