Effects of the Treatment of Carpal Tunnel Syndrome with Surgery and Injections on the Hospital Anxiety and Depression Scale (HADS)

Background: The prevalence of carpal tunnel syndrome (CTS) and of anxiety and depression in primary care practice are high. Different studies had shown an increased prevalence of anxiety and depression in CTS patients. Nevertheless, few papers had been published studying the anxiety and depression scales in the treatment of CTS, either with corticosteroid injections (I) or with surgical decompression (S). Objective: To assess whether clinical improvement observed after the treatment of CTS either with I or with S correlates with an improvement in the punctuations of the Hospital Anxiety and Depression scales (HADS), at 3, 6 and 12-month follow-up. Methods: Randomized and open-label clinical trial, comparing I and S. Patients with symptoms suggestive of CTS (nocturnal paraesthesias) of at least 3 months duration and neurophysiological confirmation were included. Patients with clinically apparent motor impairment were excluded. The subjective evaluation of symptoms was carried out using the visual-analogue scale of pain (VAS-p). Clinical reviews were performed 3, 6 and 12 months after treatment. Each patient completed the HADS questionnaire and a VAS-p at 0, 3, 6, and 12 months. Statistical significance was established using the Student’s t test and the Mann-Whitney U test when necessary. A linear regression analysis was used to know the effect of the treatment adjusted for the initial score of both scales. Results: 65 patients were included (30 in group I and 35 in group S). There was no statistical difference between both groups in terms of age, gender distribution, disease duration, VAS-p, neurophysiological testing severity of CTS or the 8 subscales of HADS. Both groups improved significantly in relation to the baseline VAS-p values, in the reviews at 3, 6 and 12 months, with no significant differences between I and S. At 6 months, the reduction in the anxiety scale was around 3 points for both treatments (S = 3.6 and I = 3.2), without reaching significant differences. At 12 months, it was somewhat higher for those treated with I, but always around 3 points and without significant differences. The Depression scale score was slightly reduced at 6 months, and in a similar way for both groups (I = 1 and S = 1.19;p = 0.8). After 12 months, group I doubled the previous reduction, with group S experiencing a very slight change (I = 1.96 and S = 1.03;p = 0.3). When analysing the effect of group S on group I, the result was a reduction of 0.25 points for Anxiety (p = 0.7) and of 0.02 points for Depression (p = 0.9). Conclusions: Treatment of CTS with I or S results in a similar and discrete improvement in Anxiety scores on the HADS scale at 6 and 12 months. For both types of treatment, the Depression scores barely changed at 6 months, being somewhat higher in group I after 12-month follow-up. The independent effect of the S on both scales is small and not significant.

Study on the impact of comprehensive geriatric assessment on anxiety and depression in chronic obstructive pulmonary disease patients

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.

Cronbach's a reliability, concurrent validity, and factorial structure of the Death Depression Scale in an Iranian hospital staff sample

Objective: Death depression is an important component in the process of death and dying. Death depression is the second element of death. Depression is one of the important features in death distress. The aim of this study was to explore the performance of the Farsi version of the Death Depression Scale with an Iranian convenience sample of nurses (n =106).Methods: Nurses were selected using a convenience sampling method, and completed the Death Depression Scale (DDS), Death Concern Scale (DCS), Collett-Lester Fear of Death Scale (CLFDS), Reasons for Death Fear Scale (RDFS), Templer's Death Anxiety Scale (DAS), and Death Obsession Scale (DOS). Results: The results of exploratory factor analysis on DDS identified 4 factors (56.16%of variance). Factor 1 labeled"Death sadness", Factor 2 labeled"Death finality/end and Death dread/fear", Factor 3 labeled"Death despair and Death depression", and Factor 4 labeled"Death loneliness". Cronbach's a coefficient was 0.84, Spearman-Brown coefficient 0.85, and Guttman Split-Half coefficient 0.81 The DDS correlated 0.40 with the DCS, 0.39 with the CLFDS, 0.50 with the DAS, 0.35 with the RDFS, and 0.44 with the DOS, indicating good construct and criterion-related validity. Concurrent validity for the DDS with the other scales were significant. Conclusions: The DDS has good validity and reliability, and it can use in clinical and research settings.

