正念减压疗法对冠心病合并高血压患者睡眠质量、心理状态及心血管事件发生率的影响

目的 探讨正念减压疗法对冠心病合并高血压患者睡眠质量、心理状态及心血管事件发生率的影响。方法 纳入2018年12月～2019年12月期间我院接诊的113例冠心病合并高血压患者作为本次研究对象,随机抽签法分为两组,对照组56例患者接受常规干预,研究组57例患者在常规干预基础上加用正念减压疗法,比较两组患者失眠质量、心理状态及心肌梗死、心力衰竭、心律失常等心血管事件的发生情况。结果 干预后,两组患者SPIEGEL睡眠评分明显降低,且研究组低于对照组(P0.05);两组患者SAS评分及SDS评分均明显降低,且研究组患者SAS评分及SDS评分较对照组更低(P0.05);研究组患者收缩压、舒张压水平低于对照组,心血管事件发生率较对照组更低(P0.05)。结论 正念减压疗法能稳定冠心病合并高血压患者血压水平,减轻患者负面情绪,改善睡眠质量,减少心血管时间发生。     

正念减压疗法对脑卒中后抑郁的影响

目的探讨正念减压疗法(MBSR)对脑卒中后抑郁(PSD)患者的影响。方法将某三级甲等医院神经内科一年内确诊的68名PSD患者按确诊时间排序,并按最小不平衡指数法分为研究组和对照组各34名,两组均进行常规健康教育与治疗,研究组在此基础上进行每周1次、共8次的正念减压训练。治疗前后采用汉密尔顿抑郁量表24项版(HAMD-24)对患者进行测评,评估治疗效果。结果研究组经MBSR治疗后HAMD-24评分较治疗前低,差异有统计学意义[(16.20±2.04)vs.(21.32±1.86),P0.01],对照组治疗前后HAMD-24评分差异无统计学意义(P0.05),治疗后研究组HAMD-24评分低于对照组,差异有统计学意义(P0.01)。结论正念减压疗法对脑卒中后抑郁可能有效。     

正念减压疗法对不孕症患者的焦虑抑郁情绪和睡眠质量的影响

目的分析不孕症患者应用正念减压疗法治疗后焦虑抑郁情绪、睡眠质量及生活质量变化。方法将我院89例不孕症患者采用随机数字表法进行分组,对照组44例给予常规心理治疗,观察组45例增加正念减压疗法联合治疗,对比两组患者治疗前后焦虑情绪、抑郁情绪及睡眠质量改变,和两组患者治疗后生活质量变化。结果治疗后,观察组SAS、PSQI、及SDS评分均低于对照组,SF-36评分高于对照组(P0.05)。结论正念减压疗法能够有效缓解不孕症患者焦虑抑郁情绪,提升睡眠质量及生活质量。     

正念减压疗法对老年冠心病患者心理状态和睡眠质量的影响

目的 探讨对老年冠心病患者进行基于疾病分期干预模式的正念减压疗法的效果及对其睡眠质量和心理状态的影响.方法 选取我院2018年7月～2020年7月收治的冠心病老年患者115例,随机数字表法分为两组,对照组57例给予常规临床干预,观察组58例予基于疾病分期干预模式下的正念减压疗法,均干预2个月,对比两组干预效果,焦虑、抑...     

社区综合干预对康复期精神分裂症患者临床症状及生存质量的影响

目的探讨社区综合干预对康复期精神分裂症患者临床症状及生存质量的影响。方法采用随机数字表法将符合《中国精神障碍分类与诊断标准(第3版)》(CCMD-3)的76例康复期精神分裂症患者分为社区综合干预组(研究组)和常规康复治疗组(对照组)各38例,分别采用社区综合干预法和常规康复法治疗6个月。在干预前及干预后6个月末采用阳性与阴性症状量表(PANSS)和世界卫生组织生存质量测定量表简表(WHOQOLBREF)分别评定精神症状的严重程度和生存质量。结果社区综合干预6个月后研究组与对照组有效率分别为92.1%和71.1%,差异有统计学意义(P0.05)。干预6个月后,两组WHOQOL-BREF 4个领域评分与干预前比较差异有统计学意义(P0.05),两组间比较差异也有统计学意义(P0.05)。结论全面利用家庭、社区、社会等支持资源的社区综合干预模式可能有利于改善精神分裂症症状,增强康复效果和提高生存质量。     

