基于跨理论模型的干预和动机性访谈对住院冠心病患者抑郁管理的效果：一项随机对照试验。
Effects of a transtheoretical model - based intervention and motivational interviewing on the management of depression in hospitalized patients with coronary heart disease: a randomized controlled trial.
机构信息
Xiangya Nursing School of Central South University, 172 Tong Zi Po Road, Changsha, 410000, Hunan, China.
Department of Nephrology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
出版信息
BMC Public Health. 2020 Mar 30;20(1):420. doi: 10.1186/s12889-020-08568-x.
BACKGROUND
Depression is a major risk factor for the morbidity and mortality of cardiovascular disease. A transtheoretical model-based intervention and motivational interviewing have been used to change health risk behaviors and have demonstrated positive effects. To our knowledge, no studies of patients with coronary heart disease (CHD) have used a transtheoretical model-based intervention and motivational interviewing as an intervention to provide dynamic education. Therefore, this study aimed to determine the effects of the transtheoretical model-based intervention and motivational interviewing on the management of depression in hospitalized patients with CHD.
METHOD
A randomized controlled trial was designed. A total of 110 participants were randomly divided into an intervention group (n = 55) and a control group (n = 55). The Hamilton Rating Scale for Depression and the Depression Prevention & Management Survey items (stages of change, perceived benefits, perceived barriers, process of change and self-efficacy) were used to collect data at all time points. Analysis of covariance, chi-square test and repeated measures analysis of variance were used to analyze the data.
RESULTS
After the intervention, there were more positive changes in stages of change, higher scores for the cognitive and behavioral levels, the perceived benefits, and self-efficacy, and lower perceived barriers and depression in the intervention group than in the control group. Finally, there were statistically significant differences in the depression scores at different time points in the intervention group (F = 17.814, p = 0.000 < 0.01).
CONCLUSIONS
The study showed that a transtheoretical model-based intervention and motivational interviewing exert positive effects on the management of depression in hospitalized patients with CHD.
TRIAL REGISTRATION
Clinicaltrials.gov, NCT03953924 (Date assigned: 16/5/2019). Retrospectively registered.
背景
抑郁是心血管疾病发病率和死亡率的一个主要危险因素。基于跨理论模型的干预和动机性访谈已被用于改变健康风险行为，并已显示出积极的效果。据我们所知，尚无研究使用基于跨理论模型的干预和动机性访谈作为干预措施为冠心病（CHD）患者提供动态教育。因此，本研究旨在确定基于跨理论模型的干预和动机性访谈对住院冠心病患者抑郁管理的影响。
方法
设计了一项随机对照试验。共纳入 110 名参与者，随机分为干预组（n = 55）和对照组（n = 55）。采用汉密尔顿抑郁量表和抑郁预防和管理调查项目（改变阶段、感知益处、感知障碍、改变过程和自我效能）在所有时间点收集数据。采用协方差分析、卡方检验和重复测量方差分析对数据进行分析。
结果
干预后，干预组在改变阶段、认知和行为水平、感知益处和自我效能方面有更多的积极变化，感知障碍和抑郁程度更低，而对照组则没有。最后，干预组在不同时间点的抑郁评分存在统计学差异（F = 17.814，p = 0.000 < 0.01）。
结论
本研究表明，基于跨理论模型的干预和动机性访谈对住院冠心病患者的抑郁管理有积极的影响。
试验注册
Clinicaltrials.gov，NCT03953924（分配日期：2019 年 5 月 16 日）。回顾性注册。
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