认知行为疗法对冠心病患者心理及运动处方依从性的影响  

Influence of cognitive behavioral therapy on psychology and compliance to exercise prescription in CHD patients

作　　者：周友根[1] 宋平[2] 邓晓剑[1] 何顶秀[3] 黄楷森[1] ZHOU You-gen;SONG Ping;DENG Xiao-jian;HE Ding-xiu;HUANG Kai-sen(Department of Cardiology,People＇ s Hospital of Deyang City,Deyang,Sichuan,618000,China Corresponding author： HUANG Kai-sen,E-mail：[e-mail])

机构地区：[1]德阳市人民医院心内科,四川德阳618000 [2]德阳市人民医院神经内科,四川德阳618000 [3]德阳市人民医院急诊科,四川德阳618000

出　　处：《心血管康复医学杂志》2018年第4期369-372,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

基　　金：四川省医学科研青年创新课题(Q16027;Q15064)~~

摘　　要：目的:探讨Ⅰ期院内康复治疗基础上加用认知行为疗法对冠心病(CHD)患者焦虑、抑郁状态及运动处方依从性的影响。方法:入选2016年1月～4月于我科住院的CHD患者144例,随机分为常规康复组(73例,接受常规Ⅰ期院内康复治疗)和联合干预组(71例,在常规康复组基础上加用认知行为治疗),疗程7d。比较两组患者治疗前后医院内焦虑抑郁量表(HADS)焦虑、抑郁评分及出院后6个月的运动处方依从性。结果:与治疗前相比,联合干预组治疗后HADS焦虑、抑郁评分均显著下降(P=0.001,0.02)。与常规康复组比较,联合干预组治疗后HADS焦虑评分[(8.88±3.56)分比(7.42±3.01)分],HADS抑郁评分[(7.68±3.54)分比(6.37±3.19)分]均显著降低,而运动处方完全依从率(17.80%比35.21%)显著升高,P<0.05或<0.01。结论:Ⅰ期院内康复治疗基础上加用认知行为治疗可降低冠心病患者HADS焦虑和抑郁评分,提高其运动处方依从性,值得推广。Objective： To explore influence of stage I in-hospital rehabilitative treatment combined cognitive behavior- al therapy on anxiety, depression status and compliance to exercise prescription in patients with coronary heart dis- ease （CHD）. Methods： A total of 144 CHD patients, who were hospitalized in our department from Jan 2016 to Apr 2016, were randomly divided into routine rehabilitation group （n = 73, received routine stage I in-hospital reha- bilitative treatment） and combined intervention group （n=71, received cognitive behavioral therapy based on rou- tine rehabilitation group）, both groups were treated for 7 d. Hospital anxiety-depression scale （HADS） anxiety and depression scores before and after treatment, compliance to exercise prescription on six months after discharge were compared between two groups. Results： Compared with before treatment, there were significant reductions in HADS anxiety and depression scores after treatment in combined intervention group, P = 0. 001, 0. 02. Compared with routine rehabilitation group after treatment, there were significant reductions in HADS anxiety score [ （8.88 ± 3.56） scores vs. （7.42 ± 3.01） scores] and HADS depression score [ （7.68 ± 3.54） scores vs. （6. 37 ± 3.19） scores] and significant rise in complete compliance rate to exercise prescription （17.80% vs. 35.21%） in combined intervention group, P〈0.05 or d0.01. Conclusion： Stage I in-hospital rehabilitative treatment combined cognitive behavioral therapy can reduce HADS anxiety and depression score, improve their compliance to exercise prescription in CHD patients, which is worth extending.

关 键 词：冠心病 认知疗法 焦虑 抑郁 

分 类 号：R541.409[医药卫生—心血管疾病]