动机性访谈对代谢综合征女性静坐行为、抑郁症状及健康相关生活质量的影响
Motivational Counseling to Reduce Sedentary Behaviors and Depressive Symptoms and Improve Health-Related Quality of Life Among Women With Metabolic Syndrome.
机构信息
Li-Chi Chiang, PhD, RN Professor, School of Nursing, China Medical University, Taichung; and School of Nursing & Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan, R.O.C. Margaret McLean Heitkemper, PhD, RN, FAAN Professor and Chairperson, Department of Biobehavioral Nursing and Health Systems, and Adjunct Professor, Division of Gastroenterology, School of Medicine, University of Washington, Seattle. Shang-Lin Chiang, MD, PhD Assistant Professor, School of Medicine, National Defense Medical Center; and Director, Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, Taipei, Taiwan, ROC. Wen-Chii Tzeng, PhD, RN Associate Professor, School of Nursing, National Defense Medical Center, Taipei, Taiwan, R.O.C. Meei-Shyuan Lee, PhD Professor, School of Public Health & Graduate Institute of Medical Science, National Defense Medical Center, Taipei, Taiwan, R.O.C. Yi-Jen Hung, MD Professor, School of Medicine, National Defense Medical Center; and Superintendent, Songshan Branch of Tri-Service General Hospital, Taipei, Taiwan, R.O.C. Chia-Huei Lin, PhD, RN Assistant Professor, Schools of Nursing and Medicine, National Defense Medical Center; and Supervisor, Department of Nursing, Songshan Branch of Tri-Service General Hospital, Taipei, Taiwan, R.O.C.
出版信息
J Cardiovasc Nurs. 2019 Jul/Aug;34(4):327-335. doi: 10.1097/JCN.0000000000000573.
BACKGROUND
Motivational interviewing, as a counseling approach, could promote not only behavioral changes but also individuals' psychological adaptation. Previous studies provide evidence that motivational interviewing focused on increasing physical activity decreases the risk of metabolic syndrome in women. Its effects on sedentary behaviors, depressive symptoms, and health-related quality of life (HRQL) remain unknown.
OBJECTIVES
The aim of this study was to evaluate whether a 12-week motivational counseling program reduces sedentary behaviors and depressive symptoms and improves HRQL in Taiwanese women.
METHODS
A randomized controlled study was conducted. Participants (n = 115) were randomly assigned into 3 groups: experimental group (received a brochure on lifestyle modification combined with 12 weeks of motivational counseling), comparison group (received a lifestyle modification brochure), and usual care group (UCG). Outcome variables were measured at baseline and at 12 weeks post intervention by the International Physical Activity Questionnaire, Beck Depression Inventory, and Medical Outcomes Short Form-36 Health Survey. Generalized estimating equations were applied to analyze the intervention effects of groups by interaction of group and time.
RESULTS
Women in the experimental group not only reduced (P < .001) weekly sitting time by 374 minutes but also decreased (P < .05) depressive symptoms, as well as had greater overall HRQL including 8 subscales as compared with the UCG. As compared with the UCG, the women in the comparison group had no change in sedentary behaviors, but they had reduced depressive symptoms and improvement on some HRQL subscales.
CONCLUSIONS
Motivational counseling that incorporates behavioral change principles is effective in reducing sedentary behaviors and depressive symptoms and improving HRQL for women with metabolic syndrome.
背景
作为一种咨询方法，动机性访谈不仅可以促进行为改变，还可以促进个体的心理适应。先前的研究表明，以增加身体活动为重点的动机性访谈可以降低女性患代谢综合征的风险。但其对久坐行为、抑郁症状和健康相关生活质量（HRQL）的影响尚不清楚。
目的
本研究旨在评估为期 12 周的动机性咨询方案是否可以减少台湾女性的久坐行为和抑郁症状，并改善其 HRQL。
方法
进行了一项随机对照研究。参与者（n=115）被随机分为 3 组：实验组（接受生活方式改变手册和 12 周动机性咨询）、对照组（接受生活方式改变手册）和常规护理组（UCG）。在基线和干预后 12 周，通过国际体力活动问卷、贝克抑郁量表和医疗结局短式 36 健康调查评估结局变量。应用广义估计方程分析组间和时间交互作用的干预效果。
结果
实验组女性不仅每周久坐时间减少了 374 分钟（P<0.001），而且抑郁症状也有所减轻（P<0.05），总体 HRQL 包括 8 个亚量表也有所提高，与 UCG 相比。与 UCG 相比，对照组女性的久坐行为没有变化，但抑郁症状有所减轻，一些 HRQL 亚量表有所改善。
结论
纳入行为改变原则的动机性咨询对于代谢综合征女性减少久坐行为、抑郁症状和改善 HRQL 是有效的。
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