本文關(guān)鍵詞：呼吸生物反饋療法對冠心病患者負(fù)性情緒及睡眠質(zhì)量影響的臨床研究　出處：《皖南醫(yī)學(xué)院》2017年碩士論文　論文類型：學(xué)位論文

  更多相關(guān)文章： 生物反饋 冠心病 深呼吸 負(fù)性情緒 睡眠

【摘要】：目的:調(diào)查冠心病住院患者伴有焦慮或抑郁情緒以及睡眠質(zhì)量的現(xiàn)狀,并探討呼吸生物反饋療法改善冠心病患者焦慮、抑郁以及睡眠質(zhì)量的臨床效果,為日后該療法在護(hù)理工作中的運(yùn)用提供科學(xué)依據(jù)。方法:選擇2015年10月至2016年10月皖南醫(yī)學(xué)院弋磯山醫(yī)院心內(nèi)科收治的冠心病患者,使用醫(yī)院焦慮抑郁量表篩選出符合條件的115例患者,隨機(jī)分為A組與B組,A組52例,B組63例。自患者入院當(dāng)天開始直至出院,B組患者給予心內(nèi)科常規(guī)護(hù)理,A組患者在此基礎(chǔ)上采用的Spirit-8型多通道生物反饋儀給予呼吸生物反饋治療,隔日一次。采用自制的一般資料調(diào)查問卷、醫(yī)院焦慮抑郁量表、匹茲堡睡眠指數(shù)分別于入院當(dāng)日、出院當(dāng)天進(jìn)行評估作為患者的原始及改善情況。比較治療前后焦慮、抑郁,睡眠質(zhì)量,自主神經(jīng)功能的變化,比較兩組患者在住院期間心血管事件的發(fā)生率及住院日。結(jié)果:①180例冠心病住院患者中有115例患者的焦慮或抑郁亞量表評分≥8分,約占63.8%,伴有焦慮或抑郁癥狀的患者中84.0%的患者睡眠質(zhì)量總分≥7分,睡眠質(zhì)量受到影響。②治療后兩組患者的焦慮、抑郁,睡眠質(zhì)量均有所改善,醫(yī)院焦慮抑郁量表評分、匹茲堡睡眠指數(shù)評分均顯著降低,差異均有統(tǒng)計學(xué)意義(P0.05),治療后A組患者的焦慮、抑郁癥狀改善優(yōu)于B組、主觀睡眠質(zhì)量和入睡時間提升均明顯高于B組,差異均有統(tǒng)計學(xué)意義(P0.05),醫(yī)院焦慮抑郁量表評分(11.56±1.61,13.97±1.49)、匹茲堡睡眠指數(shù)總分(7.44±1.94,8.61±2.16)、主觀睡眠質(zhì)量(0.97±0.43,1.25±0.43)、入睡時間(1.05±0.31,1.32±0.47)因子得分均明顯低于B組,差異均有統(tǒng)計學(xué)意義(P0.05)。③治療前后A組患者SDNN值由50.79±42.75上升到53.95±42.27,B組患者由39.60±12.88下降到30.93±7.79,差異均有統(tǒng)計學(xué)意義(P0.05)。④A組患者心血管事件發(fā)生率為23.3%,B組發(fā)生率為43.9%,差異有統(tǒng)計學(xué)意義(P0.05),A組患者住院日為10.28±3.813,B組患者住院日為9.53±3.586,差異無統(tǒng)計學(xué)意義(P0.05)。結(jié)論:①超過一半的冠心病住院患者伴有焦慮、抑郁等負(fù)性情緒,伴有焦慮、抑郁的冠心病患者睡眠質(zhì)量受到影響。②呼吸生物反饋療法可以顯著改善冠心病患者的焦慮、抑郁(以焦慮癥狀為主)、提升患者的主觀睡眠質(zhì)量及入睡時間。③呼吸生物反饋療法可以提升冠心病患者的心率變異性指數(shù)(正常心動周期的標(biāo)準(zhǔn)差),減少住院期間發(fā)生心血管事件,但并不能縮短住院日。
[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.

【學(xué)位授予單位】：皖南醫(yī)學(xué)院
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R473.5

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本文編號：1362704