呼吸生物反馈疗法对冠心病患者负性情绪及睡眠质量影响的临床研究

发布时间：2018-01-01 03:19

本文关键词：呼吸生物反馈疗法对冠心病患者负性情绪及睡眠质量影响的临床研究　出处：《皖南医学院》2017年硕士论文　论文类型：学位论文

【摘要】：目的:调查冠心病住院患者伴有焦虑或抑郁情绪以及睡眠质量的现状,并探讨呼吸生物反馈疗法改善冠心病患者焦虑、抑郁以及睡眠质量的临床效果,为日后该疗法在护理工作中的运用提供科学依据。方法:选择2015年10月至2016年10月皖南医学院弋矶山医院心内科收治的冠心病患者,使用医院焦虑抑郁量表筛选出符合条件的115例患者,随机分为A组与B组,A组52例,B组63例。自患者入院当天开始直至出院,B组患者给予心内科常规护理,A组患者在此基础上采用的Spirit-8型多通道生物反馈仪给予呼吸生物反馈治疗,隔日一次。采用自制的一般资料调查问卷、医院焦虑抑郁量表、匹兹堡睡眠指数分别于入院当日、出院当天进行评估作为患者的原始及改善情况。比较治疗前后焦虑、抑郁,睡眠质量,自主神经功能的变化,比较两组患者在住院期间心血管事件的发生率及住院日。结果:①180例冠心病住院患者中有115例患者的焦虑或抑郁亚量表评分≥8分,约占63.8%,伴有焦虑或抑郁症状的患者中84.0%的患者睡眠质量总分≥7分,睡眠质量受到影响。②治疗后两组患者的焦虑、抑郁,睡眠质量均有所改善,医院焦虑抑郁量表评分、匹兹堡睡眠指数评分均显著降低,差异均有统计学意义(P0.05),治疗后A组患者的焦虑、抑郁症状改善优于B组、主观睡眠质量和入睡时间提升均明显高于B组,差异均有统计学意义(P0.05),医院焦虑抑郁量表评分(11.56±1.61,13.97±1.49)、匹兹堡睡眠指数总分(7.44±1.94,8.61±2.16)、主观睡眠质量(0.97±0.43,1.25±0.43)、入睡时间(1.05±0.31,1.32±0.47)因子得分均明显低于B组,差异均有统计学意义(P0.05)。③治疗前后A组患者SDNN值由50.79±42.75上升到53.95±42.27,B组患者由39.60±12.88下降到30.93±7.79,差异均有统计学意义(P0.05)。④A组患者心血管事件发生率为23.3%,B组发生率为43.9%,差异有统计学意义(P0.05),A组患者住院日为10.28±3.813,B组患者住院日为9.53±3.586,差异无统计学意义(P0.05)。结论:①超过一半的冠心病住院患者伴有焦虑、抑郁等负性情绪,伴有焦虑、抑郁的冠心病患者睡眠质量受到影响。②呼吸生物反馈疗法可以显著改善冠心病患者的焦虑、抑郁(以焦虑症状为主)、提升患者的主观睡眠质量及入睡时间。③呼吸生物反馈疗法可以提升冠心病患者的心率变异性指数(正常心动周期的标准差),减少住院期间发生心血管事件,但并不能缩短住院日。
[Abstract]:Objective: To investigate the hospitalized patients with coronary heart disease accompanied by anxiety or depression and sleep quality of the status quo, and to investigate the respiratory biofeedback therapy to improve the anxiety of patients with coronary heart disease, depression and clinical effects of sleep quality, and provide scientific basis for the use of the therapy in the nursing work of the day. Methods: from October 2015 to October 2016 admitted to the Department of Cardiology, yijishan Hospital of Wangnan Medical College the patients with coronary heart disease, using the hospital anxiety and depression scale screening of 115 eligible patients were randomly divided into A group and B group, A group of 52 cases, 63 cases in B group. Since the admission day until discharge, given routine nursing in Department of cardiology patients in the B group, Spirit-8 with A patients on the basis of the multi channel bio feedback instrument for respiratory biofeedback therapy, once every other day. Using the self-made general information questionnaire, hospital anxiety and depression scale, sleep index in Pittsburgh Not from the day of admission, discharge the same day as the original evaluation and improvement of patients. Before and after the treatment of anxiety, depression, sleep quality, the changes of the autonomic nervous function were compared between the two groups in the incidence of cardiovascular events during hospitalization and hospitalization. Results: 180 cases of hospitalized patients with coronary heart disease in 115 patients with anxiety or depression subscale scores more than 8 points, accounting for about 63.8%, 84% patients with anxiety or depressive symptoms in patients with sleep quality score more than 7 points, the quality of sleep affected. Anxiety, two groups of patients after the treatment of depression, sleep quality were improved, the hospital anxiety and Depression Scale score, sleep index in Pittsburgh scores were significantly lower, the differences were statistically significant (P0.05), A group of patients after treatment of anxiety, depressive symptoms improved better than that of B group, subjective sleep quality and sleep time increased was significantly higher than B group, the differences were all Statistically significant (P0.05), hospital anxiety and Depression Scale score (11.56 + 1.61,13.97 + 1.49), Pittsburgh total sleep index (7.44 + 1.94,8.61 + 2.16), subjective sleep quality (0.97 + 0.43,1.25 + 0.43), sleep time (1.05 + 0.31,1.32 + 0.47) factor scores were significantly lower than B group, the differences were statistically meaning (P0.05). The A group before and after treatment in patients with SDNN values from 50.79 up to 53.95 + 42.75 + 42.27, B + 12.88 group of patients from 39.60 down to 30.93 + 7.79, the differences were statistically significant (P0.05). The patients in the A group the incidence rate of cardiovascular events was 23.3%, the occurrence rate of group B was 43.9%, there was statistical significant differences (P0.05), A group patients hospitalization was 10.28 + 3.813, B group of patients hospitalization was 9.53 + 3.586, the difference was not statistically significant (P0.05). Conclusion: the coronary heart disease in more than half of the patients with anxiety, depression and other negative emotion, anxiety, sleep quality and depression in patients with coronary heart disease The amount of affected. The respiratory biofeedback therapy can significantly improve the anxiety of patients with coronary heart disease, depression (with anxiety symptoms), enhance the subjective sleep quality and sleep time of patients. The respiratory biofeedback therapy can improve the index of heart rate variability in patients with coronary heart disease (normalcardiaccycle standard deviation), reduce the incidence of cardiovascular events during hospitalization, but can not shorten the hospitalization days.

【学位授予单位】：皖南医学院
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R473.5

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