ObjectiveTo investigate the role of mindfulness-based stress reduction in improving anxiety and depression in elderly patients with chronic heart failure.MethodsFrom August 2016 to August 2018, a total of 196 elderly patients with chronic heart failure were randomly divided into the treatment group and the control group, with 98 cases in each group. The control group received routine care. The treatment group received routine care plus mindfulness-based stress reduction in two 60-minute sessions a week for 8 weeks. The level of serum N-terminal pro-brain natriuretic peptide (NT-proBNP) was detected by electrochemiluminescence immunoassay, and left ventricular ejection fraction (LVEF) was measured by echocardiography before intervention and at week 8 of intervention; the effective rate was calculated. Self-rating Anxiety Scale (SAS), Self-rating Depression Scale (SDS), and General Well-Being scale (GWB) were used to assess the degree of anxiety, depression, and well-being of patients before intervention and at week 8 of intervention.ResultsThe serum NT-proBNP levels at week 8 of intervention in the two groups were lower than those before intervention, and the LVEFs were higher than those before intervention (P<0.05). The treatment group showed significant changes when compared with the control group (P<0.05). The effective rate of the treatment group was higher than that of the control group (89.80% vs. 69.39%, P<0.05). Before intervention, the SAS scores in the treatment group and the control group were 56.61±8.25 and 55.98±6.32, respectively, the SDS scores were 59.98±7.21 and 58.86±6.17, respectively, and the GWB scores were 53.19±12.38 and 54.06±10.93, respectively; at week 8 of intervention, the SAS scores in the treatment group and the control group were 40.56±8.17 and 46.25±5.43, respectively, the SDS scores were 42.85±5.77 and 48.34±8.01, respectively, and the GWB scores were 76.17±9.63 and 68.58±13.30, respectively. At week 8 of intervention, the SAS and SDS scores of the two groups were both lower than those before intervention, and the GWB scores were higher than those before intervention (P<0.05). The treatment group showed significant changes when compared with the control group (P<0.05).ConclusionMindfulness-based stress reduction can improve the anxiety and depression of elderly patients with chronic heart failure, improve their well-being and promote the recovery of heart function.
ObjectiveTo investigate the status of quality of life and influencing factors among newly diagnosed epilepsy patients with co-morbid anxiety and depression. MethodsA total of 180 newly diagnosed epilepsy patients from June 2022 to December 2022 in a district of Shanghai were selected as the study subjects. The Quality of Life in Epilepsy-31 (QOLIE-31), Hamilton Depression Rating Scale (HAMD-24), Hamilton Anxiety Rating Scale (HAMA), and Epilepsy Self-Management Scale (ESMS) were used to assess patients' quality of life, depression levels, anxiety levels, and self-management abilities, respectively. Patients were divided into the co-morbid depression group (HAMA≥14 and HAMD>17) and the control group (HAMA<14 and HAMD≤17), and their general characteristics and scale scores were compared. Spearman correlation, Pearson correlation, and multiple linear regression analysis were used to identify influencing factors of quality of life in epilepsy patients with co-morbid depression. ResultsCompared to the control group, the anxiety comorbid with depression group of older adults had a higher proportion, higher unemployment rate, lower personal and family annual income in the past year, higher frequency of epileptic seizures, and lower medication adherence (P<0.05). The correlational analysis revealed a negative correlation between the quality of life abilities of epilepsy patients with comorbid anxiety and depression and the severity of anxiety and depression. (r=?0.589, ?0.620, P<0.05). The results of multiple linear regression analysis showed that the frequency of seizures in the past year (β=?1.379, P<0.05), severity of anxiety (β=?0.279, P<0.05), and severity of depression (β=?0.361, P<0.05) have an impact on the ability to quality of life in epilepsy patients with co-morbid anxiety and depression. These factors account for 44.1% of the total variability in quality of life (R2=0.4411, P<0.05). ConclusionThe frequency of seizures in the past year, as well as the severity of anxiety and depression, are important factors that influence the ability to quality of life in epilepsy patients with comorbid anxiety and depression. For these patients, it is crucial to take into account these factors and provide appropriate support and interventions.
