家庭医生强化心理疏导对社区“1+1+1”签约原发性高血压患者焦虑抑郁情绪的影响

杨涛; 邱忠民; 黄雷; 周蓉; 郁敏杰; 滕斌; 许丹丹; 邵丹丹; 王朝昕

doi:10.16766/j.cnki.issn.1674-4152.002730

家庭医生强化心理疏导对社区“1+1+1”签约原发性高血压患者焦虑抑郁情绪的影响

doi: 10.16766/j.cnki.issn.1674-4152.002730

杨涛^{1, 2},
邱忠民^{1, 3, ,},
黄雷²,
周蓉²,
郁敏杰²,
滕斌²,
许丹丹²,
邵丹丹⁴,
王朝昕⁵

1.
同济大学医学院，上海 200438
2.
上海市黄浦区五里桥街道社区卫生服务中心全科，上海 200023
3.
同济大学附属同济医院呼吸科，上海 200065
4.
上海市黄浦区老西门街道社区卫生服务中心行政科，上海 200011
5.
上海交通大学医学院公共卫生学院，上海 200025

基金项目:

上海市“医苑新星”青年医学人才培养资助计划沪卫计人事[2019]72号

上海市黄浦区科研项目课题 HKW201932

详细信息

通讯作者:
邱忠民, E-mail: qiuzhongmin@tongji.edu.cn

中图分类号: R544.1 R395.6
计量
- 文章访问数: 200
- HTML全文浏览量: 55
- PDF下载量: 6
- 被引次数: 0
出版历程
- 收稿日期: 2021-06-03
- 网络出版日期: 2022-12-30

The influence of family doctors' intensive psychological counseling on the anxiety and depression of patients with essential hypertension contracted by "1+1+1" in the community

1.
Tongji University School of Medicine, Shanghai 200438, China

摘要

摘要: 目的通过对社区“1+1+1”签约原发性高血压患者进行家庭医生强化心理疏导干预，探讨该干预方式对患者焦虑抑郁情绪的影响。方法选取2018年2月—2020年2月接受“1+1+1”社区签约服务的116例原发性高血压伴焦虑抑郁患者，按照随机数字表法分为对照组(58例)和观察组(58例)，对照组采取家庭医生常规干预，观察组采取家庭医生强化心理疏导干预。采用症状自评量表(SCL-90)、社会支持评定量表(SSRS)、汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)比较干预前及干预第6、12个月2组患者的心理健康水平以及焦虑抑郁情况，并观察2组患者收缩压(SBP)和舒张压(DBP)的变化情况。结果干预后，随着时间的延长，2组SCL-90评分、HAMD评分及HAMA评分均降低，且观察组始终低于对照组(均P＜0.05)，2组SSRS评分均升高，且观察组始终高于对照组(均P＜0.05)。随着干预时间的延长，2组患者SBP、DBP均下降，且观察组较对照组下降更明显(均P＜0.05)。结论家庭医生对社区“1+1+1”签约原发性高血压患者进行强化心理疏导有助于控制其血压水平，改善患者焦虑抑郁情绪，提高生活质量，具有较高的临床应用价值。
- 原发性高血压 /
- 家庭医生 /
- 心理疏导 /
- 焦虑 /
- 抑郁
Abstract: Objective To explore the effect of family doctors' intensive psychological intervention on anxiety and depression of patients with essential hypertension contracted by "1+1+1" in the community. Methods A total of 116 patients with essential hypertension with anxiety and depression who received the "1+1+1" community contract service from February 2018 to February 2020 were divided into control group (58 cases) and observation group (58 cases) according to the random number table method. The control group was given routine intervention by family doctors, while the observation group was given intensive psychological counseling intervention by family doctors. The symptom checklist 90 (SCL-90), Hamilton anxiety scale (HAMA), Hamilton depression scale (HAMD), and social support revalued scale (SSRS) were used to compare the anxiety and depression of the two groups of patients before the intervention and the 6th and 12th months after the intervention, and the changes in systolic blood pressure (SBP) and diastolic blood pressure (DBP) of the two groups were observed. Results With the extension of time after the intervention, the scores of the SCL-90, HAMD and HAMA of the two groups decreased, and the observation group was always lower than the control group (all P < 0.05), the scores of the two groups of SSRS increased, and the observation group was always higher than the control group (all P < 0.05). With the extension of the intervention time, SBP and DBP of the two groups decreased, and the decrease in the observation group was more obvious than that in the control group (all P < 0.05). Conclusion Family doctors' intensive psychological counseling for patients with essential hypertension contracted by the community "1+1+1" can help control their blood pressure level, and improve their anxiety and depression, improve the quality of life, which has a high clinical value.
- Essential hypertension /
- Family doctor /
- Psychological counseling /
- Anxiety /
- Depression

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表 1 2组原发性高血压患者干预前后SCL-90评分、SSRS评分比较(x±s，分)

Table 1. Comparison of SCL-90 score and SSRS score before and after intervention between the two groups of patients with essential hypertension (x±s, points)

组别	例数	SCL-90评分			SSRS评分
组别	例数	干预前	干预6个月	干预12个月	干预前	干预6个月	干预12个月
观察组	58	3.95±0.76	3.27±0.52^a	2.69±0.38^ab	37.05±5.63	44.67±7.53^a	52.76±8.09^ab
对照组	58	4.01±0.82	3.60±0.59^a	3.02±0.41^ab	36.22±5.84	41.28±6.62^a	48.63±7.74^ab
t值		0.409	3.196	4.496	0.779	2.575	2.809
P值		0.684	0.002	＜0.001	0.437	0.011	0.006
注：与同组干预前比较，^aP＜0.05；与同组干预6个月比较，^bP＜0.05。

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表 2 2组原发性高血压患者干预前后HAMD评分、HAMA评分比较(x±s，分)

Table 2. Comparison of HAMD score and HAMA score between the two groups of patients with essential hypertension before and after intervention (x±s, points)

组别	例数	HAMD评分			HAMA评分
组别	例数	干预前	干预6个月	干预12个月	干预前	干预6个月	干预12个月
观察组	58	24.85±5.74	16.38±3.97^a	8.69±2.52^ab	18.23±3.81	13.65±2.43^a	8.57±1.98^ab
对照组	58	23.16±5.32	19.56±3.58^a	10.34±3.01^ab	17.46±3.29	15.98±2.94^a	10.03±2.62^ab
t值		1.645	4.530	3.201	1.165	4.652	3.502
P值		0.103	＜0.001	0.002	0.246	＜0.001	0.001
注：与同组干预前比较，^aP＜0.05；与同组干预6个月比较，^bP＜0.05。

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表 3 2组原发性高血压患者干预前后SBP、DBP比较(x±s，mm Hg)

Table 3. Comparison of SBP and DBP before and after intervention between the two groups of patients with essential hypertension (x±s, mm Hg)

组别	例数	SBP			DBP
组别	例数	干预前	干预6个月	干预12个月	干预前	干预6个月	干预12个月
观察组	58	167.09±17.35	143.15±15.87^a	129.70±14.81^ab	108.11±11.92	96.14±10.89^a	83.22±8.63^ab
对照组	58	166.15±17.29	157.34±16.49^a	141.03±15.67^ab	107.34±11.69	101.57±10.69^a	95.13±9.74^ab
t值		0.292	4.722	4.002	0.351	2.710	6.385
P值		0.771	＜0.001	＜0.001	0.726	0.008	＜0.001
注：与同组干预前比较，^aP＜0.05；与同组干预6个月比较，^bP＜0.05。

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