综合心理行为干预对离退休人群健康行为及负性情绪的影响

目的调查离退休人群干预前后健康知识知晓率、健康行为形成率及其心理状态；比较分析综合心理干预与一般心理干预对于离退休人群的健康行为形成及改善负性情绪的效果。方法采用队列研究方法，将符合入选标准的206例离退休人员按随机数字表随机人组，分成综合心理干预（实验组）组和仅给予一般心理干预组（对照组），每组各103例。综合心理干预组（实验组）给予健康行为及认知干预、一般心理干预、家属的心理干预以及社会家庭式照护干预，对照组健康行为及认知干预、一般心理干预；给予所有人员均予1周内首评，2周后第2次评定，4周后终评；健康行为调查采用财政部、卫生部《关于补助公共卫生专项资金的通知》中“城市社区健康教育试点项目”中的问卷，健康状态与生存质量评定采用家庭关怀度指数（APGAR），心理状态评价及疗效判定采用汉密尔顿抑郁量表（HAMD），日常生活能力采用MBI指数法评定；比较两组人群干预前后健康知识知晓率及其不同干预方法对健康行为形成率及其心理状态的影响。结果经x。检验实验组和对照组在年龄、性别、文化程度等社会学特征差异无显著性意义；HAMD、MBI及APGAR评估成绩基线水平也差异无显著性。通过综合心理干预措施的实施，受试者健康知识知晓率均有不同程度地提高，而且干预后实验组明显高于对照组（P〈0．05）；两组受试人群的健康行为在血压监测、体育健身、菜板生熟分开等项目上均有不同程度改善，同时，虽未经干预，在对血压的监测方面，对照组亦较基线状态有明显提高（P〈0．05）。干预后实验组APGAR评分为（8．53±1．43）分较干预前的（7．90±1．64）分明显上升（P〈0．05）、HAMD评分则由（12．55±2．36）分下降为（3．32±1．06）分、MBI评分由（10．34±1．77）分下降为（5．37±1．43）分，差异均有显著性（P〈0．01），而对照组干预前后差别无显著性（P〉0．05）。结论综合心理干预能明显提高离退休人员健康知识的知晓率以及健康行为的形成率，改善离退休人员的负性情绪状态，提高离退休人员的日常生活能力。

Effect of comprehensive psychological intervention on health behavior and negative emotions in retired people

Objective To investigate the awareness rate of health knowledge, health behavior formation rate and psychological state before and after retirement intervention, analyse comprehensive psychological interven- tion and general psychological intervention to health behavior formation and improve the negative emotion in retired population. Methods By using cohort study method, 206 retired people were randomly divided into comprehen- sive psychological intervention group （experimental group） and only given general psychological intervention group （control group） , and each group included 103 cases. Comprehensive psychological intervention group were given health behavior and cognitive intervention, psychological intervention, psychological intervention in general family and social family care intervention, and the control group was given healthy behavior and cognitive intervention, psychological intervention. The staff were treated within 1 weeks of first assessment, 2 weeks after the second as- sessment, 4 weeks after the final. Health behavior was surveyed by Ministry of finance, the Ministry of health on public health ＂subsidies special funds＂ notice ＂in city community health education pilot project＂ in the question- naire. Health status and quality of life were assessed with the family APGAR index （APGAR）. Mental state eval- uation and assessment of the treatment effect by using Hamilton Depression Scale （ HAMD）, MBI index method was assessed with activities of daily living. The effect of the two groups were compared before and after the inter- vention of health knowledge rate and formation rate of different intervention methods and psychological state of health behavior. Results The results showed that there were no significant differences between experimental group and control group in age, sex, level of education and other social, and there was no significant difference in HAMD, MBI and APGAR scores at baseline. Through the implementation of the comprehensive of psychological intervention, subjects have varying degrees of improving the awareness rate of health knowledge, and the interven-tion group was significantly higher than the control group （P〈 0.05 ）. The two group of healthy behavior of subjects in the chopping board monitoring, physical fitness, blood pressure to separate raw and cooked on such projects had different degrees of improvement, at the same time, although no intervention, in the monitoring of blood pressure. The control group increased compared with the baseline significantly （P 〈 0.05）. Intervention group had significant difference in APGAR score increased （P〈 0.05）. HAMD score and MBI score decreased and the differences were statistically significant （P 〈 0.01 ）, while the control group had no significant difference before and after interven- tion. Conclusion Comprehensive psychological intervention can significantly improve the rate of formation from the awareness rate of health knowledge and health behavior of retirees, and improve the state of negative emotions from retiree.