老年慢性心力衰竭患者照顾者的抑郁焦虑状况及影响因素

目的分析老年慢性心力衰竭(CHF)患者照顾者的抑郁焦虑状况及影响因素。方法以124例CHF患者照顾者为研究组,100例非CHF患者的照顾者为对照组,应用抑郁自评量表(SDS)、焦虑自评量表(SAS)评价被试者的抑郁焦虑状况及相关因素。结果 CHF患者照顾者的抑郁得分为(38.73±5.75),焦虑得分为(34.61±4.23),均高于对照组(P<0.05)。其单因素分析显示,照顾者抑郁评分与教育程度、工作情况、经济状况、自我感觉压力值有关,焦虑评分与工作情况、经济状况、自我感觉压力值有关,差异均有统计学意义(P<0.05)。其多因素分析显示,抑郁评分与自我感觉压力值呈正相关,与教育程度呈负相关;焦虑评分与自我感觉压力值呈正相关。结论 CHF患者照顾者存在一定程度的抑郁焦虑症状,应给予有针对性的护理干预。     

高龄胃癌患者自我效能感与生活质量、社会支持及焦虑抑郁的相关性

目的探讨高龄胃癌患者的自我效能感与生活质量、社会支持及焦虑抑郁的相关性。方法 88例高龄胃癌患者应用一般资料调查问卷、癌症患者自我效能感量表、欧洲生活质量协作组癌症核心量表(EORTC QLQ-C30)中文量表、社会支持问卷及综合医院焦虑抑郁量表进行调查分析。结果高龄胃癌患者自我效能感总分为(84.15±5.245)分;总体生活质量得分(52.08±18.210)分,处于中等偏低水平;社会支持总分为(37.82±3.360)分,自我效能感总分与总体生活质量总分及功能领域得分均呈显著正相关(r=0.813、0.365,P<0.01),与社会支持总分呈正相关(r=0.240,P<0.05);与焦虑呈负相关(r=-0.215,P<0.05)。结论临床医护人员应重视胃癌患者的自我效能感,充分应用社会支持,制定科学可行、高质量的癌症患者自我管理项目和方案,从而提升其生存质量。     

自我效能护理对慢性心力衰竭患者焦虑抑郁情绪的影响

目的探讨自我效能护理对慢性心力衰竭(CHF)焦虑抑郁情绪的影响。方法选择自2014年1月~2016年1月于陆军总医院干四科收治的老年慢性心力衰竭伴抑郁焦虑患者110例,随机分成A、B两组,每组各55例,A组实施老年科护理常规,平均年龄(72±3.57)岁,B组在此基础上实施自我效能护理训练(具体措施包括心理疏导,言语激励,病友互动,加强社会支持,拒绝负面消息等个体自我护理能力和创新水平的训练),平均年龄(73±4.43)岁。4周后,采用焦虑自评量表(SAS)和抑郁自评量表(SDS)比较两组患者的焦虑和抑郁评分。结果护理前两组SAS和SDS评分的差异无统计学意义(P0.05);护理后两组的SAS和SDS评分均较前下降,B组下降较明显,与A组相比有统计学意义(P0.05)。结论自我效能护理能明显改善慢性心力衰竭患者的焦虑和抑郁状态,提高其生活质量。     

老年卧床不起患者社会支持与心理健康的相关性

目的探讨老年卧床不起患者的社会支持与心理健康状况的相互关系。方法对94例老年卧床不起患者与121例老年非卧床不起患者121例,采用自制结构式问卷进行心理健康状况与社会支持情况的调查。调查内容包括:自拟个人基本情况调查表、焦虑自评量表、老年抑郁量表与社会支持量表。结果病例组焦虑总分(51.87±8.31)、抑郁总分(12.53±6.28)均显著高于对照组(40.55±10.06,7.05±4.71,P<0.01);病例组社会支持总分(38.45±8.39)、主观支持评分(19.62±4.44)和支持利用度评分(7.55±2.17)显著低于对照组(分别为40.91±8.52,21.11±5.53和8.62±2.71,P<0.05或0.01),而客观支持评分两组差异无统计学意义(分别为10.65±3.95及11.09±3.30,P=0.38);病例组心理健康状况与总体社会支持、主观支持、支持利用度均呈负相关,差异有统计学意义(P<0.05或0.01)。结论老年卧床不起患者社会支持与心理健康呈负相关,提高主观支持和对支持的利用度是改善患者心理健康的关键。     

