基于微信直播的正念训练对经皮冠状动脉介入治疗术后患者阈下抑郁症状的影响

doi:10.3761/j.issn.0254-1769.2022.11.004

摘要/Abstract

摘要：

目的探讨基于微信直播的正念训练对经皮冠状动脉介入治疗（percutaneous coronary intervention,PCI）术后患者阈下抑郁症状及生活质量的影响。方法采用便利抽样法,选取2020年10月—2021年4月唐山市某三级甲等医院心内科64例PCI术后阈下抑郁患者作为研究对象,采用抽签法随机抽取4个病区中的2个病区,采用抛硬币法确定试验组和对照组,每组各32例。试验组在常规护理的基础上接受基于微信直接的正念训练,对照组接受常规护理。采用中文版冠心病患者抑郁量表、中文版五因素正念量表、西雅图心绞痛量表在干预前、干预后、干预完成后3个月对患者阈下抑郁症状、正念水平和生活质量进行评估。结果干预前,两组正念水平、阈下抑郁症状和生活质量的差异均无统计学意义（P>0.05）。干预后和干预完成后3个月,与对照组相比,试验组阈下抑郁症状得分均下降（LS均差分别为-18.241, -10.270）,正念水平均升高（LS均差分别为31.148,13.856）,差异均有统计学意义（P<0.001）;试验组的生活质量虽高于对照组,但差异无统计学意义（P>0.05）。干预完成后3个月,两组阈下抑郁症状发生率差异有统计学意义（OR=0.564,P=0.032）。结论正念训练可有效缓解PCI术后患者阈下抑郁症状,暂未改善其生活质量。

关键词: 经皮冠状动脉介入治疗, 阈下抑郁症状, 正念训练, 生活质量, 护理

Abstract:

Objective To investigate the effect of mindfulness training based on WeChat live broadcast on subthreshold depressive symptoms and quality of life in patients with subthreshold depression after PCI. Methods A total of 64 patients with subthreshold depression after PCI in the department of cardiology of a tertiary hospital in Tangshan city from October 2020 to April 2021 were randomly selected by convenience sampling method as the research subjects. 2 out of 4 wards were randomly selected by drawing lots,and the experimental group and the control group were determined by coin toss,with 32 cases in each group. The experimental group was given mindfulness training on the basis of routine nursing,and the control group was given routine nursing. Subthreshold depressive symptoms,mindfulness level and quality of life were assessed by the Chinese version of Cardiac Depression Scale（C-CDS） and the Chinese version of Five Facet Mindfulness Questionnaire（Ch-FFMQ） and the Seattle angina questionnaire（SAQ） before the intervention（T1）,after the intervention（T2） and 3 months after the intervention（T3）. Results Before the intervention,there was no statistical significance in the level of mindfulness,subthreshold depressive symptoms and quality of life（P>0.05）. After the intervention and 3 months after the intervention,compared with the control group,the scores of subthreshold depressive symptoms in the experimental group decreased（LS mean difference of -18.241 and -10.270,respectively）,and the scores of mindfulness level increased （LS mean difference of 31.148 and 13.856,respectively）,with statistical significance（P<0.001）. The quality of life score was higher than that of the control group,but the difference was not statistically significant（P>0.05）. 3 months after the intervention,there was statistically significant difference in the incidence of subthreshold depressive symptoms between the 2 groups（OR=0.564,P=0.032）. Conclusion Mindfulness training can effectively relieve subthreshold depression symptoms of patients after PCI,but it cannot improve their quality of life.

Key words: Percutaneous Coronary Intervention, Subthreshold Depression Symptoms, Mindfulness Training, Quality of Life, Nursing Care

白铁娟, 秦璐, 董建秀, 蒋苗苗, 王丹, 李宇婷, 王建辉. 基于微信直播的正念训练对经皮冠状动脉介入治疗术后患者阈下抑郁症状的影响[J]. 中华护理杂志, 2022, 57(11): 1304-1309.

BAI Tiejuan, QIN Lu, DONG Jianxiu, JIANG Miaomiao, WANG Dan, LI Yuting, WANG Jianhui. Effects of mindfulness training based on WeChat live broadcast on subthreshold depressive symptoms after PCI[J]. Chinese Journal of Nursing, 2022, 57(11): 1304-1309.

图/表 4

表1 正念训练干预内容

Table 1 Mindfulness training intervention content

表2 两组一般资料的比较

Table 2 General data of patients in 2 groups

表3 干预前后两组患者阈下抑郁症状、正念水平、生活质量得分比较（分,$\bar{x} \pm s$）

Table 3 Comparison of subthreshold depression symptoms,mindfulness level,quality of life score between the two groups before and after intervention（score,$\bar{x} \pm s$）

表4 阈下抑郁症状发生率的广义估计方程分析[例（百分比,%）]

Table 4 Generalized estimation equation analysis of the incidence of subthreshold depressive symptoms[case（percentage,%）]

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