社区康复延伸性干预对抑郁症病人社会功能与应对方式的影响

目的:探讨社区康复延伸性干预对抑郁症病人恢复社会功能和改善应对方式的作用.方法:选取抑郁症病人100例,按病人所在社区分为对照组和干预组,各50例.2组在院期间均进行常规治疗及护理,对照组于出院后3、12个月分别进行随访;干预组出院后进行社区康复延伸性护理,定期随访,共12个月.比较2组病人的汉密尔顿抑郁量表(HAMD)评分及复发情况、生活质量评分和应对方式评分.结果:2组病人入院及出院时的HAMD评分差异均无统计学意义(P>0.05),且2组出院时评分均明显低于入院时(P<0.01);出院后,2组病人HAMD评分均逐渐升高(P<0.01),但干预组病人的HAMD评分始终显著低于对照组(P<0.01).出院后3个月,2组复发率差异无统计学意义(P>0.05);出院后12个月,干预组复发率低于对照组(P<0.05).出院后12个月,干预组病人除疼痛感评分与对照组差异无统计学意义(P>0.05)外,其余7项生活质量评分均高于对照组(P<0.05~P<0.01).2组病人入院时的积极应对和消极应对评分差异均无统计学意义(P>0.05);出院后12个月,干预组的积极应对评分明显高于对照组,消极应对评分明显低于对照组(P<0.01).结论:社区康复延伸性干预有利于促进抑郁症病人生存质量和社会功能的恢复,改善其面对应激事件的应对方式,从而改善临床疗效,降低复发率.

Effect of community rehabilitation extension intervention on recovering social function and improving coping style in patients with depression

Objective:To investigate the effects of community rehabilitation extension intervention on recovering social function and improving coping style in patients with depression.Methods:One hundred patients with depression were divided into the control group and intervention group according to the patient′s community(50 cases each group).Two groups were treated with routine nursing.After discharge,the control group was followed up after 3 and 12 months,and the intervention group was treated with community rehabilitation extension nursing and regularly followed up for 12 months.The scores of HAMD,quality of life and coping style,and recurrence between two groups were compared.Results:The differences of the HAMD scores at admission and discharge between two groups were not statistically significant(P>0.05),and the HAMD scores in two groups at discharge were significantly lower than that at admission(P<0.01).After discharge,the HAMD scores in two groups gradually increased(P<0.01),and which in intervention group was significantly lower than that in control group(P<0.01).The difference of the recurrence rate after 3 months of discharge between two groups was not statistically significant(P>0.05),and the recurrence rate after 12 months of discharge in intervention group was lower than that in control group(P<0.05).After 12 months of discharge,the difference of the pain score between two groups was not statistically significant(P>0.05),the other 7 items scores in intervention group were higher than those in control group(P<0.05 to P<0.01).The differences of the positive and negative coping scores at admission between two groups were not statistically significant(P>0.05).After 12 months of discharge,the positive coping score and negative coping score in intervention group were significantly higher and lower than those in control group,respectively(P<0.01).Conclusions:The community rehabilitation extension intervention is beneficial to the improvement of the life quality and recovery of social function in patients with depression,can improve the way of coping with stress events,enhance the clinical efficacy and reduce the recurrence.