精神分裂症恢复期患者病耻感与焦虑和抑郁情绪的关系

目的探讨精神分裂症恢复期患者病耻感与焦虑和抑郁情绪的关系。方法选择136例恢复期精神分裂症患者,采用问卷调查的方式了解其病耻感、焦虑和抑郁情绪及其关系。结果 136例精神分裂症恢复期患者病耻感量表中文版(SSMI-C)总分(53.31±11.03)分,卡尔加里抑郁症状评定量表(CDSS)得分(13.38±4.34)分,焦虑自评量表(SAS)得分(57.08±7.21)分。不同年龄患者SSMI-C总分、歧视因子和病情掩饰因子得分差异有统计学意义(P<0.05),不同性别、婚姻状况、文化程度、职业和病程间SSMI-C各因子得分及总分差异无统计学意义(P>0.05);歧视因子、积极效应因子得分和SSMI-C总分在抑郁组和非抑郁组差异有统计学意义(P<0.05);精神分裂症恢复期患者抑郁情绪发生率为29.4%,SSMI-C总分、歧视因子和病情掩饰因子得分与CDSS得分、SAS得分呈正相关(P<0.05)。结论精神分裂症恢复期患者具有较高水平病耻感,且易发生抑郁情绪,应减少歧视对精神分裂症患者的影响,给予精神分裂症恢复期患者更多支持和关爱,预防焦虑和抑郁情绪的发生。     

心源性胸痛与非心源性胸痛患者焦虑抑郁情绪对比分析

目的了解心源性胸痛(cardiogenic chest pain,CCP)与非心源性胸痛(non cardiac chest pain,NCCP)患者的心理精神因素异常状况,探讨与其相关的因素。方法采用Zung’s焦虑自评量表(SAS)和抑郁自评量表(SDS),调查住院和门诊就诊患者128例,其中CCP患者56例,NCCP患者72例,分析其焦虑抑郁发病率及得分水平的差异。结果 56例CCP患者中35.7%有焦虑,26.8%有抑郁,14.3%合并有焦虑抑郁;72例NCCP患者中38.9%有焦虑,40.3%有抑郁,29.2%合并有焦虑抑郁,两组患者焦虑症状比较,差异无统计学意义(P0.05),而两组抑郁症状比较,差异有统计学意义(P0.01)。CCP患者焦虑得分(42.56±11.23)分,抑郁得分(41.51±10.23)分;NCCP患者焦虑得分(45.67±12.32)分,抑郁得分(49.21±11.29)分,两组焦虑抑郁的分均高于中国常模,差异有统计学意义(P0.01)。结论两种胸痛患者均应关注心理状况,NCCP患者远期的心理问题影响明显,更值得关注。     

D型与非D型人格患者冠状动脉介入治疗后恢复对比研究

目的比较D型与非D型人格患者在冠状动脉介入治疗后的心理、生理和术后恢复方面的差别。方法选择住院后行经皮冠状动脉介入治疗的患者共203例,采用D型人格量表（DS14）分为D型人格组（n=65）和非D型人格组（n=138）,治疗后均接受了一般问卷、疲劳评定量表、抑郁自评量表、生活质量综合评定问卷测试并收集临床生理指标。结果D型人格组与非D型人格组中大部分生理指标与疲劳评定量表评分比较,差异无统计学意义（P〉0．05）;抑郁自评量表评分结果显示,D型人格组抑郁情绪比非D型人格组严重,差异有统计学意义[（55．63±9．20）分诋（50．53±8．80）分,P〈0．05]。两组患者躯体[（47．73-＋11．21）分vs．（58．16±10．27）分,P〈0．05]、心理[（56．15±13．46）分vs.（63．80±11．21）分,P〈0．05]、社会功能维度[（54．13±11．89）分vs（62．15±9．356）分,P〈0．05]和总分[（40．17±11．80）分vs（45．93±9．99）分,P〈0．05]比较,差异均有统计学意义。结论D型人格对经皮冠状动脉介入治疗后患者的生理指标无影响,但对患者治疗后的心理、生活质量有影响。     