A survey on 564 cases of inpatients with anxiety and depression in general hospitals in 2015

Objective: To understand the prevalence of anxiety and depression in medical patients in general hospitals and find out main influencing factors. Methods: According to the inclusion criteria, a total of 564 inpatients from the Third Affiliated Hospital of Inner Mongolia Medical University were selected during January to June of 2015. Patients were assessed for anxiety and/or depression by use of Hospital Anxiety and Depression Scale (HADS), Hamilton Anxiety Scale (HAMAS) and Hamilton Depression Scale (HAMDS). Meanwhile, final diagnosis was made on the basis of diagnostic criteria listed in Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV). Results: In different departments, the positive rate (HADS ≥ 8) was the highest in Department of Oncology (45.42%), and the lowest in Department of Gastroenterology (16.05%). After assessment with the help of HAMD and HAMA, the prevalence of anxiety/depression was the highest in Department of Oncology (46.43%), and the lowest in Department of Gastroenterology (16.05%). There was no statistical significance in diagnostic results acquired from HAMD and HAMA (p = .071). Two types of diagnostic methods were highly consistent (κ = 0.852, p = .000). Inpatients aged from 40 to 59 years, with junior high school education or below, very tiring work, poor marital status (separated, divorced, widowed), unharmonious family, low personal income, completely self-paying and family history of anxiety and depression, currently unable to take care of themselves were more prone to anxiety and depression (p < .05). Conclusions: The prevalence of anxiety and depression in medical patients in general hospitals is high due to many influencing factors. It is necessary to establish an effective diagnosis and treatment system for anxiety and depression, in order to make patients easy to receive an early and comprehensive treatment and improve their life quality.

Role of irrational beliefs in depression and anxiety: a review

Irrational beliefs play a central role in cognitive theory and therapy;they have been shown to be related to a variety of disorders such as depression and anxiety. Irrational beliefs, which can be assessed via clinical interviewing techniques, are frequently assessed by self-report measures, both clinically and for research purposes. Much of the research demonstrating the effect of irrational beliefs has utilized such measures. The present article reviews the empirical work on irrational beliefs assessment and identifies 25 scales and techniques. The measures are organized according to their theoretical affiliation (i.e., either the Ellis or Beck model), with the goal of providing investigators a source to identify the available tests, their shortcomings, and potential applications. The authors conclude with recommendations which would strengthen empirical cohesion and precision in the measurement of irrational beliefs.

Peripartum depression and its predictors:A longitudinal observational hospital-based study

BACKGROUND Depression is a common problem in women in childbearing years due to burdens of motherhood and building a family.Few studies estimate the prevalence of antepartum depression compared to those in the postpartum period.AIM To estimate the prevalence and the severities of peripartum depression and major depressive disorder and their predictors.METHODS This is a longitudinal observation study.It included 200 women scoring≥13 with the Edinburgh Postpartum Depression Scale,indicating presence of symptoms of depression.They had a gestational age of≥6 wk and did follow-ups until the 10^(th) week to 12^(th) weeks postpartum.Information of women's reactions to life circumstances and stressors during the current pregnancy were gathered from answers to questions of the designed unstructured clinical questionnaire.Severities of depression,anxiety,and parenting stress were determined by the Beck Depression Inventory,State-Trait Anxiety Inventory for Adults,and Parenting Stress Index-Short Form,respectively.Psychiatric interviewing was done to confirm the diagnosis of major depression.Measuring the levels of triiodothronine(T3),thyroxine(T4),and thyroid stimulating hormone(TSH)was done in both antepartum and postpartum periods.RESULTS Out of 968(mean age=27.35±6.42 years),20.66%(n=200)of the patients had clinically significant symptoms of depression and 7.44%had major depression.Previous premenstrual dysphoria,post-abortive depression,and depression unrelated to pregnancy and were reported in 43%,8%,and 4.5%of the patients,respectively.Psychosocial stressors were reported in 15.5%of the patients.Antepartum anxiety and parenting stress were reported in 90.5%and 65%of the patients,respectively.Postpartum T3,T4,and TSH levels did not significantly differ from reference values.Regression analysis showed that anxiety trait was a predictor for antepartum(standardized regression coefficients=0.514,t=8.507,P=0.001)and postpartum(standardized regression coefficients=0.573,t=0.040,P=0.041)depression.Antepartum depression(standardized regression coefficients=-0.086,t=-2.750,P=0.007),and parenting stress(standardized regression coefficients=0.080,t=14.34,P=0.0001)were also predictors for postpartum depression.CONCLUSION Results showed that 20.66%of the patients had clinically significant symptoms of depression and 7.44%had major depression.Anxiety was a predictor for antepartum and postpartum depression.Antepartum depression and parenting stress were also predictors for postpartum depression.

