摘要
目的:探讨认知行为治疗(渐进性放松训练联合刺激控制疗法)对改善维持性血液透析(maintained hemodialysis,MHD)患者失眠的效果。方法:采用随机对照研究,将合并失眠的MHD患者103例随机分为干预组(52例)和对照组(51例)。对照组接受常规的血液透析(hemodialysis,HD)治疗;干预组在此基础上,接受为期3个月的认知行为治疗。干预前和干预2、4、6、8、10、12周(干预结束)后分别用症状自评量表(Symptom Checklist90,SCL-90)和匹兹堡睡眠质量指数问卷(Pittsburgh sleep quality index,PSQI)对两组患者进行评定。结果:共98例患者(干预组51例,对照组47例)完成试验。干预后,干预组的SCL-90总分及躯体化、抑郁、焦虑、敌对、附加因子分,和PSQI量表总分及睡眠质量、入睡潜伏期、睡眠时间、睡眠效率、睡眠障碍、催眠药物、日间功能障碍因子分均低于对照组[如,SCL-90总分(1.94±0.50)vs.(2.29±0.31);PSQI量表总分(12.63±2.27)vs.(16.40±2.16);均P<0.01]。结论:渐进性肌肉放松训练联合刺激控制疗法能有效改善MHD患者的心理健康状况,提高他们的睡眠质量。
Objecgive： To explore the effects of sleep-related behavior modification and progressive muscle relaxation on insomnia of maintained hemodialysis （MHD） patients. Method： A total of 103 MHD patients with insornnia were randomly assigned to the intervention group （52 patients ） or the control group （ 51 patients ） . The control group received the conventional therapy. The intervention group received the conventional therapy combined with psychological intervention, including sleep-related behavior modification and progressive muscle relaxation. All cases were assessed with the Symptom Checklist 90 （ SCL-90 ） and Pittsburgh Sleep Quality Index （ PSQI ） before and after intervention. Results： Fifty-one patients in intervention group and 47 patients in control group completed the study. In intervention group, some factor scores were significantly lower than those in control group, including somatization, depression, anxiety, hostility, additional items, subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbance, used sleep medication, and daytime dysfunction [ SCL-90 total score： （1.94±0.50）vs. （2.29±0.31）, P〈0.01; PSQI total score： （12.63±2.27） vs. （16.40±2.16）, P 〈 0.01 ] . Conclusion： Sleep-related behavior modification and progressive muscle relaxation can effectively improve the mental state and sleep quality of MHD patients with insomnia.
出处
《中国心理卫生杂志》
CSSCI
CSCD
北大核心
2009年第8期538-542,553,共6页
Chinese Mental Health Journal
基金
2006年度湛江市第七批科技攻关项目(2006C07002)
关键词
维持性血液透析
认知行为治疗
渐进性肌肉放松训练
刺激控制疗法
失眠
睡眠质量
随机对照研究
maintained hemodialysis
cognitive behavior therapy
progressive muscle relaxation
stimulus control therapy
insomnia
quality of sleep
randomly controlled study