正念练习对产妇负性情绪的效果

目的 探讨正念练习对产妇负性情绪的干预效果。方法 采用目的性抽样法选取2020年1月～2020年12月期间到本院进行产检、分娩的100例产妇。随机数字表法分为两组,各50例。对照组给予常规护理,研究组在常规护理同时应用正念练习。比较两组干预效果。结果 干预后,研究组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分低于对照组,五因素心智觉知度量表(FFMQ)评分高于对照组(P0.05);研究组第1产程、第2产程、第3产程视觉模拟评分法(VAS)评分均低于对照组(P0.05);研究组无一例出现产后抑郁,对照组发生率为12.00%(P0.05)。结论 产妇护理中实施正念练习可减轻其负性情绪,提升正念水平,缓解产程疼痛程度,减少产后抑郁发生。     

微骨孔完全显微血管减压术治疗三叉神经痛的短期疗效及并发症观察

目的探讨微骨孔完全显微血管减压术对三叉神经痛(TN)的短期疗效及并发症影响。方法回顾性分析2012-05-2015-04入院行微骨孔完全显微血管减压术的22例三叉神经痛患者(研究组,n=22)和同期行传统显微血管减压术的30例患者(对照组,n=30)的临床资料。对比2组短期疗效,记录其术后并发症发生情况及复发情况,分析治疗前后睡眠质量与疼痛评分。结果研究组治疗总有效率为95.5%,对照组为96.7%,差异无统计学意义(P0.05)。2组术后并发症发生率及复发率比较,差异均无统计学意义(P0.05)。治疗后,2组PSQI评分及NRS评分均较治疗前显著降低,差异有统计学意义(P0.05);但组间比较差异无统计学意义(P0.05)。结论微骨孔完全显微血管减压术具有短期疗效显著、术后并发症发生率低等特点,可在促进TN患者病情转归等方面发挥积极作用。     

外伤性视神经病变患者视神经减压术围手术期综合护理干预

目的探讨综合护理干预对外伤性视神经病变患者行鼻内镜下视神经减压术围手术期心理应激反应及生活质量的影响。方法选取我院2015-02—2017-04外伤性视神经病变107例,均行鼻内镜下视神经减压术治疗,按入院顺序分组,对照组53例予以常规护理干预,研究组54例在对照组基础上予以综合护理干预,比较2组干预前后抑郁(SDS)、焦虑(SAS)、生活质量(SF-36)评分、临床效果及并发症发生率。结果研究组干预后SDS、SAS评分低于对照组,差异有统计学意义(P0.05);研究组临床效果优于对照组,研究组总有效率96.30%(52/54)高于对照组81.13%(43/53),差异有统计学意义(P0.05);研究组并发症发生率1.85%(1/54)低于对照组20.75%(11/53),差异有统计学意义(P0.05);研究组术后躯体功能、社会功能、精力、心理健康等SF-36评分均高于对照组,差异有统计学意义(P0.05)。结论给予外伤性视神经病变行鼻内镜下视神经减压术患者围手术期综合护理干预效果显著,可明显改善其心理应激反应及生活质量,且安全性较高。     

心理干预联合音乐放松疗法对晚期肺癌化疗患者希望水平、心理痛苦程度、癌因性疲乏的影响

目的 探讨基于希望理论的心理干预联合音乐放松疗法对晚期肺癌化疗患者希望水平、心理痛苦程度、癌因性疲乏的影响。方法 选取2016年12月～2019年12月我院晚期肺癌化疗患者106例,按入院时间顺序分为研究组(n=53)、对照组(n=53)。对照组采取常规护理干预,于常规护理干预基础上研究组采取基于希望理论的心理干预配合音乐放松疗法,均干预1个月。比较两组治疗依从性及干预前、干预1个月后心理痛苦程度、希望水平(HHI)、癌因性疲乏(PFS)评分。结果 干预1个月后研究组对现实和未来的积极态度、采取积极行动、与他人保持亲密关系评分高于对照组(P0.05);干预1个月后研究组心理痛苦程度优于对照组(P0.05);干预1个月后研究组行为、情感、感知、认知评分低于对照组(P0.05);研究组治疗依从率94.34%高于对照组81.13%(P0.05)。结论 基于希望理论的心理干预配合音乐放松疗法应用于晚期肺癌化疗患者,可减轻其心理痛苦程度,提高患者希望水平,缓解其癌因性疲乏,提高治疗依从性。     