Campus Connectedness and Its Relationship to Stress, Anxiety and Depression among Nepalese Undergraduate Nursing Students

Background: Campus connectedness is a kind of social connectedness that determines the students’ perception of their belonging to the other populace of the campus that includes students, teachers, administrators, and other staff. Campus connectedness plays a significant role in determining stress, anxiety, and depression among students. The purpose of the study was to examine the relationship of campus connectedness to stress, anxiety, and depression among nursing students. Methods: This cross-sectional analytical study was conducted among 680 undergraduate nursing students from nine nursing colleges affiliated with a university in Kathmandu Valley. Data were collected from June 1, 2018, through July 10, 2018. Depression, Anxiety, Stress Scale and Campus Connectedness Scale were used to collect data. The data were analyzed using Statistical Package for Social Sciences version 23. A one-way multivariate analysis of variance (MANOVA) test was used to examine the relationship of campus connectedness to stress, anxiety, and depression. Discriminant analysis was done as a follow-up procedure to MANOVA. Results: Students had moderate to extremely severe levels of depression (51.7%), anxiety (72.9%) and stress (47%). High campus connectedness score was observed (M = 62.42;SD = 9.79). Statistically significant differences were found among the levels of campus connectedness on the outcome variables, Wilks’ lambda (λ) = 0.90, F(3, 676) = 24.56, p < 0.001. Depression demonstrated the strongest relationship with the discriminant function. Conclusions: There was a significant relationship of campus connectedness to stress, anxiety, and depression. Despite the high level of campus connectedness, students had moderate to severe levels of stress, anxiety, and depression. The campus adminstration must take measures and efforts to provide conducive environment and counseling services for the wellbeing of their students.

Relationship between Female Sexual Function and Depression or Anxiety in Japan

Background: Sexual dysfunction is sexual complaints or disorders. There are various causes, but the onset leads to deterioration of relationships and quality of life with partners. There is still a deep-rooted awareness that sexuality is a secret in Japan. Aim: This study aims to clarify the relationship between female sexual function and depression or anxiety. Method: Four hundred and fifty-eight Japanese healthy women who worked in four randomly selected medical institutions in Okinawa Prefecture in Japan from March to May 2012 were asked to agree to a consent form of their own free will and participate in self-reported questionnaires. For their evaluation, the Female Sexual Function Index (FSFI;Rosen et al. 2000, which includes the six domains of desire, arousal, lubrication, orgasm, pain, and satisfaction) and the Kessler Psychological Distress Scale (K6;Kessler, 2002, which includes the following six items: felt nervous, hopeless, restless or fidgety, worthless, depressed, and felt that everything was an effort) was used. Moreover, participants’ characteristics showed age, marriage, menopause, annual income, and drinking. In addition, JMP16.2 and R 4.2.0 was used to perform Pearson’s chi-square test, Fisher’s exact test, Mann-Whitney U test, Kruskal-Wallis test, Steel-Dwass test, Spearman’s Rank-Order Correlation, and Cronbach’s alpha. This study was approved by the university and the medical institutional review board (IRB). Results: 178 women were included in the final analysis, and the median (IQR, interquartile range) was 39 (32 - 48) years old, and the mean ± SD (standard deviation) was 40.2 ± 10.4 years old. The median (IQR) and mean ± SD of FSFI Total Score were 22.0 (9.3 - 26.6) and 19.2 ± 9.6. The median (IQR) and the mean ± SD of K6 Total Score were 3 (0 - 7) and 4.2 ± 4.5. 16% of all women with a K6 Total Score of 10 and more, and 5% of all women with a K6 Total Score of 13 and more considered a serious mental illness. There was no clear association between female sexual function and depression or anxiety in all health worker participants between FSFI Total Score and K6 Total Score by Spearman’s Rank-Order Correlation Coefficient (ρ). However, there was a moderate correlation between the K6 Total Score and the FSFI Total Score in health worker participants with a K6 Total Score of 11 or more (n =19, ρ = ?0.62, P = 0.005). Moreover, there was a weak correlation between them in both married and drinking women or married and non-menopausal women. In the Mann-Whitney U test where few participants had morbid depression, significant relationships were found in the association between a sexual function with high depression or anxiety, whereas the low group had a K6 cut-off value of 11. Conclusion: Female sexual morbidity for high depression or anxiety should be managed with interventions. Especially, the intervention for decreasing female sexual function in the K6 Total Score of 11 or more will be needed, and a randomized study is required for more evidence.

