团体认知行为疗法对老年慢性阻塞性肺疾病患者的干预效果研究

目的探讨团体认知行为疗法对老年慢性阻塞性肺疾病(COPD)患者焦虑、抑郁、自我效能及生活质量的干预效果.方法采用方便抽样的方法,选取2017年9月至2018年9月山西省某三级甲等医院呼吸与危重症医学科收治的276例老年COPD患者为研究对象,按入院时间将患者分为实验组(n=132)和对照组(n=144),对照组接受常规护理和健康教育,实验组在常规护理基础上增加团体认知行为干预,在干预前、干预后、干预后1个月使用抑郁自评量表、焦虑自评量表、一般自我效能量表、生活质量量表评价干预效果.结果干预前两组患者焦虑自评量表、抑郁自评量表、一般自我效能量表及生活质量量表评分差异均无统计学意义(P>0.05);干预后、干预后1个月两组患者焦虑自评量表、抑郁自评量表、生活质量量表、一般自我效能量表评分均优于干预前,且差异均具有统计学意义(P<0.05).结论团体认知行为疗法可缓解老年COPD患者的焦虑、抑郁症状,提升自我效能感,改善其生活质量.本研究为老年COPD患者心理护理方法的改进提供了科学依据,同时为其他慢病人群的护理管理和健康教育提供参考.

Effectiveness of cognitive behavioral group therapy in elderly patients with chronic obstructive pulmonary disease

Objective To investigate the effectiveness of cognitive behavioral group therapy(CBGT)in intervening anxiety,depression,self-efficacy,and quality of life in elderly patients with chronic obstructive pulmonary disease(COPD).Methods Totally,276 elderly COPD patients admitted to a tertiary hospital in Shanxi Province from September 2017 to September 2018 were selected as the research subjects using a convenient sampling method.The patients were divided into an intervention group(n=132)and a control group(n=144)according to the date of admission.The control group received conventional nursing and health education,and the intervention group received CBGT in addition to the conventional care.The effectiveness of the intervention was evaluated using Self-Rating Depression Scale(SDS),Self-Rating Anxiety Scale(SAS),General Self-Efficacy Scale(GSES),and Short Form of Life 36 Health Survey Questionnaire(SF-36).Results There were no significant differences in SAS,SDS,GSES,and SF-36 scores between the two groups before the treatment(P>0.05).The SAS,SDS,SF-36,and GSES scores were significantly superior in both groups immediately after the intervention and one month after the intervention over these before intervention(both P<0.05).Conclusion CBGT can relieve anxiety and depression and improve sense of self-efficacy and quality of life in elderly patients with COPD.This study provides a scientific basis for improving psychological nursing for elderly patients with COPD and also offers evidence for the nursing management and health education of other chronically ill patients.