正念分娩疗法对孕妇焦虑抑郁情绪的影响

目的探究正念分娩疗法对孕妇焦虑抑郁情绪的影响,以期为孕妇的心理干预提供参考。方法选择2018年10月-2019年3月在绵阳市第三人民医院产科就诊、符合《精神障碍诊断与统计手册(第5版)》(DSM-5)轻中度焦虑和抑郁诊断标准的孕妇80例,采用随机数字表法分为对照组和试验组各40例,两组均接受常规的心理健康教育,试验组在此基础上接受每周1次、共8次的正念分娩训练。于干预前和干预后,使用患者健康问卷抑郁量表(PHQ-9)和广泛性焦虑量表(GAD-7)对孕妇进行评定。结果干预前后,试验组PHQ-9评分[(6.95±1.40)分vs.(2.10±1.34)分,P0.05]、GAD-7评分[(7.23±1.29)分vs.(2.08±1.51)分,P0.05]差异均有统计学意义,对照组PHQ-9评分[(7.00±1.43)分vs.(3.65±1.35)分,P0.05]、GAD-7评分[(7.18±1.57)分vs.(3.38±1.66)分,P0.05]差异均有统计学意义。干预后,试验组PHQ-9评分和GAD-7评分均低于对照组,差异均有统计学意义(t=5.161、3.666,P均0.01)。结论常规心理健康教育联合正念分娩疗法可能有助于缓解孕妇焦虑抑郁情绪,其效果优于单用常规心理健康教育。     

正念干预对炎症性肠病患者抑郁、焦虑及生活质量影响的Meta分析

目的评价正念干预对炎症性肠病(IBD)患者抑郁、焦虑及生活质量的影响,为IBD患者正念干预的临床应用提供循证参考。方法对PubMed、Embase、PsycINFO、Cochrane Library、中国知网、万方数据库、中国生物医学文献数据库进行检索,收集关于正念疗法干预IBD患者的随机对照研究的相关数据,采用RevMan 5. 3进行Meta分析。结果共纳入5项随机对照研究,包括319例IBD患者,其中干预组163例,对照组156例。Meta分析结果显示,干预结束时,与对照组相比,正念干预组抑郁水平更低,差异有统计学意义(SMD=-0. 56,95%CI:-0. 87～-0. 26,P0. 05),正念干预对IBD患者焦虑水平(SMD=-0. 15,95%CI:-0. 59～0. 30,P=0. 52)、生活质量(SMD=0. 13,95%CI:-0. 20～0. 47,P=0. 44)的改善无统计学意义;长期随访,与对照组相比,正念干预对IBD患者抑郁、焦虑及生活质量的改善差异无统计学意义(P0. 05)。结论正念干预可能有助于降低IBD患者抑郁水平,但长期效应尚不明确。     

Effects of Mindfulness-Based Stress Reduction Intervention on Psychological Well-being and Quality of Life: Is Increased Mindfulness Indeed the Mechanism?

Background  Although several studies have reported positive effects of mindfulness-based stress reduction (MBSR) intervention on psychological well-being, it is not known whether these effects are attributable to a change in mindfulness. Purpose  The aim of this study is to compare the effects of MBSR to a waiting-list control condition in a randomized controlled trial while examining potentially mediating effects of mindfulness. Methods  Forty women and 20 men from the community with symptoms of distress (mean age 43.6 years, SD = 10.1) were randomized into a group receiving MBSR or a waiting-list control group. Before and after the intervention period, questionnaires were completed on psychological well-being, quality of life, and mindfulness. Results  Repeated measures multiple analysis of variance (MANCOVAs) showed that, compared with the control group, the intervention resulted in significantly stronger reductions of perceived stress (p = 0.016) and vital exhaustion (p = 0.001) and stronger elevations of positive affect (p = 0.006), quality of life (p = .009), as well as mindfulness (p = 0.001). When mindfulness was included as a covariate in the MANCOVA, the group effects on perceived stress and quality of life were reduced to nonsignificance. Conclusion  Increased mindfulness may, at least partially, mediate the positive effects of mindfulness-based stress reduction intervention.     