基于HADS评价疏肝和胃方对非糜烂性反流病患者的心理干预作用

目的:探讨疏肝和胃方对非糜烂性反流病(non-erosive reflux disease,NERD)患者焦虑抑郁状态的影响。方法:将90例NERD患者随机分为中药组(予疏肝和胃方颗粒剂)和西药组(予雷贝拉唑钠肠溶片)各45例,疗程8周,治疗前后应用医院焦虑抑郁量表(hospital anxiety and depression scale,HADS)评价两组患者焦虑抑郁状态。结果:HADS-A、HADS-D积分中药组治疗前后组内及两组治疗后组间比较差异均有统计学意义(P<0.05)。结论:疏肝和胃方可改善NERD患者焦虑抑郁状态。

Translation and validation of the Malay version of the short-form DASS-21 for the epidemiology survey of working population

Increasing occurrences of mental health problems such as depression,anxiety and stress amongst workers presents practical demands for employers and occupational health practitioners to assess the self-perceived depression,anxiety and stress in workers with reliable and valid instruments.The present study aims to validate the Malay version of the short form Depression Anxiety Stress Scale (DASS-21) among Malaysian workers designed to screen the self-reported of depression,anxiety and stress among workers in Malaysia.Eighty-eight workers of two major automotive assembly plants in Pekan,Pahang consented to participate in the study and was administered the Malay version of the DASS-21.Translation (English-Malay) and back translation (Malay-English) of the DASS-21 was made to ensure the face validity of the questionnaire.Reliability was determined using Cronbach's alpha for internal consistency whilst construct validity was assessed using the exploratory factor analysis (principal component analysis with varimax rotation).The results indicated that the Cronbach's alpha coefficients were acceptable for DASS-Depression (0.81),DASS-Anxiety (0.85) and DASS-Stress (0.85).Exploratory factor analysis showed three meaningful common factors that could explain the three theoretical dimensions or constructs of the DASS-21.The validation study suggests that the Malay version of DASS-21 is reliable and valid screening instruments for assessing self-reported depression,anxiety and stress in Malaysian working population.

Assessment of Stress Cognitive Control and Executive Function with Stress Control Rating Scale (ECOSTRESS) and Low Resolution Brain Electromagnetic Tomography (LORETA) (In Portuguese People in Situations of Unemployment and Economic Insufficiency)

This article reviews the constructs of stress, appraisal, coping, according to a transactional perspective, and executive function, and presents a stress control rating scale (ECOSTRESS), which design is founded in these constructs. This psychometric tool is useful in the assessment of cognitive control of stress, correlated with the function of dorsolateral prefrontal cortex. It has been validated for its use in the assessment of Portuguese people in situations of stress related to unemployment and economic insufficiency. Also, within the context of the cognitive control of stress, it is highlighted the usefulness of low resolution brain electromagnetic tomography (LORETA).

