Home-based nursing for improvement of quality of life and depression in patients with postpartum depression

BACKGROUND Postpartum depression is a common mental illness in puerpera,with an incidence of approximately 3.5%-33.0%abroad,and the incidence of postpartum depression in China is higher than the international level,reaching 10.0%-38.0%.Providing effective nursing care in clinical nursing activities is one of the key points of obstetrical care.However,little research has been designed to investigate the positive role of home-based nursing in the prevention of postpartum depression.AIM To study the effect of home-based nursing for postpartum depression patients on their quality of life and depression.METHODS The clinical data of 92 patients with postpartum depression treated at our hospital were retrospectively analyzed.The patients were grouped according to the nursing methods used;40 patients receiving basic nursing were included in a basic nursing group,and 52 receiving home-based nursing were included in a home-based nursing group.Depression and anxiety were evaluated and compared between the two groups.The estradiol(E2),serotonin(5-hydroxytryptamine,5-HT),and progesterone(PRGE)levels were measured.RESULTS The SAS and SDS scores of the home-based nursing group were significantly lower than those of the basic nursing group(P<0.05).The E2 and 5-HT levels of the home-based nursing group were significantly higher than those of the basic nursing group,but the PRGE level was significantly lower than that of the basic nursing group.The GQOLI-74 scores(material,social,somatic,and psychological)and nursing satisfaction were significantly higher in the home-based nursing group(P<0.05).CONCLUSION Postpartum depression through home-based nursing can effectively alleviate depression and improve the quality of life of patients,help modulate their serum E2,5-HT,and PRGE levels,and improve their satisfaction with nursing care.

Impact of spiritual care on the spiritual and mental health and quality of life of patients with advanced cancer

BACKGROUND Cancer is a growing threat to human health.Due to the double torment of cancer and cancer treatment,patients with advanced cancer generally have a low quality of life.At present,there is a lack of systematic spiritual care plans for patients with advanced cancer as well as systematic guidance plans on the specific clinical application of spiritual care for advanced cancer patients.We hypothesized that our care plan would be effective in improving the spiritual and mental health and quality of life of patients with advanced cancer.AIM To construct a spiritual care plan suitable for Chinese patients with advanced cancer through literature analysis.METHODS From February to December 2018,through purpose sampling,we selected 100 advanced cancer patients from the Oncology Department and Hospice Ward of a tertiary hospital in Liaoning Province who met the study standards.Patients were randomly divided into experimental and control groups,with 50 cases in each group.The control group received the current routine care,while the experimental group received the advanced cancer spiritual care intervention in addition to routine care.RESULTS After the intervention,the overall spiritual health score for the experimental group was higher than that of the control group(4.68±1.36 vs 3.63±1.71).The difference between the groups was statistically significant(P<0.05).The proportion of anxiety-free patients in the experimental group was 95.45%,which was significantly higher than the 60.98%in the control group.Moreover,the proportion of non-depressed patients in the experimental group was 97.73%,which was significantly higher than the 85.37%in the control group(P<0.05).The overall quality of life score for the experimental group was significantly higher than that of the control group(5.36±1.16 vs 4.39±1.36,P<0.05).CONCLUSION Our spiritual care plan for patients with advanced cancer could improve their spiritual health and quality of life and reduce negative mental health symptoms.

Pharmaceutical Care of the Patients Suffering from Depression

Depression is the most present mental disorders with a very expensive treatment costs. Due to the high prevalence of depression in Bosnia and Herzegovina and high work load of psychiatrists, patients that suffer from depression are often marginalised, stigmatised and inadequately treated. Therefore, a pharmacist can influence an adequate selection of a therapy through an interdisciplinary approach and pharmaceutical care and alos provide patient monitoring, counselling about side effects and interactions of the prescribed drugs, which will in the end improve the quality of life for patients that suffer from depression. The aim of this work was to establish the influence of pharmaceutical care on the outcome of the quality of life and the pharmacological treatment of patients suffering from depression. Results showed that the involvement of pharmacist in a multidisciplinary approach to the treatment of depression lead to improvement of the effect of therapy and increased quality of life.

