团体心理辅导对耐多药结核病患者的抑郁症状干预效果
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摘要
目的评价团体心理辅导方式对耐多药肺结核(MDR-TB)患者心理干预的效果,为促进耐多药结核病患者心理健康提供依据。方法对武汉市全球基金耐多药结核病防治领域2013—2014年纳入治疗的128例MDR-TB患者,使用Zung抑郁自评量表(Self-rating Depression Scale,SDS)进行面对面问卷调查,筛选出61例有抑郁症状者为研究对象,将研究对象分成干预组(n=30)和对照组(n=31),干预组进行团体心理辅导8次,对照组不接受心理干预,比较干预前后调查数据。结果两组研究对象在干预前评分差异无统计学意义(P>0.05)。团体心理辅导后,干预组抑郁评分较干预前下降(48.17±5.10vs61.00±2.08),差异有统计学意义(t=12.58,P<0.001),对照组抑郁评分干预前后比较差异无统计学意义(61.99±3.64vs60.64±3.18,t=1.23,P>0.05)。结论实施团体心理辅导可降低耐多药肺结核患者抑郁症状水平,对提高患者的治疗依从性具有重要意义。
Objective To assess the effectiveness of psychological intervention in a grouped counseling participated by multi-drug resistant tuberculosis( MDR- TB) patients,and provide reference for enhancing the mental well-being of MDR- TB patients.Methods From 2013 to 2014,128 MDR- TB patients who had been included and treated by the global funds MDR- TB program in Wuhan were deemed as study subjects. A Zung Self-rating Depression Scale( SDS) was incorporated into a questionnaire which was handed out in a person-to-person interview. The 61MDR- TB patients who have depressive symptoms were randomly divided into intervention group( n = 30) and control group( n = 31). The intervention group received 8 rounds of grouped counseling,the control group received no intervention. Comparison was made between data collected prior and after the implementation of psychological intervention. Results Before the group guidance,the intervention group and control group had no significant differences in both Scales( P > 0. 05). After the group psychological counseling,the intervention group showed significant decrease in score of SDS( 48. 17 ± 5. 10 vs 61. 00 ± 2. 08,t = 12. 58,P < 0. 001. There was no significant differences in control group. Conclusion Intervention of grouped psychological counseling was constructive in terms of lowering the level of depression in MDR- TB patients,therefore it is of great significance regarding enhancing patients' treatment compliance.
Objective To assess the effectiveness of psychological intervention in a grouped counseling participated by multi-drug resistant tuberculosis( MDR- TB) patients,and provide reference for enhancing the mental well-being of MDR- TB patients.Methods From 2013 to 2014,128 MDR- TB patients who had been included and treated by the global funds MDR- TB program in Wuhan were deemed as study subjects. A Zung Self-rating Depression Scale( SDS) was incorporated into a questionnaire which was handed out in a person-to-person interview. The 61MDR- TB patients who have depressive symptoms were randomly divided into intervention group( n = 30) and control group( n = 31). The intervention group received 8 rounds of grouped counseling,the control group received no intervention. Comparison was made between data collected prior and after the implementation of psychological intervention. Results Before the group guidance,the intervention group and control group had no significant differences in both Scales( P > 0. 05). After the group psychological counseling,the intervention group showed significant decrease in score of SDS( 48. 17 ± 5. 10 vs 61. 00 ± 2. 08,t = 12. 58,P < 0. 001. There was no significant differences in control group. Conclusion Intervention of grouped psychological counseling was constructive in terms of lowering the level of depression in MDR- TB patients,therefore it is of great significance regarding enhancing patients' treatment compliance.
引文
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[4]冯丽文.健康教育及心理护理对耐多药结核病患者治疗效果的影响[J].中国煤炭工业医学杂志,2012,15(8):1269-1270.
[5]樊富珉.团体咨询的理论与实践[M].北京:清华大学出版社,1996:141-196.
[6]Mimunya JM,Kredot,Volminkj.Patient education and counselling for promoting adherence to treatment for tuberculosis[J].Cochrane Database SystRev,2012(3):6-9.