ObjectiveTo investigate the fatigue of asthma patients, and to analyze its influencing factors, and provide a reference for clinical intervention.MethodsThe convenience sampling method was adopted to select asthma patients who were in clinic of the First Affiliated Hospital of Guangxi Medical University from November 2018 to March 2019. The patients’ lung function were measured. And questionnaires were conducted, including general data questionnaire, Chinese version of Checklist Individual Strength-Fatigue, Asthma Control Test, Chinese version of Self-rating Depression Scale. Relevant data were collected for multiple stepwise linear regression analysis.ResultsFinally, 120 patients were enrolled. The results of multiple stepwise linear regression analysis showed that age, education level, place of residence, time period of frequent asthma symptoms, degree of small airway obstruction, Asthma Control Test score and degree of depression were the influencing factors of fatigue in asthma patients (P≤0.05). Multivariate linear stepwise regression analysis showed that degree of small airway obstruction, degree of depression and time period of frequent asthma symptoms were the main influencing factors of fatigue in asthma patients, which could explain 51.8% of the variance of fatigue (ΔR2=0.518).ConclusionsThe incidence of fatigue in asthma patients is at a relatively high level. Medical staff should pay attention to the symptoms of fatigue in asthma patients. For asthma patients, it is recommended to strengthen standardized diagnosis and treatment, reduce the onset of symptoms at night and eliminate small airway obstruction. Psychological intervention methods are needed to improve patients’ depression, reduce fatigue symptoms, and improve quality of life.
Objective To assess the efficacy and safety of acupuncture versus western medicine in the treatment of depression neurosis. Methods Randomized controlled trials (RCTs) involving acupuncture versus western medicine in the treatment of depression neurosis were identified from CBM (1978 to 2009),VIP (1989 to 2009),WANFANG Database (1998 to 2009), CNKI (1979 to 2009), PubMed (1966 to 2009), EMbase (1980 to 2009), and The Cochrane Library (Issue 4,2008). We also hand searched relevant journals from Tianjin University of Traditional Chinese Medicine. Data were extracted and evaluated by two reviewers independently with a specially designed extraction form. The Cochrane Collaboration’s RevMan 5.0.2 software was used for data analyses. Results A total of 9 trials involving 903 patients were included. Meta-analyses showed that the total effective rate in the acupuncture group was similar when compared with Dailixin (RR= 1.01, 95%CI 0.82 to 1.23) on 20 d, fluoxetine (RR= 1.06, 95%CI 0.82 to 1.37) at week 8, but showing difference between acupuncture and fluoxetine (RR= 1.15, 95CI 1.07 to 1.22) at week 12. As for the HAMD score, no significant difference was noted between acupuncture and Dailixin (WMD= 0.45, 95%CI – 2.47 to 3.37) at 20 d, or amitriptyline at week 6, or fluoxetine on 30 d, and weeks 4, 8, 12; there was a difference between acupuncture and amitriptyline observed at week 1 (WMD= – 2.67, 95%CI – 4.38 to – 0.96) and week 2 (WMD= – 2.18, 95%CI – 3.28 to – 1.08). In terms of the SDS scores, significant difference was found between acupuncture and fluoxetine (WMD= – 4.26, 95%CI – 6.67 to – 1.85) at week 6, but no difference at week 4 and 12. Four trials reported adverse events. One trial found that no adverse events existed in acupuncture according with TESS score, contrasting with thirst, constipation, vision vague, shimmy, fast heart rate, and some change in liver function and cardiogram in amitriptyline group.Two trials reported very low score in acupuncture showing difference when compared with the drugs. And one trial described that four people had stomach and intestinal tract disorders. While no adverse reactions happened in the acupuncture group. Conclusion Acupuncture is not inferior to western medicine, and it is worth noting that acupuncture is associated with few adverse reactions. Further large-scale trials are required to define the role of acupuncture in the treatment of depression neurosis.