社会支持在抑郁老年人死亡焦虑和生活质量中的中介作用

目的 了解抑郁老年人死亡焦虑、生活质量及社会支持现状,探讨社会支持在抑郁老年人死亡焦虑与生活质量间的中介作用。方法 采用死亡焦虑量表、生活质量量表及社会支持量表对200例抑郁老年人进行相关数据收集,并使用Person相关分析各变量间的相关性,最后使用Bootstrap方法检验社会支持在死亡焦虑和生活质量中的中介效应。结果 抑郁老年人死亡焦虑得分为（50.89±8.01）分;社会支持总分得分为（37.10±5.65）分,主观社会支持得分为（19.06±3.46）分,客观社会支持得分为（11.28±2.63）分,社会支持利用度得分为（6.76±2.09）分;生活质量各维度得分分别为生理功能（69.00±23.75）分、生理职能（41.50±33.67）分、躯体疼痛（66.41±24.74）分、总体健康（38.44±15.51）分、活力（35.62±14.88）分、社会功能（35.38±20.05）分、情感职能（8.87±19.09）分、精神健康（30.89±15.95）分。抑郁老年人的死亡焦虑与生活质量中生理功能（r=-0.233）、生理职能（r=-0.150）、总体健康（r=-0.390...     

黛力新对冠心病伴焦虑抑郁患者治疗效果和生活质量的影响

目的探讨黛力新与抗心肌缺血治疗对冠心病伴焦虑抑郁患者的疗效和对生活质量的影响。方法冠心病伴焦虑抑郁患者128例,随机被均分为观察组和对照组,分别给予抗心肌缺血药物联合黛力新治疗,单纯抗心肌缺血治疗。疗程8周时观察临床症状、心电图及焦虑自评量表和抑郁自评量表评分的变化;半年后采用中国心血管病人生活质量评定问卷进行生活质量评估。结果观察组心绞痛和心电图疗效分别为92.19%和84.38%,明显高于对照组的79.69%和68.75%(P均<0.05),观察组焦虑自评量表和抑郁自评量表评分在治疗后显著下降(P均<0.01),且显著优于对照组(P均0.05);观察组中国心血管病人生活质量评定问卷的得分均高于对照组(P均<0.01)。结论黛力新治疗冠心病伴焦虑、抑郁患者效果良好,能够改善患者的生活质量。     

慢性心力衰竭患者及家庭照顾者疾病管理和生活质量现况

目的了解慢性心力衰竭(CHF)患者及其家庭照顾者的疾病管理和生活质量情况。方法选取2010年2月至2013年9月CHF患者及其家庭照顾者各89例,采用心力衰竭患者自我护理行为量表(SCHFI)及明尼苏达州心力衰竭生活质量量表(MLHFQ)对CHF患者进行调查,采用疾病管理行为问卷及家庭照顾者生活质量量表(FAMQOL)对CHF患者家庭照顾者进行调查。结果 CHF患者SCHFI得分为(39.66±5.42)分,自我护理行为执行良好占8.99%,执行一般者占39.33%,执行较差者占51.69%;家庭照顾者疾病管理行为分数(56.27±13.81)分,其中家庭照顾者疾病管理行为执行良好者占15.73%,执行一般占37.08%,执行较差占47.19%。Pearson相关性分析显示,CHF患者自我护理行为得分与家庭照顾者疾病管理行为得分呈正相关(P<0.05),CHF患者生活质量评分与其家庭照顾者生活质量评分呈正相关(P<0.05)。结论 CHF患者和家庭照顾者对该病管理现状不合理,二者的生活质量均受损,临床上应采取措施进行干预,建立并完善CHF家庭康复体系,培养具备高水平疾病管理能力的家庭照顾者,切实改善CHF患者生活质量。     

The distressed (type D) personality is independently associated with impaired health status and increased depressive symptoms in chronic heart failure.

