健康教育干预对综合医院抑郁症治疗依从性的影响  

Effect of Health Education on Compliance of Patients with Depression in a General Hospital

作　　者：张慧敏[1] 黄贞杰[1] 许晶[1] 王俊平[1] 

机构地区：[1]大连医科大学附属第一临床学院神经内科,大连116011

出　　处：《中国心理卫生杂志》2007年第9期630-633,645,共5页Chinese Mental Health Journal

基　　金：国家自然科学基金资助项目(30570477)

摘　　要：目的：通过对患者抑郁症知识及药物副作用的认知教育干预,系统随诊,提高患者治疗依从性。方法：以60例综合医院神经内科门诊及住院患者为研究对象,全部符合DSM-Ⅳ重症抑郁单次发作诊断标准。入组患者填写一般情况问卷,按照随机对照原则,分成干预组及对照组,对照组一般常规治疗,干预组定期电话随访,两名神经内科医师进行抑郁症教育一次,发放抑郁症教育小册子,制作随诊卡。随访6个月,以脱落率代表治疗依从性,干预组与对照组进行比较。结果：（1）随访6个月共脱落32人,干预组脱落11人（36.7%）,对照组脱落21人（70.0%）。干预组与对照组脱落率分别为1个月（13.2%,36.7%）、3个月（20%,50%）、6个月（36.7%,70%）,以上组间差异具有统计学意义（P〈0.05）。（2）1个月内干预组与对照组比较,因不认可诊断（3.3%,10.0%）、药物副作用（3.3%,16.7%）及治疗无效（3.3%,6.7%）而停止治疗比例减少。1-3个月干预组中未见因为药物副作用或治疗无效脱落者,3-6个月干预组因治疗好转脱落者少于对照组（3.3%,10.0%）。结论：综合性医院抑郁症患者治疗依从性差;电话交谈、系统规范的门诊随诊、集体教育等多维认知教育干预方法,可以提高抑郁症患者治疗依从性。Objective： Increase the treatment compliance through educating depressive patients about knowledge of the illness, side-effects of antidepressants and fixed follow-up survey. Methods： The patients with depression （ 60 cases） were collected from out- patient clinic and inpatient of Department of Neurology in general hospital. The patients＇diagnoses were consistent with relevant criteria in DSM - Ⅳ. Patients fill in the self-administered questionnaire. According to the rule of randomized control, those patients were divided into tow groups： the intervention group and the control group. Patients in the control received ordinary treatment, and those in the intervention experienced fixed follow-up survey through telephone, were given the knowledge handbooks, received the education about depression. Both groups were followed up for 6 months. Dropout rate represents the incompliance. Results： 1. Within 6 months, 32 patients were badly compliant, including llcases in the intervention group （36.7%）, 21 in the control （70% ） . The two groups had significant differences in the rate of dropout in the 1st （ 13.2%, 36. 7% ） 3rd （20%, 50% ） and 6th month （36.7%, 70% ）, 2. Within 1st month, the dropout of the intervention because of no consent degree （3.3%, 10.0%）, side effect （3.3%, 16.7% ）, and no effect about treatment （3.3%, 6.7% ） were all lower than the control No patients of intervention group stopped treatment within 1 st to 3rdmonth because of side effects and non-response. Dropout rate in the intervention group was low within 3rd to 6th month （3.3%, 10.0% ） Conclusion： 1. Compliance of depression treatment in the general hospital is poor. 2. Compliance can be improved by telephone talk, good clinic follow-up, and group education.

关 键 词：抑郁症 随机对照 综合医院 健康教育 神经内科 认知 干预 

分 类 号：R749.41[医药卫生—神经病学与精神病学]