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目的研究心理干预对慢性心力衰竭(CHF)合并心房颤动(房颤)患者生活质量的影响。方法 320例慢性心力衰竭合并房颤患者,按照入院先后顺序分为住院对照组和住院心理干预组,每组160例。住院对照组给予正常的内科护理,住院心理干预组给予心理疏导。住院心理干预组患者出院后继续随机分为社区对照组、社区心理干预组,各80例。社区对照组给予每周电话随访及每月家庭随访,社区心理干预组在此基础上对患者的生理、心理、运动、用药、饮食起居等方面实施综合健康护理心理干预,干预时间为1年。使用明尼苏达心力衰竭量表对两组患者在实验后的生活质量进行观察和比较,使用抑郁自评量表(SDS)和焦虑自评量表(SAS)评价患者在实验后的负面情绪并比较。结果住院心理干预组的生活质量评分高于住院对照组,社区心理干预组的生活质量评分也高于社区对照组(P<0.05);住院心理干预组的SAS、SDS评分低于住院对照组(P<0.05);社区心理干预组的SAS、SDS评分低于社区对照组(P<0.05)。结论心理干预可以很好的对慢性心力衰竭合并房颤患者的焦虑情绪进行疏导,进而改善患者的生活质量,值得临床推广。
Objective To investigate the effect of psychological intervention on quality of life in patients with chronic heart failure (CHF) complicated with atrial fibrillation (AF). Methods A total of 320 patients with chronic heart failure complicated with atrial fibrillation were divided into in-hospital control group and in-hospital psychological intervention group according to the order of hospital admission, with 160 cases in each group. Inpatient control group was given normal medical care, psychological intervention in hospital psychological intervention group. Patients in hospital psychological intervention group were randomly divided into community control group and community psychological intervention group, 80 cases in each group. The community control group was given weekly telephone follow-up and monthly family follow-up. Based on this, the community psychological intervention group conducted a comprehensive health care psychological intervention on patients’ physical, psychological, exercise, medication, and dietary habits. The intervention time was 1 year. The Minnesota Heart Failure Scale was used to observe and compare the quality of life of the two groups after the experiment. The self-rating depression scale (SDS) and anxiety self-rating scale (SAS) were used to evaluate the negative emotions of the patients after the experiment. Results The quality of life scores of hospitalized psychological intervention group were higher than those of hospitalized control group, and the quality of life scores of community psychological intervention group were also higher than those of community control group (P <0.05). SAS and SDS scores of hospitalized psychological intervention group were lower than those of hospitalized control group P <0.05). SAS and SDS scores of community psychological intervention group were lower than those of community control group (P <0.05). Conclusion Psychological intervention can be very good for patients with chronic heart failure and atrial fibrillation anxiety to ease, thereby improving the quality of life of patients, it is worth clinical promotion.