Depression risk in patients with coronary heart disease in Germany

AIM To determine the prevalence of depression and its risk factors among patients with coronary heart disease(CHD) treated in German primary care practices.METHODS Longitudinal data from nationwide general practices in Germany(n = 1072) were analyzed.Individuals initially diagnosed with CHD(2009-2013) were identified,and 59992 patients were included and matched(1:1) to 59992 controls.The primary outcome measure was an initial diagnosis of depression within five years after the index date among patients with and without CHD.Cox proportional hazards models were used to adjust for confounders.RESULTS Mean age was equal to 68.0 years(SD = 11.3).A total of 55.9% of patients were men.After a five-year follow-up,21.8% of the CHD group and 14.2% of the control group were diagnosed with depression(P < 0.001).In the multivariate regression model,CHD was a strong risk factor for developing depression(HR =1.54,95%CI:1.49-1.59,P < 0.001).Prior depressive episodes,dementia,and eight other chronic conditions were associated with a higher risk of developing depression.Interestingly,older patients and women were also more likely to be diagnosed with depression compared with younger patients and men,respectively.CONCLUSION The risk of depression is significantly increased among patients with CHD compared with patients without CHD treated in primary care practices in Germany.CHD patients should be routinely screened for depression to ensure improved treatment and management.

Effects of multiple nursing cares on quality of life in individuals with coronary artery disease complicated with diabetes mellitus

Patients with coronary artery disease （CAD） complicated with diabetes mellitus （DM） have a reduced quality of life （QOL） partly due to their limited range of physical activity and independence. The primary objective of this study was to examine the effect of the application of the multiple nursing cares on QOL and de- pressive symptoms in individuals with CAD complicated with DM. Methods A total of 82 CAD complicated with DM patients in Guangdong General Hospital from January 2014 to January 2015 were selected, and random- ly divided into control group （n = 41） and experimental group （n = 41） according to World Health Organization DM diagnosis criteria. The subjects in control group received routine nursing care, and the subjects in experimen- tal group were treated with the multiple nursing cares additionally for a 10-week period. The outcome measures include the Short Form-36 Health Survey （SF-36）, and Self-Rating Anxiety Scale （SAS）. Results Following 10-week intervention, the QOL scores and SAS anxiety scores in all groups were improved （P 〈 0.05）. In addi- tion, QOL and SAS anxiety scores in the experimental group were significantly improved （P 〈 0.05）, when com- pare with the control group. Conclusions Based on the results of this study, the application of the multiple nurs- ing cares to individuals with CAD complicated with DM is effective in increasing selected aspects of a general QOL and improving the anxiety situation in individuals with CAD complicated with DM. It is worthwhile to be widely used in clinical practice.

Analysis of Humanistic Nursing Care in Regulating the Emotion, Satisfaction, and Sleep Quality of Inpatients with Hematologic Neoplasms

Objective:To explore the clinical application value of humanistic nursing care in the treatment of hematologic neoplasm inpatients.Methods:Fifty-two patients with hematologic neoplasms admitted to a hospital from May 2019 to February 2022 were selected as the research subjects.According to a random number table,they were divided into two groups:the control group(n=25,routine clinical nursing)and the observation group(n=27,humanistic nursing care).The negative emotion score,nursing satisfaction,and sleep quality were compared between the two groups under different nursing modes.Results:The SAS and SDS scores before and after nursing were compared between the two groups.There was no significant difference between the two groups before nursing(p>0.05).However,the SDS and SAS scores in the two groups after nursing were lower than those before nursing,in which the observation group was slightly lower than the control group,and the difference was statistically significant(p<0.001).In terms of nursing satisfaction,it was as high as 96.29%in the observation group,whereas in the control group,the satisfaction rate was only 72.00%;the PSQI scores were compared between the two groups before and after nursing,and there was no significant difference between the two groups before nursing(p>0.05).However,the PSQI scores and total score of the observation group after nursing were lower than those of the control group(p<0.001).Conclusion:In the clinical treatment of patients with hematologic neoplasms,the implementation of humanistic nursing care can significantly improve patients’anxiety,depression,other negative emotions,sleep quality,and nursing satisfaction,all of which have significance in promoting the prognosis of patients and improving their quality of life.

