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教育干预对心肌梗死后患者抑郁和焦虑的影响:一项随机对照试验

Educational Intervention Effects on Depression and Anxiety in Patients after Myocardial Infarction: A Randomized Controlled Trial.

作者信息

Zhamaliyeva Lazzat M, Zhamankulova Damira G, Abenova Nurgul A, Koshmaganbetova Gulbakit K

机构信息

Department of Family Medicine, West Kazakhstan Marat Ospanov Medical University, Aktobe 030019, Kazakhstan.

Department of Internal Diseases, West Kazakhstan Marat Ospanov Medical University, Aktobe 030019, Kazakhstan.

出版信息

J Cardiovasc Dev Dis. 2023 Jun 22;10(7):267. doi: 10.3390/jcdd10070267.

Abstract

Depression and anxiety in cardiovascular disease worsen the prognosis of patients. Treatments for these disorders often provide limited improvement. The present study aimed to test, for the first time, the impact of educational technology on anxiety and depressive symptoms in patients participating in a cardiac rehabilitation program. A 12-month randomized controlled trial was conducted, in which 207 patients were randomly assigned to either the experimental (n = 76) or control (n = 69) groups. The intervention involved a structured patient education program provided by medical students who had undergone specially designed training in cardiac rehabilitation. The primary outcomes were death, hospitalization, heart failure, and recurrent myocardial infarction. The study also assessed anxiety and depression. A year later, the experimental group showed a statistically significant decrease in anxiety and depression on the HADS scale, with reductions of 2.0 and 1.9 points, respectively ( < 0.05). The control group showed reductions of 1.5 and 1.2 points ( < 0.05). The difference in the Hamilton Rating Scale for Depression between the groups at 12 months was -1.29 in favor of the main group (95% CI, -0.7 to -1.88), and the standardized mean difference was 0.36 (95% CI, 0.03 to 0.69). No treatment-related adverse events were observed. The results suggest that educational interventions can have a positive impact on mental health. The study's strengths include a structured intervention, randomization, and long-term follow-up. The limitations include the lack of blinding of study participants and a relatively small sample size.

摘要

心血管疾病中的抑郁和焦虑会使患者的预后恶化。针对这些病症的治疗通常只能带来有限的改善。本研究旨在首次测试教育技术对参与心脏康复计划患者的焦虑和抑郁症状的影响。进行了一项为期12个月的随机对照试验,207名患者被随机分配到实验组(n = 76)或对照组(n = 69)。干预措施包括由接受过心脏康复专门设计培训的医学生提供的结构化患者教育计划。主要结局指标为死亡、住院、心力衰竭和复发性心肌梗死。该研究还评估了焦虑和抑郁情况。一年后,实验组在医院焦虑抑郁量表(HADS)上的焦虑和抑郁得分有统计学显著下降,分别降低了2.0分和1.9分(P < 0.05)。对照组分别降低了1.5分和1.2分(P < 0.05)。两组在12个月时汉密尔顿抑郁量表评分的差异为-1.29,有利于主要组(95%可信区间,-0.7至-1.88),标准化平均差为0.36(95%可信区间,0.03至0.69)。未观察到与治疗相关的不良事件。结果表明教育干预可对心理健康产生积极影响。该研究的优势包括结构化干预、随机分组和长期随访。局限性包括研究参与者未设盲以及样本量相对较小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d118/10380402/2106073384d5/jcdd-10-00267-g001.jpg

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