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一项新设计的强化照护者教育计划可降低急性缺血性脑卒中患者的认知障碍、焦虑和抑郁。

A newly designed intensive caregiver education program reduces cognitive impairment, anxiety, and depression in patients with acute ischemic stroke.

机构信息

Department of Neurology, The First Affiliated Hospital of Harbin Medical University, Harbin, China.

出版信息

Braz J Med Biol Res. 2019;52(9):e8533. doi: 10.1590/1414-431X20198533. Epub 2019 Sep 2.

Abstract

This study aimed to evaluate the effect of a newly designed intensive caregiver education program (ICEP) on reducing cognitive impairment, anxiety, and depression in acute ischemic stroke (AIS) patients. One hundred and ninety-six AIS patients were divided into ICEP group and Control group in a 1:1 ratio using blocked randomization method. In the ICEP group, the caregivers received ICEP, while in the Control group caregivers received usual education and guidance. All patients received conventional rehabilitation treatment. Cognitive impairment (assessed by Mini Mental State Examination (MMSE) score and Montreal Cognitive Assessment (MoCA) score), anxiety (assessed by Hospital Anxiety and Depression Scale (HADS)-A score and Self-rating Anxiety Scale (SAS) score), and depression (assessed by HADS-D score and Self-rating Depression Scale (SDS) score) were assessed at baseline (M0), 3 months (M3), 6 months (M6), and 12 months (M12). Cognitive impairment score at M12 and cognitive impairment score change (M12-M0) were increased, while cognitive impairment rate at M12 was reduced in the ICEP group compared with the Control group. Anxiety score change (M12-M0), anxiety score at M12, and anxiety rate at M12 were decreased in the ICEP group compared with the Control group. Depression score change (M12-M0), depression score at M12, and depression rate at M12 were lower in the ICEP group compared with the Control group. Further subgroup analysis based on baseline features also provided similar results. In conclusion, ICEP effectively reduced cognitive impairment, anxiety, and depression in AIS patients.

摘要

本研究旨在评估新设计的强化照护者教育计划(ICEP)对降低急性缺血性脑卒中(AIS)患者认知障碍、焦虑和抑郁的效果。196 例 AIS 患者采用区组随机化方法按 1:1 比例分为 ICEP 组和对照组。在 ICEP 组中,照护者接受 ICEP,而在对照组中,照护者接受常规教育和指导。所有患者均接受常规康复治疗。认知障碍(采用简易精神状态检查(MMSE)评分和蒙特利尔认知评估(MoCA)评分评估)、焦虑(采用医院焦虑和抑郁量表(HADS)-A 评分和自评焦虑量表(SAS)评分评估)和抑郁(采用 HADS-D 评分和自评抑郁量表(SDS)评分评估)在基线(M0)、3 个月(M3)、6 个月(M6)和 12 个月(M12)时进行评估。与对照组相比,ICEP 组 M12 时认知障碍评分增加,而 M12 时认知障碍发生率降低;与对照组相比,ICEP 组 M12 时焦虑评分变化(M12-M0)、M12 时焦虑评分和 M12 时焦虑发生率降低;与对照组相比,ICEP 组 M12 时抑郁评分变化(M12-M0)、M12 时抑郁评分和 M12 时抑郁发生率降低。进一步基于基线特征的亚组分析也提供了类似的结果。总之,ICEP 可有效降低 AIS 患者的认知障碍、焦虑和抑郁。

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