健康生态学指导下认知行为干预对老年高血压合并冠心病患者心理状态和健康行为的影响

Effects of cognitive behavior intervention under the guidance of health ecology on mental state and health behavior of elderly patients with hypertension and coronary heart disease

中文关键词: 老年, 冠心病, 高血压, 健康生态学, 认知行为干预

英文关键词: elderly  coronary heart disease  hypertension  health ecology  cognitive behavioral intervention

中文摘要:

      目的 观察健康生态学指导下认知行为干预对老年高血压合并冠心病患者心理状态和健康行为的影响.方法 研究对象为2020年8月-2023年8月于空军军医大学第一附属医院就诊的212例老年高血压合并冠心病患者,按随机数字表法分观察组与对照组,每组106例.对照组接受常规护理,观察组在对照组基础上接受健康生态学指导下认知行为干预.比较2组干预前后血压水平、对疾病认知程度、心理状态、健康行为、出院6个月内心血管意外事件发生率.结果 干预后,观察组收缩压水平、舒张压水平均低于对照组(均P＜0.05);观察组疾病发病机制、饮食认知、遵医用药知识、运动锻炼知识、日常生活知识评分均高于对照组(P＜0.05);观察组焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分均低于对照组(均P＜0.05);观察组健康行为评分均高于对照组(P＜0.05);观察组心血管意外事件发生率低于对照组(P＜0.05).结论 健康生态学指导下的认知行为干预可显著改善老年高血压合并冠心病患者的血压水平,并改善其疾病认知水平,明显缓解焦虑和抑郁情绪,提高健康行为水平,进而降低心血管意外事件的发生率,具有一定的临床应用价值.

英文摘要:

      Objective To observe the effects of cognitive behavior intervention under the guidance of health ecology on mental state and health behavior of elderly patients with hypertension and coronary heart disease.Methods The subjects were 212 elderly patients with hypertension and coronary heart disease who were treated in First Affiliated Hospital of Air Force Mili-tary Medical University from August 2020 to August 2023.They were divided into observation group and control group accord-ing to random number table method,with 106 cases in each group.The control group received routine nursing,and the obser-vation group received cognitive behavior intervention under the guidance of health ecology on the basis of the control group.The blood pressure,disease cognition,mental state and health behavior before and after intervention and the incidence of cardi-ovascular accidents within 6 months after discharge were compared between the two groups.Results After intervention,the systolic blood pressure and diastolic blood pressure in the observation group were lower than those in the control group(all P＜0.05).The scores of disease pathogenesis,diet cognition,medical knowledge,exercise knowledge and daily life knowledge in the observation group were higher than those in the control group(P＜0.05).The scores of Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)in the observation group were lower than those in the control group(all P＜0.05).The health behavior scores of the observation group were higher than those of the control group(P＜0.05).The incidence of cardiovascular accidents in the observation group was lower than that in the control group(P＜0.05).Conclusion The cogni-tive behavior intervention under the guidance of health ecology can significantly improve the blood pressure level of elderly pa-tients with hypertension and coronary heart disease,improve their disease cognition level,significantly relieve anxiety and de-pression,improve health behavior level,and thereby reduce the incidence of cardiovascular accidents.It has certain clinical ap-plication value.