BACKGROUND: Chronic heart failure (CHF) is a serious condition that is associated with impaired health status and a high prevalence of depressive symptoms. To date, little is known about the determinants of health status and depressive symptoms in CHF. Therefore, the aim of this study was to assess whether Type D personality is associated with impaired health status and increased depressive symptoms in heart failure patients, independent of disease characteristics. METHODS: Eighty-four patients (63 men and 21 women, mean age=65.9+/-12.1 years) with systolic CHF completed four questionnaires to assess Type D personality (14-item Type D Personality Scale [DS14]), health status (Minnesota Living with Heart Failure Questionnaire [MLWHFQ]), depressive symptoms (Center for Epidemiological Studies Depression Scale [CES-D]) and mood status (Global Mood Scale [GMS]) when visiting an outpatient heart failure clinic. Information on clinical variables was obtained from patients' medical records. RESULTS: Type D patients were more likely to experience impairment in health status (18/38=47%) as compared to non-Type Ds (11/46=24%), P=0.027. They also more often reported symptoms of depression; namely 18 of 38=47% versus 6 of 46=13%, P=0.001. When controlling for severity and etiology of CHF, age and gender, Type D remained a significant associate of impaired health status [odds ratio (OR) 3.0, 95% confidence interval (CI) 1.12-7.78] and depressive symptoms (OR 6.3, 95% CI 2.08-19.12). CONCLUSIONS: Type D was associated with impaired health status and increased depressive symptoms in CHF patients. These preliminary findings demonstrate the value of including personality factors in CHF research.     

慢性心力衰竭患者心身症状综合征、焦虑抑郁状态和影响因素分析

目的 观察慢性心力衰竭(CHF)患者心身症状综合征(PSS)、焦虑和抑郁的发生情况和相关影响因素.方法 选取2018年5月至2020年1月于秦皇岛第一医院心内科门诊就诊的371例CHF患者为研究对象,应用心身症状量表、焦虑自评量表和抑郁自评量表对CHF患者进行问卷调查,将PSS作为因变量,心功能分级、焦虑、抑郁、年龄及...     

Noncardiac chest pain in the emergency department: the role of cardiac history, anxiety or depression and Type D personality.

BACKGROUND: Noncardiac chest pain is common in patients presenting to emergency departments and is frequently associated with panic disorder. This can represent a major burden for patients and the healthcare system. Little is known about the patient characteristics that increase the risk of noncardiac chest pain. We examined whether cardiac history or Type D personality was associated with panic disorder and/or depression-driven noncardiac chest pain. METHODS AND RESULTS: Patients presenting with noncardiac chest pain to the emergency department of the University Hospital Maastricht were screened using the Hospital Anxiety and Depression Scale (HADS). Patients scoring > or =8 on the HADS subscale were invited for a psychiatric interview; a consecutive sample of patients scoring <8 on the HADS was included as a reference group. Type D personality (tendency to experience emotional distress) was assessed with the DS14. Among the 304 HADS-positive patients, 89% were diagnosed with panic disorder/depression as compared with 8% of the 106 HADS-negative patients. Previous cardiac history was not associated with psychiatric diagnosis. Type D patients reported more anxiety symptoms (12.4+/-4.0 vs. 8.1+/-4.9) and depression symptoms on the HADS (10.2+/-4.7 vs. 5.8+/-4.9) and more often had comorbid panic disorder/depression (91/157=58% vs. 57/253=23%) than non-Type D patients (P<0.0001). Type D personality (odds ratio =8.67, 95% confidence interval 4.69-16.02), younger age and male sex were independently associated with increased risk of panic disorder or depression. Type D was independently associated with comorbid panic disorder/depression (odds ratio=14.49). CONCLUSION: Type D personality, but not cardiac history, is independently associated with the presence of psychopathology in noncardiac chest pain. Type D is associated with a substantially increased risk of co-occurring PD/depression in these patients.     