Increased P wave duration in patients with depression or anxiety disorder

BACKGROUND： Activation of the sympathetic nervous system plays an important role in regulating cardiovascular actions. P wave parameters can provide general information on central cardiovascular autonomic regulatory responses, which are altered in patients with anxiety disorders and depression. In particular, there are no reports addressing changes in P wave duration and dispersion. OBJECTIVE： To compare the differences in P wave duration and P wave dispersion between patients with anxiety disorders and depression, because patients with anxiety disorders and depression develop abnormal electrocardiograms. DESIGN, TIME AND SETTING： A non-randomized concurrent controlled study was performed. Patients with depression and general anxiety disorders were admitted at the psychiatry outpatient clinics of the Medical Faculty of Duezce University of Turkey between May 2005 and October 2006. PARTICIPANTS： A total of 71 consecutive patients with depression and anxiety disorders, as well as 50 physically and mentally healthy age- and gender-matched controls were selected. METHODS： Electrocardiogram records were obtained at the time of admission to the outpatient clinics. MAIN OUTCOME MEASURES： P wave duration and P wave dispersion were measured. RESULTS： Both the maximum （Prnax） and minimum （Pmin） P wave duration were greater in patients with psychiatric disorders than in healthy controls. Pmax was significantly greater in patients with depression or anxiety disorders （Bonferroni test, P 〈 0.017）. The P wave dispersion was similar between patients and controls （P 〉 0.017）. P waves were similar between panic patients and other anxiety patients. Beck depression results were positively correlated with Prawn and Prnax （r= 0.374, 0.302, P = 0.013, 0.049, respectively）, and not associated with P wave dispersion （P 〉 0.05）. CONCLUSION： Psychiatric disorders are associated with increases in Prnax, but not with P wave dispersion. The P wave changes were associated with the degree of depression.

One-year outcomes of resveratrol supplement with aflibercept versus aflibercept monotherapy in wet agerelated macular degeneration

AIM:To determine the one-year outcomes of resveratrol oral supplement in patients suffering from wet age-related macular degeneration(AMD).METHODS:Fifty naïve and previously untreated patients suffering from wet AMD,were randomly assigned in two subgroups of 25 patients each.All the participants were treated with 3 monthly intravitreal injections of 2.0 mg aflibercept(IAIs)followed by injections“according to need”,while in one group the patients also received daily two tablets of resveratrol oral supplement.Prior to treatment initiation,a complete ophthalmological examination,including best corrected visual acuity(BCVA)and contrast sensitivity evaluation,optical coherence tomography(OCT)scans,fundus autofluorescence(FAF),fluorescein angiography,indocyanine green angiography,and OCT angiography(OCTA),was performed to every participant,while all of them completed the Hospital Anxiety and Depression Scale(HADS)questionnaire,in order to assess their quality of life(QoL)status.The patients were assessed monthly for 1y with FAF,and OCT or OCTA;the main endpoints were the number IAIs,the changes in BCVA,in contrast sensitivity,and in patients’QoL status.RESULTS:No significant differences were present between the groups regarding the baseline demographic and clinical data.Over the 12-month period,a similar number of IAIs was applied in both groups(4.52±1.00 vs 4.28±0.90,P=0.38),while the rest of the clinical data also did not differ significantly after the completion of the study period.However,for HADS Depression(11.88±2.51 vs 8.28±1.54,P<0.001)and HADS Anxiety(11.92±2.52 vs 7.76±1.51,P<0.001)questionnaires values,the score was significantly better in patients who received resveratrol supplements.Moreover,a statistically significant difference was detected in the mean change from baseline values of contrast sensitivity(0.17±0.19 vs 0.35±0.24,P=0.005),HADS Depression(0.08±1.38 vs-3.88±1.48,P<0.001),and HADS Anxiety(0.36±1.98 vs-5.12±2.70,P<0.001)scores,in favour of the patients treated with resveratrol supplements.CONCLUSION:The resveratrol oral supplement is a complementary treatment in cases of wet AMD,highlighting its effectiveness in improving patients’QoL status.

