问题管理家对冠心病合并心理障碍病人的干预效果研究  

Intervention effect of problem management plus on coronary heart disease patients with psychological disorders

作　　者：李婷 吴浩 王靖伊 徐京菁 杨晨[1] 张勇[1,2] LI Ting;WU Hao;WANG Jingyi;XU Jingjing;YANG Chen;ZHANG Yong(Department of Cardiology of Geriatrics,The First Affiliated Hospital of Anhui Medical University,Hefei,Anhui 230022,China;Department of Cardiovascular Medicine,The First Affiliated Hospital of Anhui Medical University(Dongcheng Campus),Hefei,Anhui 231600,China;Psychological Assistance Department,National Center for Mental Health and Mental Hygiene Prevention and Treatment,Beijing 100029,China)

机构地区：[1]安徽医科大学第一附属医院老年心内科,安徽合肥230022 [2]安徽医科大学第一附属医院(东城院区)心血管内科,安徽合肥231600 [3]国家心理健康和精神卫生防治中心心理援助部,北京100029

出　　处：《安徽医药》2024年第9期1836-1841,共6页Anhui Medical and Pharmaceutical Journal

基　　金：合肥市卫生健康委应用医学研究项目(Hwk2022zc042)。

摘　　要：目的探究问题管理家(PM+)对合并心理障碍的冠心病病人的治疗效果。方法选取2022年7—12月收住安徽医科大学第一附属医院东城院区心血管内科的合并有心理障碍的冠心病病人80例。以广泛性焦虑量表(GAD-7)或病人健康问卷(PHQ-9)得分为依据,采用分层随机分配法,每3分为1层,层内利用随机数字表分配,最终将80例合并有心理障碍的冠心病病人分为干预组(n=40)与对照组(n=40)。合并有抑郁症状的冠心病病人按随机数字表法分为抑郁干预组(n=20)与抑郁对照组(n=20);合并有焦虑症状的冠心病病人按随机数字表法分为焦虑干预组(n=20)与焦虑对照组(n=20)。所有病人均接受了介入治疗或药物治疗,干预组的病人在此基础上接受PM+干预5次,每周1次。收集所有病人的一般资料包括姓名、性别、受教育程度、婚姻状态、居住状态,比较采用χ^(2)检验。使用心理结果概况(PSYCHLOPS)、GAD-7、PHQ-9量表评估病人的心理健康状态;使用世卫组织残疾评定方案2.0(WHODAS 2.0)评估病人身体健康状态;比较采用t检验。结果抑郁干预组干预后得分(4.800±2.526)分较基线得分(9.650±2.907)分下降(t=14.49,P<0.05);抑郁对照组自身前后得分差异无统计学意义(t=1.10,P>0.05)。焦虑干预组干预后得分(3.800±1.704)分较基线得分(8.350±1.814)分下降(t=14.21,P<0.05);焦虑对照组自身前后得分差异无统计学意义(t=1.86,P>0.05)。结论PM+可以减轻合并有心理障碍的冠心病病人的焦虑、抑郁情绪,加强病人的自我管理。Objective To investigate the efficacy of Problem Management Plus(PM+)in the treatment of coronary heart disease(CHD)patients with comorbid psychological disorders.Methods Eighty patients with CHD and comorbid psychological disorders who were admitted to the Department of Cardiovascular Medicine,The First Affiliated Hospital of Anhui Medical University(Dongcheng Campus)from July to December 2022 were selected for the study.Based on the scores of the 7-item Generalised Anxiety Disorder Assessment(GAD-7)or Patient Health Questionnaire-9(PHQ-9),the stratified random allocation method was used,and every 3 scores were put into 1 layer,and the random number table was used within the layer.Finally,eighty patients with CHD with comorbid psychological disorders were assigned into the intervention group(n=40)and the control group(n=40).Patients with CHD with comorbid depressive symptoms were randomly assigned into a depression intervention group(n=20)and a depression control group(n=20);patients with CHD with comorbid anxiety symptoms were randomly assigned into an anxiety intervention group(n=20)and an anxiety control group(n=20).All patients received either interventional or pharmacological treatment,and patients in the intervention group received PM+intervention 5 times,every once a week.General information including name,gender,education,marital status,and residential status was collected for all patients and comparisons were made using a chi-square test.Patients'mental health status was assessed using the psychological outcome profiles(PSYCHLOPS),GAD-7,and PHQ-9 scales;physical health status was assessed using the WHO Disability Assessment Schedule(WHODAS 2.0);comparisons were made using t-tests.Results The post-test score for the depression intervention group was lower than the baseline score[(4.800±2.526)vs.(9.650±2.907);t=14.49,P<0.05];the difference was not statistically significant between pre-and post-scores in the depression control group(t=1.10,P>0.05).The post-test score of the anxiety intervention group was

关 键 词：冠心病 焦虑 抑郁 问题管理家 心理干预 心理障碍 临床随机对照 

分 类 号：R541.4[医药卫生—心血管疾病] R749[医药卫生—内科学]