全病程管理模式对抑郁障碍治疗效果的影响研究-东南大学学报医学版

全病程管理模式对抑郁障碍治疗效果的影响研究

单位：1. 石河子大学医学院第一附属医院康复心理科, 新疆石河子 832008;
2. 石河子绿洲医院, 新疆石河子 832008

分类号：R749.4

出版年·卷·期（页码）：2020·39·第五期（614-619）

摘要：

目的:观察全病程管理模式对抑郁障碍患者治疗效果的影响,从而为患者寻找更有效的管理模式。方法:收集2018年11月至2019年6月在石河子大学医学院第一附属医院康复心理科住院的抑郁障碍患者70例,按随机数字表法分为全病程管理组和对照组,每组35例。全病程管理组患者给予常规治疗的同时实施全病程管理治疗,对照组给予常规治疗。患者在入院后第2天、4周、8周、16周行24项汉密尔顿抑郁量表(HAMD)评分,在4、8、16周行简易应对方式量表及HAMD减分率的评估。结果:两组患者HAMD评分时点效应存在显著差异(F=194.659,P<0.05),分组具有显著差异(F=28.530,P<0.05),时点与分组存在显著相互效应(F=45.710,P<0.05);两组患者在治疗4、8周积极应对与消极应对的比例差异无统计学意义(P>0.05),治疗16周时比例差异具有统计学意义(P<0.05),全病程管理组在4、8、16周减分率均为有效。结论:全病程管理模式在常规治疗基础上可以减轻抑郁障碍患者的抑郁症状,改善患者应对方式,巩固治疗效果。

Objective: To observe the effect of the full process disease management mode on the treatment effect of patients with depression and find a more effective management mode for them. Methods: A collection of 70 patients with depression who were hospitalized in the Department of Rehabilitation Psychology of the First Hospital of the Medical College of Shihezi University from November 2018 to June 2019 were divided into the full process disease management group and the control group according to the random number table method. Each group contained 35 cases. Patients in the full process disease management group were given conventional treatment while implementing full process disease management treatment. The control group was given routine treatment. The 24-item Hamilton Depression Scale (HAMD) score was evaluated at 2 days, 4 weeks, 8 weeks, and 16 weeks after admission. The simple Coping Style Scale (SCSQ) score and HAMD score reduction rate were evaluated at 4 weeks, 8 weeks, and 16 weeks. Results: There was a significant difference in the time-point effect of HAMD score between the two groups (F=194.659, P<0.05). The grouping had significant difference (F=28.530, P<0.05). There was a significant interaction between time-point and grouping (F=45.710, P<0.05).There were no statistical significances in the differences of proportion of positive coping style and negative coping style between the two groups at 4 weeks, 8 weeks(P>0.05), but the differences of proportion at 16 weeks was statistically significant (P<0.05). The score reduction rates in the full process disease management group were effective at 4 weeks, 8 weeks and 16 weeks. Conclusion: The full process disease management mode on the basis of conventional treatment can alleviate the depressive symptoms of patients with depression, improve the coping style of patients and consolidate the therapeutic effect.

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