Department of Neurology, Affiliated Second Clinical Hospital, Harbin Medical University, Harbin, China.
Department of Auxiliary, Affiliated Second Clinical Hospital, Harbin Medical University, Harbin, China.
Braz J Med Biol Res. 2024 Sep 6;57:e13689. doi: 10.1590/1414-431X2024e13689. eCollection 2024.
Cognitive behavioral stress management (CBSM) relieves physical and psychological burdens in patients with some central nervous system diseases, while its utility in acute ischemic stroke (AIS) patients is unclear. This study aimed to explore the effect of CBSM on neurologic recovery and psychosomatic health in AIS patients. Totally, 176 naive AIS patients were randomized into routine care (RC) group (n=88) and CBSM group (n=88) to receive a 3-month corresponding intervention. Modified Rankin scale (mRS) scores at the first month after discharge (M1) (P=0.008) and the third month after discharge (M3) (P=0.016) were lower in the CBSM group than in the RC group. The proportion of AIS patients with mRS score >2 at M3 was reduced in CBSM group vs RC group (P=0.045). Hospital anxiety depression scale (HADS)-anxiety score at M3 (P=0.016), HADS-depression score at M3 (P=0.005), and depression rate at M3 (P=0.021) were decreased in the CBSM group vs the RC group. EuroQol-5 dimension scores at M1 (P=0.024) and M3 (P=0.012) were decreased, while EuroQol-visual analogue scale score at M3 (P=0.026) was increased in the CBSM group vs the RC group. By subgroup analyses, CBSM had favorable outcomes in AIS patients with age ≤65 years. CBSM was beneficial to neurologic recovery and distress relief in AIS patients with an education level of middle school or above, and to health status in those with an education level of primary school or uneducated. In conclusion, CBSM benefitted neurologic recovery and psychosomatic health in AIS patients with minor neurological deficits, however, further studies should verify these results with a larger sample size and longer follow-up.
认知行为应激管理（CBSM）可减轻某些中枢神经系统疾病患者的身心负担，但在急性缺血性脑卒中（AIS）患者中的作用尚不清楚。本研究旨在探讨 CBSM 对 AIS 患者神经功能恢复和身心健康的影响。将 176 例初发 AIS 患者随机分为常规护理（RC）组（n=88）和 CBSM 组（n=88），接受为期 3 个月的相应干预。出院后第 1 个月（M1）（P=0.008）和第 3 个月（M3）（P=0.016）的改良 Rankin 量表（mRS）评分均低于 RC 组。CBSM 组 M3 时 mRS 评分>2 的 AIS 患者比例较 RC 组减少（P=0.045）。CBSM 组 M3 时医院焦虑抑郁量表（HADS）-焦虑评分（P=0.016）、HADS-抑郁评分（P=0.005）和抑郁发生率（P=0.021）均低于 RC 组。CBSM 组 M1（P=0.024）和 M3（P=0.012）时欧洲五维健康量表（EQ-5D）评分降低，而 M3 时 EQ-视觉模拟量表（EQ-VAS）评分升高（P=0.026）。亚组分析显示，CBSM 对年龄≤65 岁的 AIS 患者有良好的效果。CBSM 对中学及以上文化程度的 AIS 患者的神经功能恢复和减轻痛苦有益，对小学及未受教育的患者的健康状况有益。总之，CBSM 有益于轻度神经功能缺损的 AIS 患者的神经功能恢复和身心健康，但需要更大样本量和更长随访时间的进一步研究来验证这些结果。