The effect of self-management training on health-related quality of life in patients with epilepsy

PurposeEpilepsy is the most common chronic neurological disease after headache. Health-related quality of life in patients with epilepsy is disturbed by psychosocial factors, seizures, and treatment side effects. This study was conducted to determine the effect of a self-management training program on quality of life in patients with epilepsy.MethodsIn this controlled clinical trial, 60 patients with epilepsy going to Zanjan Neurology Clinic were examined. The samples were selected using convenience sampling and divided randomly into the case group (30 people) and control group (30 people) using the table of random numbers. Four training sessions on the nature of epilepsy and self-managementwere run for the case group. All the patients completed an inventory for quality of life twice: before and one month after the intervention. The data were analyzed using the chi-square test, independent t-test, and paired t-test.ResultsThere was no statistically significant difference between the two groups before the intervention in terms of personal specifications and scores and dimensions of the quality of life. One month after the intervention, a statistically significant difference was observed between the two groups in terms of the scores and dimensions of quality of life that indicated improved quality of life in the case group (P < 0.001).ConclusionThe self-management training program improved the quality of life in patients with epilepsy. The present findings highlight that psychosocial variables can have incremental significance over biomedical variables in the health-related quality of life of patients with epilepsy.     

A Randomized Controlled Trial of a Mindfulness-Based Smoking Cessation Program for Individuals with Mild Intellectual Disability

Smoking is a risk factor for death and dying for individuals who smoke and for those who inhale second hand smoke. Smokers struggle to quit smoking because of the negative affect associated with nicotine withdrawal. We assessed the efficacy of a mindfulness-based intervention for smoking cessation in individuals with mild intellectual disabilities. In addition to the basic concentration meditation, the mindfulness-based smoking cessation program included daily intention, mindful observation of thoughts, and Meditation on the Soles of the Feet. In a two-group randomized controlled trial, 51 protocol-eligible participants were randomly assigned to either the experimental group (mindfulness-based intervention) or the control group (treatment as usual). Results showed a statistically significant reduction in smoking commensurate with mindfulness-based training when compared to the treatment as usual condition. This finding was evident regardless of whether the analysis included only those who completed the study or the total sample in an intent-to-treat analysis. Furthermore, those receiving the mindfulness-based intervention were significantly more successful in abstaining from smoking during a 1-year follow-up than the treatment as usual group. These results suggest mindfulness-based interventions may be effective treatments for smoking cessation in individuals with mild intellectual disabilities.     

健康信念模式综合干预对脑梗死患者治疗的影响

目的探讨基于健康信念模式为框架的综合护理干预对脑梗死患者治疗依从性及生活质量的影响。方法选取2013-11—2016-07我院66例脑梗死患者,按随机数字表法分为对照组与研究组各33例。对照组给予常规护理干预,研究组在常规护理基础上采用基于健康信念模式的综合护理干预。对比2组治疗依从性、护理满意度及护理前后2组生活质量评分(SF-36)变化情况。结果 2组治疗依从率比较,研究组[93.94%(31/33)]高于对照组[69.70%(23/33)],差异有统计学意义(P0.05);护理前2组精神健康、社会功能、生理功能、情感职能比较,差异无统计学意义(P0.05),护理后研究组SF-36各维度分值高于对照组,差异有统计学意义(P0.05)。结论基于健康信念模式为框架的综合护理干预可有效提高脑梗死患者治疗依从性及护理满意度,改善其生活质量。     

