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韩国团体认知行为疗法对临床环境中惊恐障碍患者的疗效。

The effect of Korean-group cognitive behavioural therapy among patients with panic disorder in clinic settings.

作者信息

Choi Y S, Lee E J, Cho Y

机构信息

Department of Nursing, Andong Science College, Andong, South Korea.

College of Nursing, Keimyung University, Deagu, South Korea.

出版信息

J Psychiatr Ment Health Nurs. 2017 Feb;24(1):28-40. doi: 10.1111/jpm.12337. Epub 2016 Oct 24.

Abstract

UNLABELLED

WHAT IS KNOWN ON THE SUBJECT?: Panic disorder patients display various panic-related physical symptoms and catastrophic misinterpretation of bodily sensations, which lower their quality of life by interfering with daily activities. Cognitive behavioural therapy (CBT) is a useful strategy for panic disorder patients to manage symptoms associated with inaccurate cognitive interpretation of situations resulting from the patient's cognitive vulnerability. In South Korea, however, despite the increasing prevalence of panic disorder, CBT is not a common element of nursing care plans for panic disorder patients. Moreover, few Korean researchers have attempted to assess the effects of CBT on such patients. WHAT THIS PAPER ADD TO EXISTING KNOWLEDGE?: In a strategy combining CBT and routine treatments, patients with panic disorder can experience greater positive effects in the acute treatment phase than those they experience when receiving only routine treatment. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Mental health professionals, especially psychiatric nurses in local clinics who operate most special mental health programmes for panic disorder patients, should apply a panic disorder management programme that integrates CBT and routine treatments. The integrated approach is more effective for reducing the number of panic attacks and cognitive misinterpretation in patients than providing routine treatment alone. For patients with panic disorder, the objective of CBT is to understand the relationship between psychological panic disorder sensations, emotions, thoughts and behaviours. Therefore, nurses can help patients address and improve biological, social and psychological aspects of physical health problems as well as help them improve their coping skills in general.

ABSTRACT

Introduction In panic disorder, sensitivity to bodily sensations increases due to the patient's cognitive vulnerability. Cognitive behavioural therapy (CBT) can help to decrease sensitivity to bodily sensations by correcting these cognitive distortions by controlling negative thoughts and panic attacks. Aims This study verified whether group CBT is more effective than treatment as usual (TAU) in South Korean patients with panic disorder. Methods The study participants consisted of 76 panic disorder patients. Patients in the therapy condition attended sessions once a week for a total of 12 sessions in addition to drug treatment. Results In the therapy condition, there were significant decreases in panic-related bodily sensations and ranking and belief scores for catastrophic misinterpretation of external events. Discussion Group CBT, in comparison to TAU, decreases panic and agoraphobia symptom severity in South Korean patients with panic disorder. Our study provides evidence for the effectiveness of a panic disorder management programme that integrates group CBT and traditional pharmacotherapeutic treatment for patients with panic disorder. Implications for Practice The cognitive behavioural approach is needed to reduce panic and agoraphobia symptoms for hospitalized patients with panic disorder more than activity therapies, medications and supportive counselling by doctors and nurses.

摘要

未标注

关于该主题已知的信息有哪些?:惊恐障碍患者会表现出各种与惊恐相关的身体症状以及对身体感觉的灾难性错误解读,这些症状通过干扰日常活动降低了他们的生活质量。认知行为疗法(CBT)是一种帮助惊恐障碍患者管理症状的有效策略,这些症状与患者因认知易损性而对情境进行不准确的认知解读有关。然而,在韩国,尽管惊恐障碍的患病率不断上升,但CBT并非惊恐障碍患者护理计划的常见组成部分。此外,很少有韩国研究人员尝试评估CBT对这类患者的影响。本文对现有知识的补充是什么?:在将CBT与常规治疗相结合的策略中,惊恐障碍患者在急性治疗阶段所体验到的积极效果比仅接受常规治疗时更大。对实践有何启示?:心理健康专业人员,尤其是在当地诊所为大多数惊恐障碍患者开展特殊心理健康项目的精神科护士,应应用一种将CBT与常规治疗相结合的惊恐障碍管理项目。与单独提供常规治疗相比,这种综合方法在减少患者惊恐发作次数和认知错误解读方面更有效。对于惊恐障碍患者,CBT的目标是理解心理惊恐障碍感觉、情绪、思维和行为之间的关系。因此,护士可以帮助患者解决并改善身体健康问题的生物、社会和心理方面,同时帮助他们总体上提高应对技能。

摘要

引言 在惊恐障碍中,由于患者的认知易损性,对身体感觉的敏感性会增加。认知行为疗法(CBT)可以通过控制消极思维和惊恐发作来纠正这些认知扭曲,从而帮助降低对身体感觉的敏感性。目的 本研究验证了团体CBT在韩国惊恐障碍患者中是否比常规治疗(TAU)更有效。方法 研究参与者包括76名惊恐障碍患者。治疗组患者除药物治疗外,每周参加一次治疗课程,共12次。结果 在治疗组中,与惊恐相关的身体感觉以及对外部事件灾难性错误解读的排名和信念得分显著降低。讨论 与TAU相比,团体CBT降低了韩国惊恐障碍患者的惊恐和广场恐惧症症状严重程度。我们的研究为一种将团体CBT与传统药物治疗相结合的惊恐障碍管理项目对惊恐障碍患者的有效性提供了证据。对实践的启示 对于住院的惊恐障碍患者,与医生和护士的活动疗法、药物治疗及支持性咨询相比,更需要认知行为方法来减轻惊恐和广场恐惧症症状。

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