Alpha-Stim Cranial Electrotherapy Stimulation (CES) for Anxiety Treatment: Outcomes in a United Kingdom (UK) Primary Care Practice

Background: Anxiety disorders are the most common mental disorders, typically treated with psychotherapy and medication. These treatments are not suitable for, acceptable to, or effective for everyone. Alpha-Stim AID is a Cranial Electrotherapy Stimulation (CES) treatment with evidence of effectiveness in treating anxiety disorders. Objective: The aim of this paper is to present outcomes on anxiety, depression, and quality of life of Alpha-Stim use in primary care patients in the United Kingdom’s (UK) National Health Service (NHS) who reported symptoms of anxiety. Methods: Open label patient cohort design. Self-report measures: PHQ-9 (depression), GAD-7 (anxiety) and EQ-5D-5L (health related quality of life). Twenty-three patients with symptoms of anxiety completed a six-week course of Alpha-Stim intervention. Results: Reliable improvement and remission rates respectively were 60.9% and 17.4% for the GAD-7;42.9% and 22.7% for the PHQ-9. Significant improvement and medium/large effect sizes (n2 = 0.59 and 0.56 respectively). EQ-5D-5L results showed significant improvements in quality of life. Perceived quality of life doubled with an improvement of 0.36 on the health index score, this intervention adds 3.64 Quality Adjusted Life Years (QALYs). Limitations: The study was not an RCT, there was no control group. Conclusions: Alpha-Stim AID CES can be delivered through a UK primary care practice, and can have a significant impact on symptoms of anxiety and depression, and improve quality of life in primary care patients with anxiety symptoms. Further feasibility studies in primary care and sufficiently powered RCT are required.

基于学术团体的肿瘤安宁疗护共同照护模式在晚期肿瘤病人中的应用

目的:探讨基于学术团体的安宁疗护共同照护模式在晚期肿瘤病人中的应用效果。方法:采用便利抽样方法,选取2021年1月—6月江西省某肿瘤医院收治的136例晚期肿瘤病人为研究对象。采用随机数字表法将其分为对照组和干预组,每组68例。对照组采用常规护理,干预组在常规护理基础上给予基于学术团体的安宁疗护共同照护模式。干预前后采用医院焦虑抑郁量表(HADS)、欧洲癌症研究与治疗组织生活质量核心量表(EORTC QLQ-C30)对两组病人焦虑、抑郁情绪及生活质量进行评价。结果:干预组病人干预后焦虑子量表、抑郁子量表以及总分低于对照组,2个功能领域(躯体功能、角色功能)、总体健康状况、总体生命质量得分均高于对照组,3个症状领域以及5个单测项目(失眠、食欲减退、便秘、腹泻、经济困难)得分均低于对照组,经比较差异均有统计学意义(均P<0.05)。结论:基于学术团体的肿瘤安宁疗护共同照护模式能有效降低病人焦虑、抑郁水平,提升其生活质量。

心理干预联合人文关怀对慢性心力衰竭患者心理状态、治疗依从性及睡眠质量的影响

目的:分析心理干预与人文关怀在慢性心力衰竭(CHF)患者中的应用效果。方法:选取2023年3月至2024年2月泉州市第一医院收治的CHF患者150例作为研究对象,按照随机数字表法分为观察组和对照组,每组75例。2组均接受常规治疗与护理,观察组在常规治疗、护理基础上接受心理干预与人文关怀。比较2组干预后焦虑与抑郁情绪、服药依从性、睡眠质量与生命质量。焦虑采用焦虑自评量表(SAS)评价,抑郁采用抑郁自评量表(SDS)评价,睡眠质量采用匹兹堡睡眠质量指数(PSQI)评价,生命质量采用明尼苏达心力衰竭生命质量量表(MLHFQ)评价。结果:观察组在干预后SAS、SDS评分低于对照组,服药依从率高,PSQI评分与睡眠障碍发生率较低,差异有统计学意义(P<0.05)。观察组在干预后MLHFQ评分显著低于对照组,差异有统计学意义(P<0.05)。结论:心理干预与人文关怀可改善CHF患者心理障碍与睡眠障碍,提升治疗依从性,改善生命质量。

