BACKGROUND Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease(COPD)patients and reduce the quality of life of patients,but also affect th...BACKGROUND Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease(COPD)patients and reduce the quality of life of patients,but also affect the treatment effect and long-term prognosis.Therefore,it is of great significance to explore the clinical application of senile comprehensive assessment in the treatment of COPD and its influence on psychological factors such as anxiety and depression.AIM To explore the clinical application of comprehensive geriatric assessment in COPD care and its impact on anxiety and depression in elderly patents.METHODS In this retrospective study,60 patients with COPD who were hospitalized in our hospital from 2019 to 2020 were randomly divided into two groups with 30 patients in each group.The control group was given routine nursing,and the observation group was given comprehensive assessment.Clinical symptoms,quality of life[COPD assessment test(CAT)score],anxiety and depression Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)were compared between the two groups.RESULTS CAT scores in the observation group decreased from an average of 24.5 points at admission to an average of 18.3 points at discharge,and in the control group from an average of 24.7 points at admission to an average of 18.3 points at discharge.The average score was 22.1(P<0.05).In the observation group,HAMA scores decreased from 14.2 points at admission to 8.6 points at discharge,and HAMD scores decreased from 13.8 points at admission to 7.4 points at discharge.The mean HAMD scores in the control group decreased from an average of 14.5 at admission to an average of 12.3 at discharge,and from an average of 14.1 at admission to an average of 11.8 at discharge.CONCLUSION The application of comprehensive geriatric assessment in COPD care has a significant effect on improving patients'clinical symptoms and quality of life,and can effectively reduce patients'anxiety and depression.展开更多
Objectives: Depression may be under-diagnosed and under-treated amongst older adults with multiple chronic illnesses. The current study explores the prevalence of depression diagnosis and Geriatric Depression Scale (G...Objectives: Depression may be under-diagnosed and under-treated amongst older adults with multiple chronic illnesses. The current study explores the prevalence of depression diagnosis and Geriatric Depression Scale (GDS) symptoms amongst older multimorbid outpatients, and agreement between GDS scores and doctor-diagnosed depression. Method: Deidentified data from the files of 452 patients aged over 64, with chronic conditions present in two or more organ domains, were extracted from the clinical database of a tertiary referral hospital multidisciplinary outpatient clinic in South Australia between 2005 and 2011. Frequency calculations determined the prevalence of depression diagnosis and GDS categories. Logistic regression, cross-tabulation, kappa and ROC graphs explored relationships between variables. Results: A depression diagnosis had been recorded for 71 (15.7%) patients. Using the recommended cut-off scores for the GDS, 225 (49.8%) patients met criteria for mild-severe depressive symptoms, and 96 (21.3%) met criteria for moderate-severe symptoms. Poor agreement was found between doctor diagnosis of depression and a positive screen for depression using a GDS cut-off score of either 5, k = 0.112 (p = 0.001), or 9, k = 0.189 (p < 0.001), although logistic regression found an association between severity of depression and depression diagnosis, OR = 1.15, p < 0.001 (CI = 1.08 - 1.22). Con-clusion: A much higher proportion of patients with multimorbidities reported threshold level depression symptoms than had a recorded diagnosis of depression, suggesting that although likelihood of diagnosis increases with symptom severity, depression often goes undetected in this population. Depressions’ negative impact on prognosis calls for further investigation of the barriers to screening and diagnosis of depression in multimorbid patients.展开更多
目的评价重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)联合度洛西汀在伴躯体症状老年抑郁症患者中的疗效。方法选取2018年12月至2019年12月住院治疗的伴躯体症状老年抑郁症患者186例,随机数表法随机分为对照组...目的评价重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)联合度洛西汀在伴躯体症状老年抑郁症患者中的疗效。方法选取2018年12月至2019年12月住院治疗的伴躯体症状老年抑郁症患者186例,随机数表法随机分为对照组及观察组,每组93例,分别采用度洛西汀及度洛西汀联合rTMS治疗。干预前及干预结束后2个月采用老年抑郁量表(GDS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、重复性成套神经心理状态测试(RBANS)以及不良反应量表(TESS)评价2组的干预效果,并采用临床疗效总量表评估治疗有效率。结果对照组和观察组治疗总有效率分别为93.55%及82.80%,观察组显著高于对照组,差异有统计学意义(P<0.05)。治疗前,2组患者治疗前HAMD评分、GDS评分及HAMA评分对比差异无统计学意义(P>0.05),治疗后上述指标均显著低于下降且观察组均显著低于对照组(P<0.05)。治疗前2组患者即刻记忆、视觉广度、言语、注意、延迟记忆等评分比较差异无统计学意义(P>0.05),治疗后上述指标均显著升高且观察组显著高于对照组(P<0.05)。治疗前2组患者TESS评分对比差异无统计学意义(P>0.05),治疗后TESS评分均显著降低且观察组显著低于对照组(P<0.05)。结论重复经颅刺激联合度洛西汀可以显著改善伴躯体症状的老年抑郁症患者的心理状况,具有较高的有效性和安全性,值得进一步推广。展开更多