Analysis of mental health status and related factors in patients with acute cerebral infarction

BACKGROUND Acute cerebral infarction(ACI)is characterized by a high incidence of morbidity,disability,recurrence,death and heavy economic burden,and has become a disease of concern in global researchers.As ACI has serious effects on patients’physical status,life and economy,often causing anxiety,depression and other psychological problems,these problems can lead to the aggravation of physical symptoms;thus,it is very important to understand the factors affecting the mental health of these patients.AIM To understand the elements that affect the mental health of patients who have suffered an ACI.METHODS A questionnaire survey was conducted among patients with ACI admitted to three tertiary hospitals(Quanzhou First Hospital,Fuqing City Hospital Affiliated to Fujian Medical University,and the 900 Hospital of the Joint Service Support Force of the People’s Liberation Army of China)in Fujian Province from January 2022 to December 2022 using the convenience sampling method.ACI inpatients who met the inclusion criteria were selected.Informed consent was obtained from the patients before the investigation,and a face-to-face questionnaire survey was conducted using a unified scale.The questionnaire included a general situation questionnaire,Zung’s self-rating depression scale and Zung’s self-rating anxiety scale.All questionnaires were checked by two researchers and then the data were input and sorted using Excel software.The general situation of patients with ACI was analyzed by descriptive statistics,the influence of variables on mental health by the independent sample t test and variance analysis,and the influencing factors on psychological distress were analyzed by multiple stepwise regression.RESULTS The average age of the 220 patients with ACI was 68.64±10.74 years,including 142 males and 78 females.Most of the patients were between 60 and 74 years old,the majority had high school or technical secondary school education,most lived with their spouse,and most lived in cities.The majority of patients had a personal income of 3001 to 5000 RMB yuan per month.The new rural cooperative medical insurance system had the largest number of participants.Most stroke patients were cared for by their spouses and of these patients,52.3%had previously smoked.Univariate analysis showed that gender,age,residence,course of disease,number of previous chronic diseases and smoking history were the main factors affecting the anxiety scores of patients with ACI.Age,living conditions,monthly income,course of disease and knowledge of disease were the primary variables influencing the depression score in patients with ACI.The findings of multivariate analysis revealed that the course of disease and gender were the most important factors influencing patients’anxiety scores,and the course of disease was also the most important factor influencing patients’depression scores.CONCLUSION Long disease course and female patients with ACI were more likely to have psychological problems such as a high incidence of emotional disorders.These groups require more attention and counseling.

认知行为干预对伴焦虑状态突发性聋治疗的疗效分析

目的分析认知行为干预对治疗伴焦虑状态突发性聋的疗效。方法选取2020年6月—2022年6月郑州大学第一附属医院收治的突发性聋患者353例,其中低频型108例,高频型72例,平坦型81例,全聋型92例。入院24 h内独立完成焦虑自评量表(SAS)评分,标准分>50分,汉密尔顿焦虑量表(HAMA)评分,标准分>17分接受认知行为干预为A组192例,未接受认知行为干预为B组161例,依据突发性聋诊断和治疗指南(2015)进行治疗。A组患者额外接受认知行为干预治疗。结果A、B两组中,低频型患者治疗有效率分别为90.38%(47/52)、75.00%(42/56),高频型患者治疗有效率分别为64.81%(35/54)、61.11%(11/18),平坦型患者治疗有效率分别为77.27%(34/44)、48.65%(18/37),全聋型患者治疗有效疗有效率分别为76.19%(32/42)、52.00%(26/50),A组中低频型、平坦型、全聋型治疗有效率高于B组;A组治疗总有效率高于B组,差异有统计学意义(P<0.05)。结论认知行为干预可提高伴焦虑状态的低频下降型、平坦型、全聋型治疗有效率及治疗总有效率。