卒中患者希望水平、焦虑抑郁及社会支持的研究

目的探讨卒中患者希望水平的状况及其与焦虑抑郁情绪、社会支持的关系。方法采用Herth希望量表(Herth hope index,HHI)、汉密尔顿焦虑量表(Hamilton Anxiety Scale,HAMA)、汉密尔顿抑郁量表(Hamilton Depression Scale,HAMD)、及社会支持评定量表(Social Support Revalued,SSAS)对200例卒中患者及200例健康对照者进行测评,并分析卒中患者希望水平、焦虑抑郁及社会支持的状况及其三者之间的关系。结果 (1)卒中组与对照组在希望总均分、焦虑总分、抑郁总分、社会支持总分上比较差异均有统计学意义(P<0.05)。卒中组希望总均分低于对照组(35.09±2.98vs37.26±3.87,P<0.01);卒中组焦虑总分高于对照组(6.37±0.26vs3.43±0.24,P<0.01);卒中组抑郁总分高于对照组(8.67±0.29vs2.35±0.22,P<0.01);卒中组社会支持总分低于对照组(36.16±3.66vs47.11±4.53,P<0.01)。(2)希望总均分与焦虑总分(r=0.43,p<0.001)、抑郁总分(r=-0.41,p<0.001)呈负相关,而与社会支持呈正相关(r=0.42,p<0.001)。结论焦虑抑郁及社会支持是卒中患者希望水平的重要预测因子,焦虑抑郁不利于提高卒中患者的希望水平,而社会支持有利于提高卒中患者的希望水平。     

Type D personality and depressive symptoms are independent predictors of impaired health status in chronic heart failure

OBJECTIVE: To examine whether Type D personality exerts a stable, independent effect on health status in CHF over time, adjusted for depressive symptoms. SUBJECTS: CHF outpatients (n=166; 75% men; mean age 66 years) completed the Type D Scale and Beck Depression Inventory (baseline) and the Minnesota Living with Heart Failure Questionnaire and Short-Form Health Survey (baseline and 12 months). RESULTS: There was a general improvement in disease-specific physical (p=.029) and mental (p<.001) health over time, but Type D patients scored significantly lower on both outcomes (p相似文献   

抑郁症与抑郁/焦虑共病患者的人格特征及社会支持对比研究

目的 探讨抑郁症与抑郁/焦虑共病患者的人格特征及社会支持的特点及与正常人的差异.方法 对同时符合美国精神疾病和统计手册第四版(DSM-IV)抑郁障碍和焦虑障碍诊断标准的36例患者(共病组)与33例仅符合抑郁障碍诊断者(抑郁症组)分别进行艾森克个性问卷(EPQ)和社会支持评定量表(SSRS)评定,并与30名正常人(正常组)对照,然后进行对比分析.结果 共病组和抑郁症组的EPQ-N、L因子分均高于正常组,EPQ-E因子分低于正常组,差异有显著性(P《0.05或P《0.01),SSRS总分及主观支持和对支持利用度两个因子分均低于正常组(P《0.05或P《0.01).共病组与抑郁症组的EPQ和SSRS总分及因子分组间差异无显著性(P》0.05).结论 抑郁症与抑郁/焦虑共病患者均具有神经质、内向和过度掩饰的个性特征,需要更多的社会支持.     

How are Depression and Type D Personality Associated with Outcomes in Chronic Heart Failure Patients?

This review aims to summarize the current evidence for the association of depression and Type D personality with clinical and patient-centred outcomes and self-care in chronic heart failure (CHF) patients. Emotional distress is highly prevalent in CHF patients. In contrast to results in coronary artery disease, there is inconsistent evidence for the adverse effects of depression and Type D on prognosis. Type D and depression are important predictors of impaired health status in CHF, and patients characterised by depression or Type D report reduced self-care. Pathophysiological processes associated with depression and Type D are discussed, as they may contribute to disease progression. Future research may benefit from taking inconsistencies in and problems with assessment of depression and Type D into account, as well as focusing on the network of psychophysiological and behavioural factors to elucidate their precise role in CHF patients with depression or Type D. Furthermore, it is advised that clinicians address the observed differences in self-care behaviours to improve health in CHF patients with depression or Type D personality.     

