摘要
目的探究经皮冠状动脉介入治疗(PCI)术前心理干预对急性冠状动脉综合征(ACS)患者精神压力、应对方式的影响及并发抑郁症的相关因素分析.方法选取2016年3月至2018年8月就诊的281例ACS患者作为研究对象.根据ACS患者PCI术前是否给予心理干预,将其分为干预组135例和对照组146例.采用90项症状自评量表(SCL-90)评估精神压力,采用医疗应对模式问卷(MCMQ)评估应对方式.比较2组患者术前、术后精神压力和应对方式变化.了解ACS患者PCI术后抑郁发生情况,并分析影响其抑郁的相关因素.结果PCI术后,干预组和对照组SCL-90评分中躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐惧、偏执、精神病性及寝食状态等评分均较自身术前显著降低(P<0.05),且干预组降低更为明显,差异有统计学意义(P<0.05).PCI术后,2组回避、屈服方面比较差异无统计学意义(P>0.05),且与PCI术前比较差异亦无统计学意义(P>0.05).PCI术后,干预组患者面对评分高于对照组,差异有统计学意义(P<0.05);且与自身PCI术前比较差异亦有统计学意义(P<0.05).281例ACS患者PCI术后有84例占29.89%患抑郁症.干预组患者中有26例占19.26%患抑郁症,对照组患者中有58例占39.73%患抑郁症,2组抑郁症患病率比较差异有统计学意义(P<0.05).单因素及多因素Logistic分析结果显示冠状动脉病变程度、受教育程度及PCI术前心理干预与ACS患者PCI术后并发抑郁症密切相关.结论心理干预可改善ACS患者精神压力,减少消极应对,同时可降低PCI术后并发抑郁风险.
Objective To explore the influence of psychological intervention before percutaneous coronary intervention(PCI)on mental stress,coping style and related factors of depression in patients with acute coronary syndrome(ACS).Methods 281 patients with ACS who were treated in our hospital from March 2016 to August 2018 were selected as the study subjects.According to whether psychological intervention was given to ACS patients before PCI,they were divided into intervention group(n=135)and control group(n=146).SCL-90 was used to assess mental stress and MCMQ was used to assess coping styles.The changes of mental stress and coping style before and after operation were compared between the two groups.To investigate the incidence of depression in ACS patients after PCI and analyze the related factors affecting their depression.Results After PCI,the scores of somatization,obsessive-compulsive disorder,interpersonal sensitivity,depression,anxiety,hostility,fear,paranoia,psychosis and bedtime status were decreased in the SCL-90 scores of the intervention group and the control group(P<0.05).The reduction in the intervention group was more obvious,and the difference was statistically significant(P<0.05).After PCI,there was no significant difference in avoidance and yield between the two groups(P>0.05),and there was no significant difference between the two groups before PCI(P>0.05).After PCI,the face score of intervention group was higher than that of control group(P<0.05),and compared with pre-PCI,the difference was also statistically significant(P<0.05).Of the 281 patients with ACS,84(29.89%)had depression after PCI.In the intervention group,26 patients(19.26%)suffered from depression,and 58 patients(39.73%)in the control group suffered from depression.The prevalence of depression in the two groups was statistically significant(P<0.05).Univariate and multivariate logistic analysis showed that the degree of coronary artery disease,education and psychological intervention before PCI were closely related to ACS patients with post-PCI complicated with depression.Conclusion Psychological intervention can improve the stress of ACS patients and reduce the negative response.At the same time,it can reduce the risk of depression after PCI.
作者
陈红雨
曹利佳
吴林
Chen Hongyu;Cao Lijia;Wu Lin(Department of Cardiovascular Medicine,the First Hospital of Peking University,Beijing 100034,China)
出处
《中国实用护理杂志》
2019年第26期2017-2021,共5页
Chinese Journal of Practical Nursing
基金
国家自然科学基金(81170156).
关键词
急性冠状动脉综合征
经皮冠状动脉介入治疗
心理干预
精神压力
应对方式
抑郁
Acute coronary syndrome
Percutaneous coronary intervention
Psychological intervention
Mental stress
Coping style
Depression
