Tsai Siou-Hung, Wang Mei-Yeh, Miao Nae-Fang, Chian Pei-Chuan, Chen Tso-Hsiao, Tsai Pei-Shan
Am J Nurs. 2015 Apr;115(4):24-32; quiz 33, 42. doi: 10.1097/01.NAJ.0000463023.48226.16.
Depression is common in patients with chronic kidney disease who are on hemodialysis. Available behavioral modalities for treating depression may not be feasible for patients who receive hemodialysis two or three times per week.
The purpose of this randomized controlled trial was to examine the efficacy of a nurse-led, in-center breathing training program in reducing depressive symptoms and improving sleep quality and health-related quality of life in patients on maintenance hemodialysis.
Fifty-seven patients on hemodialysis were randomly assigned either to an eight-session breathing training group or to a control group. The Beck Depression Inventory II (BDI-II), the Pittsburgh Sleep Quality Index (PSQI), and the Medical Outcome Studies 36-Item Short Form Health Survey (SF-36) were used to assess self-reported depressive symptoms, sleep quality, and health-related quality of life, respectively.
The intervention group exhibited significantly greater decreases in BDI-II scores than the control group. No significant differences in PSQI change scores were observed between the groups. SF-36 change scores for both the domain of role limitation due to emotional problems and the mental component summary were significantly higher in the breathing training group than in the control group.
This intervention significantly alleviated depressive symptoms, reduced perceived role limitation due to emotional problems, and improved the overall mental health component of quality of life in patients on maintenance hemodialysis.
抑郁症在接受血液透析的慢性肾病患者中很常见。对于每周接受两到三次血液透析的患者,现有的治疗抑郁症的行为方式可能不可行。
这项随机对照试验的目的是检验由护士主导的中心呼吸训练项目在减轻维持性血液透析患者的抑郁症状、改善睡眠质量和与健康相关的生活质量方面的疗效。
57名血液透析患者被随机分配到为期八节的呼吸训练组或对照组。分别使用贝克抑郁量表第二版(BDI-II)、匹兹堡睡眠质量指数(PSQI)和医学结局研究36项简短健康调查(SF-36)来评估自我报告的抑郁症状、睡眠质量和与健康相关的生活质量。
干预组的BDI-II得分下降幅度显著大于对照组。两组之间在PSQI变化得分上未观察到显著差异。呼吸训练组在因情绪问题导致的角色限制领域和心理成分总结方面的SF-36变化得分均显著高于对照组。
这项干预显著减轻了维持性血液透析患者的抑郁症状,减少了因情绪问题导致的感知角色限制,并改善了生活质量的整体心理健康成分。