硬膜外分娩镇痛对产妇产后抑郁的影响

目的评估硬膜外分娩镇痛(LEA)对产妇产后抑郁(PPD)的影响。方法选择经阴道分娩的初产妇628例,年龄20~36岁,BMI 20~35 kg/m 2,ASAⅡ或Ⅲ级。根据产妇是否接受硬膜外分娩镇痛分为两组:镇痛组(n=322)和非镇痛组(n=306)。记录分娩期间VAS疼痛评分最高值、产程时间、出血量、新生儿1、5 min Apgar评分和新生儿入NICU的发生情况。于分娩前1周和产后2周、6周分别采用爱丁堡产后抑郁量表(EPDS)评估PPD发生情况(EPDS评分≥11分为PPD),采用广泛性焦虑量表(GAD-7)评估产妇焦虑情绪,采用领悟社会支持量表(PSSS)评估产妇感受到的总社会支持度。结果与非镇痛组比较,镇痛组产妇分娩期间VAS疼痛评分最高值明显降低(P<0.05)。两组产妇第一产程时间、第二产程时间、出血量、新生儿1、5 min Apgar评分、新生儿入NICU比例差异无统计学意义。两组产妇产后2、6周PPD发生率、PSSS高支持状态、GAD-7≥10分差异无统计学意义。结论初产妇接受LEA不影响产后抑郁的发生风险。

胚胎移植女性孕早期睡眠质量及关联因素分析

背景胚胎移植女性经受了身体和心理的双重挑战,孕早期的生活质量,尤其是睡眠质量会受到较大的影响。目的分析胚胎移植女性孕早期睡眠质量及相关影响因素。方法选取2022年6—12月于河北医科大学第二医院生殖医学科进行体外受精-胚胎移植(in vitro fertilization-embryo transfer,IVF-ET)助孕成功的患者,在其移植后45 d返院复查B超时进行问卷调查,调查内容包括匹兹堡睡眠质量指数(Pittsburgh sleep quality index,PSQI)、焦虑自评量表(self-rating anxiety scale,SAS)、抑郁自评量表(self-rating depression scale,SDS)、中文简化版心理弹性量表(Connor Davidson resilience scale,CD-RISC)和社会支持评定量表。以PSQI>7分为判断睡眠障碍的标准,通过多因素Logistic回归模型分析睡眠质量与各个影响因素的关系,并使用信息增益算法对影响睡眠质量的主要因素进行影响程度评估。结果发放问卷336份,回收325份,回收率96.7%。325例IVF-ET孕妇年龄(32.46±4.52)岁,睡眠质量总分为(7.79±3.63)分,其中126例孕妇总分≤7分为睡眠正常组,199例孕妇总分>7分为睡眠障碍组(61.23%,199/325)。相关心理学评估:焦虑自评量表(43.75±8.86)分;抑郁自评量表(50.89±10.54)分;心理弹性量表总分(64.18±11.34),其中坚韧性(32.66±10.28)分,力量性(21.75±6.37)分,乐观性(9.74±3.26)分;社会支持评定量表总分为(42.27±4.93)分,其中客观支持(9.15±2.13)分,主观支持(25.30±4.26)分,对支持的利用度(7.82±1.91)分。Logistic回归结果提示,年龄越大、越焦虑,越容易出现睡眠障碍;文化程度中,以初中及以下人群作为参照,高中或中专学历的人群更不容易出现睡眠障碍;心理弹性水平越高,睡眠障碍出现概率越低(P均<0.05)。信息增益分析结果显示,影响睡眠质量的因素按影响力大小依次为心理弹性中的坚韧性(1.186)、社会支持量表中的主观支持分(0.807)、心理弹性量表中的力量性(0.806)、心理弹性量表中的乐观性(0.510)、社会支持量表中的对支持的利用度(0.422)、文化程度(0.419)、客观支持分(0.391)、职业(0.216)、婆媳关系(0.213)、SAS(0.192)、SDS(0.162)、第几次移植(0.146)、年龄(0.117)、第几次取卵(0.108)、社会支持总分(0.107)、现有子女个数(0.088)、月收入(0.082)、夫妻关系(0.051)、居住地(0.035)。结论胚胎移植女性在孕早期睡眠质量较差;患者的不良心理状态对睡眠有负面影响,而心理弹性和社会支持对睡眠质量则起到了积极的正面影响,临床可以从改善患者心理弹性状态、增加社会支持方向入手,帮助IVF-ET孕妇从孕早期开始改善睡眠质量,从而提高生活质量,保证母婴健康。