Objective To investigate the prevalence of depression in patients with chronic obstructive pulmonary disease ( COPD) and risk factors. Methods 215 patients with stable COPD were recruited in the study. The Patient Health Questionnaire-9 ( PHQ-9) standardized scale were performed for the depression survey. Meanwhile CAT, pulmonary function test and the history taking ( sex, age, height, weigh, smoking status, education level) were applied to evaluate all the COPD patients. The COPD patients were classified into A, B, C, and D groups according to 2011 GOLD new COPD classification system. Pearson chi-square test and multivariate logistic modeling were used to estimate the prevalence of depression and the risk factors. Results The prevalence of depression in COPD patients whose PHQ-9 scores ≥7 was 37.7% with 18.5% , 35.8% , 46.5% , and 62.5% respectively in A, B, C, and D groups. There was significant difference in prevalence between each groups ( Plt;0.05) . Compared with the COPD patients without depression, the COPD patients with depression had younger age, more female, higher education level, higher CAT scores and smaller means of body mass index ( BMI) . Logistic analysis revealed that depression in COPD was associated with age, sex, education level, BMI, FEV1% pred and CAT scores. The patients who with younger age, female sex, higher education level, lower FEV1% pred, lower BMI and higher CAT scores were had higher rsik to be complicated with depression. However no significant difference was observed between different FEV1 /FVC or smoking status. Conclusions This study confirms the high prevalence of depression in patients with stable COPD, and the prevalence in A, B, C, and D groups of COPD are different. Sex, age, education level, FEV1% pred, BMI, and CAT scores are the risk factors of depression in COPD.
ObjectiveTo investigate the situation of depression and anxiety in the patients with postoperative inflammatory small bowel obstruction (PISBO), and to provide the dependent indications for the treatment.
MethodsThe serf-rating depression scale (SDS scale) and self-rating anxiety scale (SAS scale) were used to test the depression and anxiety of 79 patients with PISBO, who treated in the Department of General Surgery of The Second Hospital of Lanzhou from Jan. 2008 to Oct. 2014. Comparison between the scores of SDS scale/SAS scale and corresponding Chinese norms was performed, and then exploring the influence factor of depression and anxiety of PISBO patients.
ResultsThe standard scores of depression and anxiety were 49.23±11.39 and 50.31±6.25 respectively, which were higher than those of corresponding Chinese norms (P < 0.05). The results of multivariate logistic regression analysis indicated that, the independent influential factors of depression and anxiety in patients with PISBO included course of disease, type of tumor, other postoperative complications, and postoperative insomnia (P < 0.05), patients whose course of disease longer than 15 days, who with malignant tumor, and who suffered from other postoperative complications and postoperative insomnia, had higher ratios of depression and anxiety.
ConclusionThe depression and anxiety is very evident in the patients with PISBO, we should pay attention to this phenomenon and give intervention for it.
Objective To explore the safety and clinical efficacy of right chest minithoracotomy for left atrial myxoma resection.
Methods We retrospectively analyzed clinical data of 32 patients with left atrial myxoma resection by right chest minithoracotomy (a small incision group, 9 males, 23 females at age of 59.1±9.5 years) in our hospital from July 2011 through March 2015. Meanwhile, we selected 17 patients with left atrial myxoma treated by conventional chest median sternotomy as a control group (7 males, 10 females at age of 60.0±9.0 years). Clinical results of the two groups were compared.
Results There was no statistical difference in preoperative clinical data of the patients between the two groups. All the patients were successfully operated. Patients in the small incision group had longer aortic clamping time than that in the control group. But there were shorter postoperative mechanical ventilation time (9.5±4.9 h), shorter ICU stay time (18.6 ± 6.2 h), less amount of thoracic cavity drainage 24 h after drainage (103.8±19.4 ml), lower bleeding reoperation rate (0.0), less blood transfusion after surgery (1.4±1.1U), shorter ambulation time (38.5±6.9 h), shorter hospital stay (8.1 ± 0.9 d), lower postoperative complication rate (0.0) than those of the control group (P<0.05).