基于认知-行为的多层次护理对卒中后抑郁的效果影响

目的探讨基于认知-行为的多层次护理干预对卒中后抑郁(post-stroke depression,PSD)的效果影响。方法选择武汉科技大学附属天佑医院神经内科2019年1月—2023年1月住院的110例PSD患者作为研究对象,对上述患者入院的前后顺序进行标号,随机分为2组,对照组(n=55)予以常规护理措施干预,在此基础上观察组(n=55)予以基于认知-行为的多层次护理干预。2组患者干预前和干预后1个月,分别采用汉密尔顿抑郁量表(Hamilton depression scale,HAMD)、汉密尔顿焦虑量表(Hamilton anxiety scale,HAMA)、简易精神状态检查量表(mini-mental state examination,MMSE)、Barthel指数(barthel index,BI)、生活质量综合评定问卷-74(generic quality of life inventory 74,GQOLI-74)评估患者的精神症状、认知状况、日常生活能力、生活质量。结果与观察组护理干预前和对照组干预后比较,观察组护理干预后HAMD(16.01±1.97)分、HAMA(14.37±1.48)分均明显降低(P<0.05);观察组护理干预后MMSE(28.74±3.16分)、BI(83.09±7.81分)及生活质量评分均明显升高(P<0.05)。结论基于认知-行为的多层次护理干预可明显改善PSD患者的精神症状、认知状况及日常生活能力,同时生活质量也得到明显地提高。

人文关怀在急性心肌梗死经鼻烟壶动脉途径行PCI术患者不良情绪及睡眠质量的影响

目的:分析人文关怀在急性心肌梗死经鼻烟壶动脉途径行经皮冠状动脉介入治疗(PCI)术患者不良情绪及睡眠质量的影响。方法:选取厦门大学附属第一医院经鼻烟壶动脉途径行PCI术治疗的急性心肌梗死患者96例作为研究对象,按照随机数字表法随机分为观察组和对照组,每组48例。对照组采用常规护理,观察组配合人文关怀护理,比较2组心肌梗死患者的恢复结果。结果:护理后,观察组心肌梗死患者焦虑、抑郁情绪程度较对照组明显更低,睡眠状况则较对照组更佳,且观察组严重心律失常、心绞痛、非致死性心肌梗死等心脏不良事件也较对照组更少(P<0.05)。结论:人文关怀在急性心肌梗死患者经鼻烟壶动脉途径行PCI术可显著提高睡眠质量。

择期手术患者提前术前访视结合人文关怀对改善术前焦虑与睡眠质量的价值

目的 研究择期手术患者提前术前访视结合人文关怀对改善术前焦虑与睡眠治疗的价值。方法 纳入2021年1~12月收治的择期手术患者140例,2021年1~6月患者实施常规术前访视干预为对照组,2021年7~12月患者实施提前术前访视时间结合人文关怀理念干预为观察组,每组70例。对比不同干预方案对择期手术患者术前生命体征、焦虑与抑郁水平、睡眠质量、访视质量及满意度评分差异。结果 2组患者入院日焦虑量表得分差异无统计学意义(P>0.05),观察组术前1 d与术前30 min得分均低于对照组(P<0.05);观察组患者术前30 min与入室5 min的心率与血压水平均低于对照组(P<0.05);2组患者访视前的入睡时间、睡眠时间与觉醒次数差异无统计学意义(P>0.05),访视后观察组的入睡时间短于对照组,睡眠时间长于对照组,觉醒次数少于对照组(P<0.05);观察组患者对术前访视内容与形式的评分均高于对照组(P<0.05)。结论 提前术前访视时间结合人文关怀干预能够显著降低择期手术患者的术前焦虑水平,改善术前生命体征水平与睡眠质量,患者满意度提高。

人文关怀在老年肌萎缩侧索硬化症病人中的应用

目的分析人文关怀护理在老年肌萎缩侧索硬化症病人中的应用效果。方法便利选取2021年2月至2023年3月南京脑科医院神经内科收治的67例老年肌萎缩侧索硬化症病人为研究对象,比较人文关怀护理实施前后病人的关怀感受、自我效能感、情绪状态与生活质量。结果人文关怀护理实施后病人的关怀行为评价量表(CBI)评分、一般自我效能感量表(GSES)评分和健康生活量表简表(SF-36)评分均高于护理前(P<0.05);状态-特质焦虑问卷(STAI)中各分表的评分均低于护理前(P<0.05);病人的治疗依从性、护理满意度均显著提高(P<0.05)。结论在老年肌萎缩侧索硬化症病人中实施人文关怀护理,不仅能增强其关怀感受,提高自我效能感,而且还能改善病人情绪状态,提升治疗依从性及护理满意度,促进其生活质量进一步提高。

