老年慢性充血性心力衰竭患者焦虑、抑郁情绪的心理干预

目的: 研究老年慢性充血性心衰(Chronic Heart Failure,GHF)患者焦虑、抑郁发生情况及放松疗法对其焦虑、抑郁情绪的干预效果.方法: 选择2004年9月-2007年9月在我院老年病科住院的老年CHF患者190例,按照其入院日的单双日随机分为实验组(基础心理护理 放松疗法,101例)和对照组(仅基础心理护理,89例);心理干预前及干预结柬1月后均用焦虑自评量表(SAS)、抑郁自评量表(SDS)测定;观察抑郁、焦虑情绪发生率、住院日及干预后两组SAS、SDS分数变化情况;随访出院后6月内再次因CHF住院率.放松疗法包括放松训练和音乐疗法,每日1小时,为期4周.结果: ①实验组及对照组问基线资料如年龄、性别、受教育程度、经济状况、照顾者身份、心功能分级、是否公费医疗、能否自理、CHF病程及心理干预前SAS、SDS分数的差异均无统计学意义;②我院老年CHF患者抑郁、焦虑情绪发生率分别是45.8%和52.6%,高于普通人群(抑郁、焦虑情绪发生率分别是5%～10%和5%);③心理干预后,实验组SAS得分由(42.3±6.8)降低至(32.8±6.1),SDS得分由(41.8±6.1)降低至(32.2±5.4);对照组SAS得分由(41.8±6.5)降低至(37.0±6.3),SDS得分由(41.0±5.9)降低至(36.4±5.9),实验组SAS、SDS得分降低程度均高于对照组(P＜0.05);④实验组平均住院日低于对照组[(29.8±1.4)vs.(32.6±2.6)],而随访结果显示:实验组出院后6月内再次因心衰住院率低于对照组(7.9%/20.2%,x2=6.064,P=0.014).结论: ①我院老年CHF患者抑郁、焦虑情绪发生率较高;②放松疗法对老年CHF患者焦虑、抑郁情绪的干预效果肯定并可改善预后.

Psychological Intervention to Anxiety and Depression in Geriatric Patients with Chronic Heart Failure

Objective:To investigate the incidence of anxiety and depression and explore the effects of psycho- logical intervention on anxiety and depression in geriatric patients with chronic heart failure (CHF).Methods:A to- tal of 190 geriatric inpatients were recruited.They were assessed with the self-rating anxiety scale (SAS) and the self- rating depression scale (SDS) before the psychological intervention.All subjects were divided into two groups (101 in case group and 89 in control group) randomly.The case gro...