Oranta Olli, Luutonen Sinikka, Salokangas Raimo K R, Vahlberg Tero, Leino-Kilpi Helena
Department of Nursing Science and Psychiatric Clinic, Turku University Central Hospital, Turku, Finland.
Nord J Psychiatry. 2010 Apr;64(2):78-86. doi: 10.3109/08039480903402227.
Depression is not treated adequately after myocardial infarction (MI). This study evaluates the interpersonal counselling (IPC) implemented by a registered nurse on outcomes for depressive symptoms and distress in MI patients.
We studied MI patients (n = 103) randomized into intervention group (n = 51) and control group (n = 52) in hospital and at 6 and 18 months after discharge using validated questionnaires, Beck's Depression Inventory (BDI) and the Symptom Checklist-25 (SCL-25).
During the 18-month follow-up, depressive symptoms decreased statistically significantly (P = 0.009) in the intervention group compared with the control group. In the IPC intervention group, depressive symptoms decreased from 37.3% to 20.4% at 6 months (P = 0.014), and to 16.7% at 18 months (P = 0.001), while distress decreased from 37.3% to 26.5% (P = 0.132) during the 6-month follow-up, and to 20.8% (P = 0.015). In the control group with normal care, the number of patients with depressive symptoms and distress varied slightly at the three measurements, from 30.2 to 39.6%.
The number of patients with depressive symptoms and distress decreased in the intervention group and remained high in the control group. The progress of severity level of depressive symptoms was toward milder symptoms in the intervention group during the 18-month follow-up. This brief intervention that can rapidly be adopted may result in enduring benefits of clinical value.
心肌梗死（MI）后抑郁症未得到充分治疗。本研究评估注册护士实施的人际咨询（IPC）对MI患者抑郁症状和痛苦结局的影响。
我们使用经过验证的问卷，即贝克抑郁量表（BDI）和症状清单-25（SCL-25），对103例MI患者进行了研究，这些患者被随机分为干预组（n = 51）和对照组（n = 52），分别在住院期间以及出院后6个月和18个月进行观察。
在18个月的随访期间，与对照组相比，干预组的抑郁症状有统计学显著下降（P = 0.009）。在IPC干预组中，抑郁症状在6个月时从37.3%降至20.4%（P = 0.014），在18个月时降至16.7%（P = 0.001），而痛苦在6个月的随访期间从37.3%降至26.5%（P = 0.132），在18个月时降至20.8%（P = 0.015）。在接受常规护理的对照组中，抑郁症状和痛苦患者的数量在三次测量中略有变化，从30.2%至39.6%。
干预组中抑郁症状和痛苦患者的数量减少，而对照组中仍居高不下。在18个月的随访期间，干预组抑郁症状严重程度呈向较轻症状发展的趋势。这种可迅速采用的简短干预可能会带来具有临床价值的持久益处。