情志护理结合症状日记对肝郁气滞型乳腺癌化疗患者癌因性疲乏、负性情绪及生活质量的影响

目的:探讨中医情志护理结合症状日记对肝郁气滞型乳腺癌(Ⅲ期)化疗患者癌因性疲乏、负性情绪及生活质量的影响。方法:筛选乳腺癌(Ⅲ期)化疗患者102例,随机分为对照组和观察组,每组51例。两组均接受多西他赛、表柔比星、环磷酰胺(taxol epirubicin cyclophosphamide,TEC)化疗方案;对照组接受常规护理干预措施;观察组在对照组的基础上给予中医情志护理结合症状日记;两组均连续治疗6个化疗周期。比较两组癌因性疲乏、负性情绪及生活质量评分。结果:治疗后,观察组癌因性疲乏量表评分、汉密尔顿焦虑量表评分、汉密尔顿抑郁量表评分均低于对照组(P<0.01);治疗后,观察组生活质量评分改善均优于对照组(P<0.01)。结论:中医情志护理结合症状日记能有效改善肝郁气滞型乳腺癌(Ⅲ期)化疗患者的癌因性疲乏、负性情绪及生活质量。

焦点解决短期治疗联合叙事护理在晚期癌症患者安宁疗护中的应用研究

目的探讨焦点解决短期治疗(Solution-focused brief therapy,SFBT)联合叙事护理对实施安宁疗护晚期癌症患者焦虑抑郁及生活质量的影响。方法选取2022年8月至2023年5月晚期癌症安宁疗护患者作为研究对象,入院时采用医院焦虑抑郁量表(Hospital anxiety and de-pression scale,HADS)进行调查,筛选评分≥8分的患者纳入本研究(n=110),按照随机数字表法分为对照组(n=55)和试验组(n=55)。对照组采用安宁疗护常规护理,试验组在对照组的基础上采用焦点解决短期治疗联合叙事护理进行干预。比较两组干预前后焦虑自评量表(Self-rating anxiety scale,SAS)、抑郁自评量表(Self-rating depression scale,SDS)和癌症治疗功能评价量表(Functional assessment of cancer therapy,FACT-G)评分的差异,评价干预效果。结果因病情变化或死亡,试验组完成52例,对照组完成53例。干预前,试验组和对照组SAS、SDS、FACT-G评分比较差异均无统计学意义(P>0.05);干预后,试验组SAS、SDS、FACT-G评分分别为(42.52±2.30)分、(57.63±3.80)分、(67.54±2.52)分,对照组SAS、SDS、FACT-G评分分别为(47.29±2.73)分、(62.25±2.87)分、(64.39±3.08)分,两组比较差异均有统计学意义(P<0.05)。结论SFBT联合叙事护理干预,可降低晚期癌症患者的负面情绪,缓解抑郁焦虑,提高其生活质量。

人文关怀护理对改善血液肿瘤住院患者焦虑抑郁情绪及满意度的价值评估

目的探讨对血液肿瘤住院患者实施人文关怀护理的临床价值,重点分析对患者焦虑抑郁情绪及护理满意度的影响情况。方法纳入对象为辽阳市第三人民医院在2020年2月至2021年1月期间诊治的110例血液肿瘤住院患者,对患者随机编号,1~110号,其中奇数号为对照组,采用常规护理,偶数号为观察组,在常规护理基础上采用人文关怀护理干预,对比两组患者护理前后焦虑抑郁评分变化情况、护理后依从性情况、护理满意度情况以及患者的生活质量评分情况。结果干预前,两组患者焦虑、抑郁评分差异无统计学意义(P>0.05);干预后,观察组患者焦虑、抑郁评分均较低,治疗依从性较高,护理满意度较高,生活质量评分较高(均P<0.05)。结论将人文关怀护理模式应用于血液肿瘤住院患者,可以有效地疏导患者负面情绪,使患者对治疗的依从性明显提升,进而提高护理满意度和生活质量。

