Hwang Boyoung, Eastwood Jo-Ann, McGuire Anthony, Chen Belinda, Cross-Bodán Rebecca, Doering Lynn V
Boyoung Hwang, PhD Assistant Professor, School of Nursing, University of California, Los Angeles. Jo-Ann Eastwood, PhD Assistant Professor, School of Nursing, University of California, Los Angeles. Anthony McGuire, PhD Assistant Professor, School of Nursing, California State University, Long Beach. Belinda Chen, MPH Project Director, School of Nursing, University of California, Los Angeles. Rebecca Cross-Bodán, PhD Assistant Professor, School of Nursing, California State University, Fullerton. Lynn V. Doering, DNSc Professor and Chair, Translational Sciences, School of Nursing, University of California, Los Angeles.
J Cardiovasc Nurs. 2015 Jul-Aug;30(4):319-24. doi: 10.1097/JCN.0000000000000155.
The aim of this study was to evaluate the relationship of ejection fraction (EF) and depressive symptoms in cardiac surgery patients assigned to nurse-guided cognitive behavioral therapy (CBT) or usual care (UC).
Depressive symptoms were assessed using the Beck Depression Inventory (BDI). Seventy-seven patients (31% women; mean [SD] age, 63.6 [9.8] years) received 8 weeks of either CBT or UC. Using repeated-measures analysis of variance, changes in depressive symptoms over time were evaluated.
There was a significant interaction among time, treatment group, and EF status (p = 0.019). In the patients with preserved EF (≥40%), mean BDI scores in the UC group worsened by 1.9%, whereas those in the CBT group improved by 31.0%. In the patients with low EF (<40%), mean BDI scores worsened by 26.8% and improved by 75.3% in the UC and CBT groups, respectively.
Nurse-guided CBT is effective in reducing depressive symptoms after cardiac surgery, particularly in patients with low EF.
本研究旨在评估接受护士指导的认知行为疗法（CBT）或常规护理（UC）的心脏手术患者的射血分数（EF）与抑郁症状之间的关系。
使用贝克抑郁量表（BDI）评估抑郁症状。77名患者（31%为女性；平均[标准差]年龄为63.6[9.8]岁）接受了为期8周的CBT或UC治疗。采用重复测量方差分析评估抑郁症状随时间的变化。
时间、治疗组和EF状态之间存在显著交互作用（p = 0.019）。在EF保留（≥40%）的患者中，UC组的平均BDI评分恶化了1.9%，而CBT组的评分改善了31.0%。在EF较低（<40%）的患者中，UC组和CBT组的平均BDI评分分别恶化了26.8%和改善了75.3%。
护士指导的CBT可有效减轻心脏手术后的抑郁症状，尤其是EF较低的患者。
