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过秀秀,章丽雅.支持性心理干预对脑卒中抑郁患者认知功能和日常生活能力的影响[J].浙江中西医结合杂志,2021,31(4):
支持性心理干预对脑卒中抑郁患者认知功能和日常生活能力的影响
Effects of Supportive Psychological Intervention on Cognitive Function and Ability of Daily Living in Patients with Post-stroke Depression
投稿时间:2020-10-13  修订日期:2020-12-08
DOI:
中文关键词:  支持性心理干预,脑卒中,PSD,认知功能
英文关键词:Supportive psychological intervention,Stroke,PSD,Cognitive function
基金项目:
作者单位E-mail
过秀秀 浙江省人民医院 1216224480@qq.com 
章丽雅 浙江省人民医院  
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中文摘要:
      【摘要】目的 探讨支持性心理干预对脑卒中后抑郁患者(post-strok depression,PSD)抑郁状态和认知功能及日常生活能力的影响。方法 选取2019年1月至2019年12月在浙江省人民医院康复科住院治疗的脑卒中后抑郁患者50例作为研究对象,随机将50例PSD患者分为干预组(n=25)和对照组(n=25)。对照组接受常规治疗、护理和康复训练。干预组在对照组治疗基础上给予支持性心理治疗干预。两组分别在治疗前、治疗8周后、16周后(治疗结束后8周)随访,分别采用汉密尔顿抑郁量表(HAMD)评定患者的抑郁状态;采用洛文斯顿作业疗法认知评定成套测验 (LOTCA)和蒙特利尔认知功能评估量表(MoCA)评定患者的认知功能;采用Barthel指数(BI)评定日常生活活动能力。结果 治疗8周后,两组患者的HAMD评分较治疗前均显著下降(P0.05)且干预组显著低于对照组(P0.05)。两组的LOTCA和MoCA各项评分及Barthel指数评分较治疗前有显著提高(P0.05),且干预组显著高于对照组(P<0.05)。16周后随访,干预组HAMD评分显著低于对照组(P0.001)。干预组LOTCA总分、MoCA总分及Barthel指数评分显著高于对照组(P<0.05)。结论 在常规治疗的基础上增加支持性心理干预可以显著改善脑卒中后抑郁患者抑郁状态,促进认知功能障碍的恢复,提高日常生活活动能力并且有持续影响作用。
英文摘要:
      Objective To explore the impact of supportive psychological intervention on post-strok depression (PSD) depression status,cognitive function and daily living ability.Methods 50 patients with post-stroke depression who were hospitalized in the rehabilitation department of Zhejiang Provincial People's Hospital from January 2019 to December 2019 were selected as research subjects.50 PSD patients were randomly divided into an intervention group (n = 25) and a control group ( n = 25).The control group received routine treatment,nursing and rehabilitation training.The intervention group was given supportive psychotherapy intervention based on the treatment of the control group.The two groups before treatment,respectively,8 weeks after treatment,and 16 weeks after the followed-up of treatment(8 weeks after the end of treatment) were assessed for depression with the Hamilton Depression Scale (HAMD).Loewenstein Occupational Therapy Cognitive Assessment (LOTCA) and Montreal Cognitive Assessment Scale (MoCA) was used to assess patients' cognitive function;the Barthel Index (BI) was used to assess their daily activities.Results After 8 weeks of treatment,the HAMD scores of the two groups were significantly lower than before treatment (P<0.05)and the intervention group was significantly lower than the control group(P<0.05).The LOTCA and MoCA scores and Barthel index scores of the two groups were significantly higher than those before treatment(P<0.05),and the intervention group was significantly higher than the control group (P<0.05).Follow-up 16 weeks later,the HAMD score of the intervention group was significantly lower than that of the control group (P<0.001).The total LOTCA score,total MoCA score and Barthel index score of the intervention group were significantly higher than those of the control group (P<0.05).Conclusion Adding supportive psychological intervention on the basis of conventional treatment can significantly improve the depressive state,recovery of cognitive dysfunction,improve the ability of daily living activities and have a continuous effect on post-stroke depression patients.
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