A pilot study of life events and mood disorders: self-report survey in chinese heroin-dependent individuals

An understanding of the relationship among life events, anxiety, depression, and heroin abuse may benefit the prevention and early treatment of heroin dependence. The objective of this study was to assess self-reported life events, anxiety, and depression in patients with heroin dependence. In this survey, Chinese heroin-dependent patients (n = 139) were asked to conduct a battery of self-reported questionnaires. A total of 76.26% of heroin-dependent patients reported the occurrence of major lifestyle pattern (dietary and sleep) changes as negative life events. Financial problems from family, unemployment, and poor interpersonal relationships were also frequently reported as negative events. Heroin-dependent patients experienced overwhelmingly more negative life events than positive life events. Those negative life events positively correlated with depression and anxiety. They also exhibited high levels of anxiety (Self-Rating Anxiety Scale, mean 44.42 ± 8.27) and depression (Self-Rating Depression Scale, mean 47.28 ± 8.54). Although preliminary, findings from this study suggest the need for further investigation of life events, anxiety, and depression in a generalized large sample, which may benefit community-based psychosocial intervention and prevention of relapse in heroin-dependent subjects.     

强化门诊随访对心力衰竭患者预后及依从性的影响

目的 评估强化门诊随访对慢性心力衰竭(心衰)患者预后及依从性的影响.方法 回顾分析333例心衰患者门诊诊治情况,按其是否定期于心衰门诊随访,分为强化门诊随访组(随访组)和常规治疗组(常规组).调查患者预后、药物治疗情况、生活质量和医疗费用.结果 随访组患者死亡与再住院率联合终点显著低于常规组(42.59%比66.67%,P<0.05);随访组患者死亡显著低于常规组(1.85%比14.35%,P<0.05);血管紧张索转换酶抑制剂/血管紧张素Ⅱ受体拮抗剂的处方率、达靶剂量率显著高于常规组(86.79%比40.54%,P<0.05;17.92%比8.65%,P<0.05);β受体阻滞剂处方率、达靶剂量率显著高于常规组(89.62%比46.49%,P<0.05;17.92%比1.62%,P<0.05).随访组患者生活质量较高(明尼苏达心衰生活质量问卷评分30.7比37.7,P<0.05),平均医疗费用节省3821.51元.结论 强化心衰门诊随访可以促进有循证医学证据的药物治疗,降低心衰患者的病死率和再入院率,改善生活质量并降低医疗费用.     

综合性心理干预对脑出血后忧郁状态患者负性情绪和生活质量的影响

目的:探讨综合心理干预对脑出血后忧郁状态患者负性情绪及生活质量的影响。方法:77例脑出血后有忧郁患者随机分为干预组(41例)和常规护理组(36例)。干预组在常规护理的基础上,进行综合心理干预。采用焦虑自评量表(SAS)、抑郁自评量表(SDS)和明尼苏达心衰生活质量调查表(MLHFQ)分别于入院时和干预1个月后对两组患者进行评分。结果:两组患者入院时SDS、SAS评分比较差异无显著性(P>0.05);1个月后,与干预前和常规护理组同期比较,干预组SDS[(58.15±8.57)分、(60.15±9.38)分比(51.20±7.81)分]、SAS评分[(58.55±6.86)分、(54.75±8.03)分比(45.85±7.14)分]显著降低,MLHFQ量表中所有分值均显著减少[总分:(64.75±6.08)分、(60.18±5.72)分比(42.45±4.71)分],P均<0.01。结论:综合性心理干预能够改善脑出血后忧郁患者的焦虑、抑郁情绪,并明显提高其生活质量。