团体咨询联合认知行为疗法在老年冠心病冠脉搭桥术患者中的应用

目的：探讨团体咨询联合认知行为疗法对老年冠心病冠脉搭桥术患者的应用效果。方法：选取行冠脉搭桥手术的老年冠心病患者180例，按照随机数字法分为观察组和对照组，对照组给予常规护理康复指导，观察组在此基础上实施团体咨询联合认知行为疗法干预，比较两组干预前、干预2个月、6个月后自我管理行为量表（CSMS）得分及相关生理指标的变化状况。结果：两组干预2个月、6个月后自我管理行为总分及各维度评分增高，体重指数、血压、糖化血红蛋白下降，在时间效应、组间效应、交互效应差异均有统计学意义（P＜0.05）。结论：老年冠心病冠脉搭桥患者中实施团体咨询联合认知行为疗法能改善患者的自我管理行为，改善疾病状况。

Effect of group counseling combined with cognitive-behavior therapy on self-management behavior in elder coronary heart disease patients after coronary artery bypass grafting

Objective: To explore the effect of group counseling combined with cognitive-behavior therapy on self-management behavior in elder coronary heart disease patients after coronary artery by pass grafting. Methods:180 elder coronary heart disease patients after coronary artery by pass grafting were selected and assigned randomly into 2 groups, the control group was given routine nursing and recovery guidance, the observation group was given group counseling combined with cognitive-behavior therapy on the basis of routine intervention, the score of coronary artery disease self-management scale(CSMS) and risk factors for coronary heart disease of the 2 groups before intervention，2 months， 6 months after intervention were compared. Results: The total score and each dimension score of CSMS, BMI, blood pressure, hemoglobin A1c were lower at 2 months, 6 months after intervention; the differences of the time effect, group effect and cross effect were statistically significant(P＜0.05).Conclusion: Group counseling combined with cognitive-behavior therapy can improve the patients’ self-management behaviorand disease status in elder coronary heart disease patients after coronary artery bypass grafting.