Conclusion Right chest minithoracotomy left atrial myxoma resection is feasible, safe and effective, is worth promoting.
ObjectiveTo explore the mediating effect of depression between fatigue and quality of life in patients with bronchial asthma, and to provide a clinical basis for alleviating fatigue and improving the quality of life in asthma patients.MethodsBronchial asthma patiens were recruited with convenience sampling method to conducta questionnaire survey in outpatients department of respiratory of a tertiary hospital in Guangxi from November 2018 to March 2019. The general data questionnaire, the Chinese version of Checklist Individual Strength-Fatigue, the Self-rating Depression Scale, the Questionnaire for Asthma Quality of Life in Adult, and the Asthma Control Test were used. We collected data to analyze the mediating effects of depression between fatigue and quality of life in patients with bronchial asthma.ResultsFinally, 120 patients were included. There were statistically significant differences in quality of life among patients with different ages, education levels, residences, time of high incidence of symptoms, degrees of lung function impairment, asthma control conditions, and degrees of depression, and between patients with fatigue and the ones without fatigue (P<0.05). The quality of life score was negatively correlated with depression score and fatigue score (r=?0.749, ?0.770; P<0.001). The depression score was positively correlated with fatigue score (r=0.769, P<0.001). The fatigue score had a negative predictive effect on quality of life score [standardized partial regression coefficient (β’)=?0.587, P<0.001], and a positive predictive effect on depression scores (β’=0.657, P<0.001). After adding depression score, the effect of fatigue score on quality of life score decreased and the β’ changed from ?0.587 to ?0.319, suggesting that depression played a partial mediating role in the relationship between fatigue and quality of life. Mediation tests showed significant mediation effects.ConclusionsRelieving or eliminating fatigue can improve the quality of life in asthma patients directly. At the same time, it can indirectly improve the quality of life in asthma patients through relieving depression.
ObjectiveTo investigate the psychological states and their influencing factors in parents of congenital defect neonates admitted to Intensive Care Unit (ICU).
MethodsThe self-designed general information questionnaire was used to collect the demographic data, and self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used to evaluate the states of anxiety and depression of the parents of congenital defect neonates admitted to ICU between June 1 and November 29, 2013.
ResultsA total of 152 parents were included in this investigation. The average score of SAS was 39.45±8.53. The average score of SDS was 43.28±10.76. Univariate analysis found that parents with lower educational level, poorer family income, positive family history and countryside residence might have higher score of SAS, while parents with Han nationality, poorer family income and family history would have higher score of SDS. Multivariate analysis discovered that living condition and family history were related to anxiety status. However, depression state was influenced by nationality, family income and family history.
ConclusionA considerable number of parents of congenital defect neonates admitted to ICU have anxiety or depression. And nationality, family income, family history and living condition are the major risk factors.
Objective To investigate the effect of music therapy plus selective serotonin reuptake inhibitors （SSRIs） on emotion and bum wound healing in bum patients. Methods Moderate and severe bum inpatient.s, aged 12-60 years were selected. Emotional problems were then measured by the Hamilton Rating Scale for Depression and Hamilton Rating Scale for Anxiety within three days after bum injury. Bum patients with depression and anxiety were randomly allocated into the trial group （28 patients） and the control group （27 patients）. Music therapy and SSRIs plus conventional burn care Were applied to the trial group, and conventional bum care to the control group, both for 30 days. The scores of anxiety, depression and the degree of bum wound healing were assessed. Results The differences of depression score and anxiety score before and after treatment were 13. 7 ±6.43 and 6.43 ±2.72 respectively in the trial group, and 4. 74 ±6.75 and 4.44 ±3.36 respectively in the control group. This showed both scores significantly improved compared with the control group （P 〈0. 05）. The time for burn wound healing was shortened in the treatment group （P 〈0. 05）. The anxiety score was positively correlated with bum index, and so was the depression score （P 〈 0.05 ）. Conclusions The anxiety and depression scores are positively correlated with the burn index. Music therapy plus SSrIs can ameliorate the emotional problems （ depression and anxiety）, and shorten the time for burn wound heating.
