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老年自杀幸存者的住院护理:以护士为主导的正念认知疗法

Inpatient Care for Elderly Suicide Survivors: Nurse-Led Mindfulness-Based Cognitive Therapy.

作者信息

Li Dandan, Fan Mingsi, Bian Hailei, Ni Li

机构信息

Operation Room, Dongfang Hospital Affiliated to Tongji University, Shanghai, China.

Cardiac Care Unit, Dongfang Hospital Affiliated to Tongji University, Shanghai, China.

出版信息

Alpha Psychiatry. 2024 Aug 1;25(4):449-455. doi: 10.5152/alphapsychiatry.2024.241519. eCollection 2024 Aug.

Abstract

OBJECTIVE

The aim was to analyze the effects of nurse-led mindfulness-based cognitive therapy (MBCT) in hospitalized elderly suicide survivors.

METHODS

The data of middle-aged and elderly suicide survivors in the medical system and nursing records of our hospital from January 2018 to August 2023 were retrospectively collected. The patients were divided into conventional group and MBCT group according to whether they actively received MBCT. The general demographic data of the patients and the changes in the scores of Suicidal Ideation Scale (SSI), Beck Hopelessness Scale (BHS), Patient Health Questionnaire 15 (PHQ-15), and Geriatric Depression Scale (GDS-15) at admission and 3 and 6 months of follow-up were collected. Propensity score matching was used to balance the baseline data of the 2 groups. Multiple logistic regression analysis was used to determine the effect of the inpatient care program on each score.

RESULTS

A total of 160 patients were included in the study, including 100 patients in the MBCT group and 60 patients in the conventional group. There was no significant difference in baseline data between the 2 groups after matching ( > .05). Suicidal Ideation Scale score, BHS score, PHQ-15 score, and GDS-15 score in MBCT group were lower than those in conventional group at 6 months of follow-up ( < .05). At the same time, multiple logistic regression analysis showed that the intervention program was the main factor affecting the SSI (OR = 1.538,  = .010), BHS (OR = 1.614,  = .006), PHQ-15 (OR = 1.797,  = .001), and GDS-15 scores (OR = 1.642,  = .004) at 6 months of follow-up.

CONCLUSIONS

The application of nurse-led MBCT in hospitalized elderly suicide survivors may reduce suicidal ideation, hopelessness, and depression and improve physical symptoms.

摘要

目的

分析护士主导的基于正念的认知疗法(MBCT)对住院老年自杀幸存者的影响。

方法

回顾性收集2018年1月至2023年8月我院医疗系统中老年自杀幸存者的数据及护理记录。根据患者是否主动接受MBCT将其分为常规组和MBCT组。收集患者的一般人口统计学数据以及入院时、随访3个月和6个月时自杀意念量表(SSI)、贝克绝望量表(BHS)、患者健康问卷15(PHQ - 15)和老年抑郁量表(GDS - 15)评分的变化。采用倾向得分匹配法平衡两组的基线数据。采用多因素logistic回归分析确定住院护理方案对各评分的影响。

结果

共纳入160例患者,其中MBCT组100例,常规组60例。匹配后两组基线数据无显著差异(>0.05)。随访6个月时,MBCT组的自杀意念量表评分、BHS评分、PHQ - 15评分和GDS - 15评分均低于常规组(<0.05)。同时,多因素logistic回归分析显示,干预方案是影响随访6个月时SSI(OR = 1.538,P = 0.010)、BHS(OR = 1.614,P = 0.006)、PHQ - 15(OR = 1.797,P = 0.001)和GDS - 15评分(OR = 1.642,P = 0.004)的主要因素。

结论

护士主导的MBCT应用于住院老年自杀幸存者可能会降低自杀意念、绝望感和抑郁情绪,并改善躯体症状。

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