摘要
目的探讨认知行为治疗(CBT)对社区老年新发糖尿病合并轻中度抑郁患者糖、脂代谢水平、抑郁情绪及生存质量的影响。方法选取2020年6月~2021年6月在上海市江湾镇街道社区卫生服务中心门诊新发(≦1年)的60岁及以上糖尿病合并轻中度抑郁患者65例,按照随机数表法分为观察组(33例)和对照组(32例)。对照组仅予糖尿病健康教育、药物治疗;观察组给与CBT、糖尿病健康教育、药物治疗,干预时间为12周,每周1次。入组前及干预后12周,统计分析比较两组患者空腹血糖(FPG)、糖化血红蛋白(HbA1c)、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)变化情况;采用抑郁症筛查量表(PHQ-9)、糖尿病患者生存质量特异性量表(DSQL)评定两组患者抑郁情绪、生存质量的变化情况。结果认知行为干预后12周,观察组和对照组组间FPG、HbA1c、TG、LDL-C水平比较,差异有统计学意义(P<0.05);观察组和对照组患者组间PHQ-9评分比较,差异有统计学意义(P<0.05),且观察组患者明显低于干预前评分,差异有统计学意义(P<0.05)。观察组和对照组组间DSQL总分比较差异有统计学意义(P<0.05),其中生理、心理、社会关系维度得分显著下降,差异有统计学意义(P<0.05)。结论社区老年新发糖尿病合并轻中度抑郁患者在糖尿病教育的基础上联合认知行为干预,可较好改善患者糖、脂代谢水平,缓解患者抑郁情绪,提高生存质量。
Objective To explore the effect of cognitive behavioral therapy(CBT)on glucose and lipid metabolism,depressive mood and quality of life in elderly newly diagnosed diabetes patients with mild to moderate depression in community.Methods From June 2020 to June 2021,65 newly diagnosed(≤1 year)diabetes patients aged 60 years and over with mild to moderate depression in the community health service center of Jiangwan Town,Shanghai were selected and divided into the intervention group(33 cases)and the control group(32 cases)according to the random number table.The control group was only given diabetes health education and drug treatment,while the intervention group was given CBT,diabetes health education and drug treatment for 12 weeks,once a week.Before enrollment and 12 weeks after intervention,the changes of fasting blood glucose(FPG),glycosylated hemoglobin(HbA1c),total cholesterol(TC),triglyceride(TG),high-density lipoprotein(HDL-C)and low-density lipoprotein(LDL-C)in the two groups were statistically analyzed and compared.The depression screening scale(PHQ-9)and diabetes patients'quality of life specific scale(DSQL)were used to assess the changes of depressive mood and quality of life in the two groups.Results The levels of FPG,HbA1c,TG and LDL-C in the intervention group and the control group were significantly lower than those in the control group 12 weeks after the cognitive behavioral intervention(P<0.05).There was a statistically significant difference in PHQ-9 scores between the intervention group and the control group(P<0.05).The PHQ-9 scores in the intervention group were significantly lower than those before the intervention(P<0.05).There was a statistically significant difference between the intervention group and the control group in the total score of DSQL(P<0.05),among which the score of physiological,psychological and social relationship dimensions decreased significantly,with a statistically significant difference(P<0.05).Conclusion The elderly newly diagnosed diabetes patients with mild to modera
作者
李雅
薛志强
汪作为
Li Ya;Xue Zhiqiang;Wang Zuowei(Jiangwan Town Street Community Health Service Center,Shanghai 200434,China)
出处
《中华保健医学杂志》
2023年第2期147-150,共4页
Chinese Journal of Health Care and Medicine
基金
虹口区卫生健康委员会医学科研课题资助项目(虹卫2002-30)
上海市医学重点专科建设计划(ZK2019A06)。
关键词
认知行为治疗
社区
老年
新发糖尿病
抑郁
Cognitive behavior therapy
Community
Senior
Newly diagnosed diabetes
Depression