基于Cox健康行为互动模式的护理在乳腺癌化疗患者中的应用

目的:探讨基于Cox健康行为互动模式(IMCHB)的护理对乳腺癌化疗患者健康结局的影响。方法:选取2016年1月1日—2019年1月1日河南省人民医院收治的109例接受化疗的乳腺癌患者,排除随访丢失4例,不遵从医嘱治疗5例,不签署受试者知情同意书8例,共纳入92例作为研究对象。采用随机对照试验设计方案将其分为观察组(n=46)和对照组(n=46)。比较两组患者治疗依从性、护理服务满意度、自我护理能力、焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、生活质量、常见化疗不良反应发生情况。结果:观察组患者治疗依从性和护理服务满意度评分高于对照组,差异有统计学意义(t=5.340、8.388,P<0.05)。治疗后,观察组患者自我护理能力评分高于对照组,差异有统计学意义(t=0.067,P<0.05);观察组患者焦虑自评量表SAS、SDS评分低于对照组,差异有统计学意义(t=-2.019、-2.084,P<0.05);观察组患者功能领域评分高于对照组,症状领域评分低于对照组,差异有统计学意义(t=0.006、0.904、0.687、3.278、3.551、1.999、-4.457、-3.089、-2.690、-2.588,P<0.05)。观察组患者不良反应发生率低于对照组,差异有统计学意义(χ^(2)=14.194,P<0.05)。结论:基于IMCHB的护理能提高乳腺癌化疗患者的治疗依从性、护理服务满意度、自我护理能力,降低患者的焦虑和抑郁情绪及化疗不良反应发生率,改善患者的生活质量。

基于磁性理念的人文关怀护理对晚期乳腺癌患者自护能力、遵医行为及希望水平的影响

目的:探讨基于磁性服务理念的人文关怀护理对晚期乳腺癌患者自护能力、遵医行为及希望水平的影响。方法:选取123例晚期乳腺癌患者为研究对象,按照护理方式不同分为干预组(n=61)和对照组(n=62)。干预组患者实施基于磁性服务理念的人文关怀护理;对照组患者实施常规护理,干预时间为初次化疗前1 d至疗程结束。比较两组患者干预前后自护能力[自我护理能力测量表(ESCA)评分]、遵医行为、希望水平[Herth期望评价指数(HHI)评分]及生活质量[癌症治疗功能评估-乳腺癌(FACT-B)评分]。结果:干预后,两组患者ESCA量表各维度评分及总分、各项遵医行为评分及HII各维度评分及总分均升高(P<0.05),且干预组高于对照组(P<0.05);干预组患者FACT-B量表中情感状况、社会/家庭状况、附加关注评分及总分高于对照组(P<0.05)。结论:基于磁性服务理念的人文关怀护理有利于增强晚期乳腺癌患者自护能力,改善遵医行为,且对提高希望水平与生活质量有积极作用。

脑卒中后焦虑影响因素及干预措施研究进展

脑卒中后焦虑(PSA)是脑卒中患者常见的精神并发症,不仅影响患者生存质量,而且可能增加再次脑卒中的风险。本研究对PSA的影响因素、临床表现、评估方法及干预措施进行阐述,旨在为进一步认识PSA,改善患者的焦虑情绪,提供理论依据和新思路。

基于多学科协作的缓和医疗在心力衰竭患者中的应用

目的探讨基于多学科协作的缓和医疗在心力衰竭(heart failure,HF)患者中的应用效果。方法采用便利抽样法,选取2022年11月-2023年5月我院心血管内科收治的156例HF患者为研究对象,采用随机数字表法分为对照组和观察组各78例,中途对照组1例无法取得联系,观察组2例拒绝随访、2例无法取得联系,最终有效样本量为151例,其中对照组77例,观察组74例。对照组给予常规护理,观察组在对照组基础上给予基于多学科协作的缓和医疗干预。分别于干预前和干预3个月后对2组患者的生活质量和焦虑抑郁水平进行比较,并于干预3个月后对2组患者再入院情况进行观察和比较。结果干预前2组患者生活质量和焦虑抑郁水平比较,差异均无统计学意义(均P>0.05);干预3个月后,观察组生活质量和焦虑抑郁水平均优于对照组(均P<0.05)。干预3个月后,观察组患者再入院率低于对照组(P<0.05)。结论基于多学科协作的缓和医疗可有效改善心力衰竭患者的生活质量和情绪状态,降低患者的再入院率,值得临床推广应用。