生酮饮食添加疗法对药物难治性癫痫儿童的疗效与生活质量的影响

目的探讨生酮饮食(KD)添加疗法对药物难治性癫痫儿童的治疗效果与生活质量的影响。方法采用前瞻性对照研究,将临床观察对象分为KD组(30例)与对照组(30例)。收集患儿的临床资料,并于KD添加疗法开始前1个月及治疗后第1、3、6、12个月采用癫痫儿童生活质量量表(QOLCE)-55对患儿进行评测。于KD添加疗法结束当天,参考Engel分级标准,对疗效进行评价。结果 KD添加治疗前1个月及治疗后第1、3个月,KD组及对照组QOLCE各项评分差异无统计学意义(均P>0.05)。KD添加治疗6个月,KD组行为功能评分显著高于对照组(P<0.05),其他评分差异无统计学意义(均P>0.05)。KD添加治疗12个月,KD组躯体功能与行为功能评分显著高于对照组(均P<0.05),其他评分差异无统计学意义(均P>0.05)。与治疗后第1个月比较,对照组及KD组治疗后第3个月躯体功能、情感健康、认知能力、社会功能和行为功能评分显著升高(均P<0.05);与治疗后第3个月比较,对照组治疗后第6个月躯体功能、情感健康、认知能力、社会功能和行为功能评分及KD组治疗后第6个月情感健康及行为功能评分显著升高(均P<0.05);与治疗后第6个月比较,对照组治疗后第12个月躯体功能、认知能力、社会功能和行为功能评分及KD组治疗后第12个月躯体功能、认知能力和行为功能评分显著升高(均P<0.05)。KD组有效率为60.0%,发作缓解率为13.3%;对照组有效率为30.0%,发作缓解率为13.3%。KD添加疗法的疗效优于常规抗癫痫治疗(χ2=6.336,P=0.042)。KD组18例发生不同程度的不良反应,经过积极处理后均改善。结论 KD添加疗法对癫痫儿童具有一定的治疗效果,短期内虽有不良反应的出现,但其后果轻微,且患儿能逐渐耐受。     

美沙酮合并心理干预对海洛因依赖者的影响

目的:评估心理干预对美沙酮维持治疗患者的应对方式、压力感受和自我效能状况的影响。方法:将美沙酮维持治疗门诊的海洛因依赖者分为研究组(n=71)和对照组(n=55)。研究组给予为期3个月的心理干预。两组在入组时,1个月后以及3个月后评定应对方式问卷(SCSQ)、压力感受量表(PSS)、自我效能量表(SES),并进行评分比较。结果:与入组时相比,研究组干预后1个月、3个月应对方式、压力感受、自我效能评分的差异均有统计学意义(P<0.01)。干预后1个月两组间积极应对方式、压力感受评分差异有统计学意义(P<0.05),消极应对方式、自我效能评分差异无统计学意义(P>0.05);干预后3个月两组间积极应对方式、消极应对方式、压力感受、自我效能评分差异均有统计学意义(P<0.05)。两组维持治疗率差异有统计学意义(P<0.01)。结论:心理干预有利于改善海洛因依赖者的应对方式和自我效能,提高美沙酮维持治疗率。     

早期护理干预联合中医治疗重度颅脑外伤的效果观察

目的探讨重度颅脑外伤患者采用早期护理干预联合中医治疗的神经功能康复效果。方法将2014-08―2016-08郑州市第九人民医院神经内科收治的50例重度颅脑外伤患者随机分为2组,均给予常规西医治疗,对照组辅助常规护理,观察组采用早期护理干预联合中医治疗,比较2组神经功能、精神状态、肢体运动功能以及生活质量。结果观察组NIHSS、MMSE、FMA评分均较对照组明显改善,差异有统计学意义(P<0.05);观察组生存质量综合评定问卷(GQLI)中躯体健康、心理健康、社会功能、物质生活条件评分均明显优于对照组,差异有统计学意义(P<0.05)。结论重度颅脑外伤患者采用早期护理干预联合中医治疗效果显著,利于神经功能及肢体运动的早期恢复,改善患者精神状态及生活质量。     

The efficacy of mindfulness-based stress reduction in the treatment of sleep disturbance in women with breast cancer: an exploratory study

OBJECTIVE: The diagnosis of breast cancer, the most common type of cancer among American women, elicits greater distress than any other diagnosis regardless of prognosis. Therefore, the present study examined the efficacy of a stress reduction intervention for women with breast cancer. METHODS: As part of a larger, randomized, controlled study of the effects on measures of stress of a mindfulness-based stress reduction (MBSR) intervention for women with breast cancer, the current analyses examined the effects on sleep complaints. RESULTS: Analyses of the data indicated that both MBSR and a free choice (FC) control condition produced significant improvement on daily diary sleep quality measures though neither showed significant improvement on sleep-efficiency. Participants in the MBSR who reported greater mindfulness practice improved significantly more on the sleep quality measure most strongly associated with distress. CONCLUSION: MBSR appears to be a promising intervention to improve the quality of sleep in woman with breast cancer whose sleep complaints are due to stress.