文摘BACKGROUND Psychological factors such as anxiety and depression will not only aggravate the symptoms of chronic obstructive pulmonary disease(COPD)patients and reduce the quality of life of patients,but also affect the treatment effect and long-term prognosis.Therefore,it is of great significance to explore the clinical application of senile comprehensive assessment in the treatment of COPD and its influence on psychological factors such as anxiety and depression.AIM To explore the clinical application of comprehensive geriatric assessment in COPD care and its impact on anxiety and depression in elderly patents.METHODS In this retrospective study,60 patients with COPD who were hospitalized in our hospital from 2019 to 2020 were randomly divided into two groups with 30 patients in each group.The control group was given routine nursing,and the observation group was given comprehensive assessment.Clinical symptoms,quality of life[COPD assessment test(CAT)score],anxiety and depression Hamilton Anxiety Rating Scale(HAMA)and Hamilton Depression Rating Scale(HAMD)were compared between the two groups.RESULTS CAT scores in the observation group decreased from an average of 24.5 points at admission to an average of 18.3 points at discharge,and in the control group from an average of 24.7 points at admission to an average of 18.3 points at discharge.The average score was 22.1(P<0.05).In the observation group,HAMA scores decreased from 14.2 points at admission to 8.6 points at discharge,and HAMD scores decreased from 13.8 points at admission to 7.4 points at discharge.The mean HAMD scores in the control group decreased from an average of 14.5 at admission to an average of 12.3 at discharge,and from an average of 14.1 at admission to an average of 11.8 at discharge.CONCLUSION The application of comprehensive geriatric assessment in COPD care has a significant effect on improving patients'clinical symptoms and quality of life,and can effectively reduce patients'anxiety and depression.
文摘Objectives: Depression may be under-diagnosed and under-treated amongst older adults with multiple chronic illnesses. The current study explores the prevalence of depression diagnosis and Geriatric Depression Scale (GDS) symptoms amongst older multimorbid outpatients, and agreement between GDS scores and doctor-diagnosed depression. Method: Deidentified data from the files of 452 patients aged over 64, with chronic conditions present in two or more organ domains, were extracted from the clinical database of a tertiary referral hospital multidisciplinary outpatient clinic in South Australia between 2005 and 2011. Frequency calculations determined the prevalence of depression diagnosis and GDS categories. Logistic regression, cross-tabulation, kappa and ROC graphs explored relationships between variables. Results: A depression diagnosis had been recorded for 71 (15.7%) patients. Using the recommended cut-off scores for the GDS, 225 (49.8%) patients met criteria for mild-severe depressive symptoms, and 96 (21.3%) met criteria for moderate-severe symptoms. Poor agreement was found between doctor diagnosis of depression and a positive screen for depression using a GDS cut-off score of either 5, k = 0.112 (p = 0.001), or 9, k = 0.189 (p < 0.001), although logistic regression found an association between severity of depression and depression diagnosis, OR = 1.15, p < 0.001 (CI = 1.08 - 1.22). Con-clusion: A much higher proportion of patients with multimorbidities reported threshold level depression symptoms than had a recorded diagnosis of depression, suggesting that although likelihood of diagnosis increases with symptom severity, depression often goes undetected in this population. Depressions’ negative impact on prognosis calls for further investigation of the barriers to screening and diagnosis of depression in multimorbid patients.
文摘目的评价重复经颅磁刺激(repetitive transcranial magnetic stimulation,rTMS)联合度洛西汀在伴躯体症状老年抑郁症患者中的疗效。方法选取2018年12月至2019年12月住院治疗的伴躯体症状老年抑郁症患者186例,随机数表法随机分为对照组及观察组,每组93例,分别采用度洛西汀及度洛西汀联合rTMS治疗。干预前及干预结束后2个月采用老年抑郁量表(GDS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、重复性成套神经心理状态测试(RBANS)以及不良反应量表(TESS)评价2组的干预效果,并采用临床疗效总量表评估治疗有效率。结果对照组和观察组治疗总有效率分别为93.55%及82.80%,观察组显著高于对照组,差异有统计学意义(P<0.05)。治疗前,2组患者治疗前HAMD评分、GDS评分及HAMA评分对比差异无统计学意义(P>0.05),治疗后上述指标均显著低于下降且观察组均显著低于对照组(P<0.05)。治疗前2组患者即刻记忆、视觉广度、言语、注意、延迟记忆等评分比较差异无统计学意义(P>0.05),治疗后上述指标均显著升高且观察组显著高于对照组(P<0.05)。治疗前2组患者TESS评分对比差异无统计学意义(P>0.05),治疗后TESS评分均显著降低且观察组显著低于对照组(P<0.05)。结论重复经颅刺激联合度洛西汀可以显著改善伴躯体症状的老年抑郁症患者的心理状况,具有较高的有效性和安全性,值得进一步推广。