[7]Khan MS,Suwannapong N,Howteerakul N,et al.Improvement of district hospital service system to increase treatment adherence among tuberculosis patients in Pakistan[J].Southeast Asian J Trop Med Public Health,2011,42(3):664-673.
[8]Morisky DE,Malotte CK,Ebin V,et al.Behavioral interventions for the control of tuberculosis among adolescents[J].Public Health Rep,2001,116(6):568-574.
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[10]周日花,沈莉莉.综合心理干预对耐多药结核病患者焦虑心理的影响[J].甘肃医药,2011,30(12):148-149.
[11]董萍,周蒨,李晗,等.抑郁情绪对老年糖尿病肾病患者血糖控制与生活质量影响[J].公共卫生与预防医学,2015,26(2):118-120.
[12]白涛,武丽.武汉市福利院老年人生命质量与抑郁关系研究[J].公共卫生与预防医学,2012,23(3):76-77.
[13]Jacobs EE,Robert LM,Riley LH,等.团体咨询的策略与方法[M].北京:中国轻工业出版社.2000:1040-1043.
[14]于兰,王静,苏伟,等.耐多药肺结核患者心理支持服务需求分析[J].中国防痨杂志,2013(5):370-372.
[15]刘贤臣,唐茂芹,陈琨,等.SDS和CES-D对大学生抑郁症状评定结果的比较[J].中国心理卫生杂志,1995,9(1):19-20.
[16]陈建兰,葛木村.咸宁市肺结核患者生活满意度及影响因素研究[J].公共卫生与预防医学,2014,25(1):100-101.
[2]中华人民共和国卫生部.全国结核病耐药性基线调查报告(2007—2008年)[M].北京:人民卫生出版社,2010.
[3]Hirpa S,Medhin G,Girma B,et al.Determinants of multidrugresistant tuberculosis in patients who underwent first-line treatment in Addis Ababa:a case control study[J].BMC Public Health,2013,13(1):1-9.
[4]冯丽文.健康教育及心理护理对耐多药结核病患者治疗效果的影响[J].中国煤炭工业医学杂志,2012,15(8):1269-1270.
[5]樊富珉.团体咨询的理论与实践[M].北京:清华大学出版社,1996:141-196.
[6]Mimunya JM,Kredot,Volminkj.Patient education and counselling for promoting adherence to treatment for tuberculosis[J].Cochrane Database SystRev,2012(3):6-9.
[7]Khan MS,Suwannapong N,Howteerakul N,et al.Improvement of district hospital service system to increase treatment adherence among tuberculosis patients in Pakistan[J].Southeast Asian J Trop Med Public Health,2011,42(3):664-673.
[8]Morisky DE,Malotte CK,Ebin V,et al.Behavioral interventions for the control of tuberculosis among adolescents[J].Public Health Rep,2001,116(6):568-574.
[9]吴文源.抑郁自评量表//中国行为医学科学编辑委员会.行为医学量表手册[M].北京:中华医学音像出版社,2005:223-224.
[10]周日花,沈莉莉.综合心理干预对耐多药结核病患者焦虑心理的影响[J].甘肃医药,2011,30(12):148-149.
[11]董萍,周蒨,李晗,等.抑郁情绪对老年糖尿病肾病患者血糖控制与生活质量影响[J].公共卫生与预防医学,2015,26(2):118-120.
[12]白涛,武丽.武汉市福利院老年人生命质量与抑郁关系研究[J].公共卫生与预防医学,2012,23(3):76-77.
[13]Jacobs EE,Robert LM,Riley LH,等.团体咨询的策略与方法[M].北京:中国轻工业出版社.2000:1040-1043.
[14]于兰,王静,苏伟,等.耐多药肺结核患者心理支持服务需求分析[J].中国防痨杂志,2013(5):370-372.
[15]刘贤臣,唐茂芹,陈琨,等.SDS和CES-D对大学生抑郁症状评定结果的比较[J].中国心理卫生杂志,1995,9(1):19-20.
[16]陈建兰,葛木村.咸宁市肺结核患者生活满意度及影响因素研究[J].公共卫生与预防医学,2014,25(1):100-101.