分析优质干预对妇产科手术患者术后疼痛及睡眠质量的影响

目的:分析优质干预对妇产科手术患者术后疼痛及睡眠质量的影响。方法:选取2023年1月至2024年1月厦门大学附属第一医院妇产科收治的手术患者98例作为研究对象,按照随机数字表法分为对照组和观察组,每组49例。对照组给予常规护理干预,观察组给予优质护理干预。采用匹兹堡睡眠质量指数(PSQI)比较2组患者睡眠质量的差异,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)比较2组患者焦虑、抑郁症状改善情况,采用爱泼沃斯嗜睡量表(ESS)比较2组患者干预前后睡眠质量变化,并比较2组患者睡眠效果、睡眠感受、睡眠可持续性的差异,采用多导睡眠监测(PSG)评价2组患者的睡眠效率、快速眼动(REM)潜伏期、睡眠潜伏期、清醒次数、睡后清醒时间,并比较2组术后疼痛可耐受性及护理满意度。结果:干预后,观察组PSQI评分、SAS评分、SDS评分、ESS评分均显著低于对照组,观察组睡眠效率、REM潜伏期高于对照组,观察组睡眠潜伏期、清醒次数、睡后清醒时间显著低于对照组,观察组疼痛耐受性评分显著高于对照组,观察组护理满意度显著高于对照组,差异均有统计学意义(均P<0.05)。结论:对妇产科手术患者实施优质护理干预既可减轻术后疼痛,又可提高其睡眠质量,加快患者康复进程,缓解患者焦虑、抑郁情绪,提高睡眠效率,值得临床推广应用。

综合干预改善老年高血压住院患者睡眠质量的效果研究

目的:观察综合干预改善老年高血压住院患者睡眠质量的应用效果。方法:选取2022年5月至2023年5月福建医科大学附属协和医院收治的老年高血压住院患者72例作为研究对象,按照随机数字表法分为对照组和观察组,每组36例。对照组采用常规护理,观察组采用综合干预。结果:干预后,观察组收缩压、舒张压、睡眠质量评分、焦虑自评量表(SAS)、抑郁自评量表(SDS)评分低于对照组,差异有统计学意义(P<0.05);观察组生命质量评分高于对照组,差异有统计学意义(P<0.05)。结论:综合干预可有效控制老年高血压住院患者血压,降低其负面情绪,有利于调节患者睡眠质量,提升生命质量。

清瘿散改善桥本甲状腺炎合并亚临床甲减患者抑郁焦虑状态及抗体紊乱的随机对照研究

[目的]观察清瘿散对于肝郁脾虚型桥本甲状腺炎合并亚临床甲减患者的抑郁焦虑状态的改善作用,及其对血清抗甲状腺过氧化物酶抗体、抗甲状腺球蛋白抗体的影响。[方法]采用前瞻性设计,将2021年7月至2022年6月在上海市中医医院甲状腺病专科门诊明确诊断为肝郁脾虚型桥本甲状腺炎(HT)合并亚临床甲减(SCH)患者154例。根据不同治疗方案,用随机数字表法分为两组,试验组以清瘿散联用优甲乐治疗(77例),对照组以单药优甲乐治疗(77例),治疗周期12周。观察治疗前后两组患者抑郁及焦虑自评量表(SDS、SAS)计分、甲状腺疾病生活质量(SF-36)计分和血清抗甲状腺过氧化物酶抗体(TPOAb)、抗甲状腺球蛋白抗体浓度(TgAb)、促甲状腺素(TSH)浓度变化。[结果]治疗12周后,试验组SDS、SAS评分较治疗前下降显著多于对照组(P<0.01)、试验组SF-36评分较治疗前提升,显著高于对照组(P<0.05);试验组血清TPOAb、TgAb较治疗前显著下降(P<0.01),对照组治疗前后均未见显著变化;两组治疗后血清TSH均较前显著下降(P<0.01)。试验组总有效率为86.4%,显著高于对照组42.6%,两组间有显著差异(P<0.01)。[结论]清瘿散加小剂量优甲乐治疗12周可显著改善肝郁脾虚型HT合并SCH患者抑郁及焦虑状态、提高患者生活质量,降低血清TSH、TPOAb、TgAb水平,临床疗效优于单药小剂量优甲乐治疗方案。