正念认知疗法对脑卒中吞咽困难的效果

doi:10.3969/j.issn.1006-9771.2018.00.008

摘要/Abstract

摘要： 目的探讨正念认知疗法对脑卒中吞咽困难的干预效果。方法 2017年10月至2018年3月,60例脑卒中吞咽困难患者随机分为对照组和试验组,各30例。两组均接受常规吞咽功能康复训练,试验组在此基础上接受正念认知疗法,共8周。干预前后分别评估两组的依从性、洼田饮水试验评分和医院焦虑抑郁量表评分。结果干预后,试验组依从性显著改善(χ² = 19.000, P < 0.001),且优于对照组(χ² = 8.044, P < 0.05);两组洼田饮水试验评分均较干预前改善(Z > 1.970, P < 0.05),试验组优于对照组(Z = -2.093, P < 0.05);两组医院焦虑抑郁量表评分均显著改善(t > 9.510, P < 0.001),试验组量表总分及焦虑和抑郁维度评分均低于对照组(t > 2.133, P < 0.05)。结论正念认知疗法可提高脑卒中吞咽困难患者吞咽训练的依从性,从而改善吞咽功能及焦虑和抑郁状态。

关键词: 脑卒中, 吞咽困难, 正念认知疗法, 依从性, 焦虑, 抑郁

Abstract: Objective To observe the effect of mindfulness-based cognitive therapy (MBCT) on dysphagia after stroke. Methods From October, 2017 to March, 2018, 60 stroke patients with dysphagia were randomly divided into control group (n = 30) and experimental group (n = 30). Both groups received routine swallowing training, while the experimental group received MBCT in addition, for eight weeks. They were investigated the compliance, and assessed with Kubota Drinking Water Test (KDWT) and Hospital Anxiety and Depression Scale (HADS) before and after intervention. Results The compliance improved in the experimental group after intervention (χ² = 19.000, P < 0.001), and it was better in the experimental group than in the control group (χ² = 8.044, P < 0.05). While the scores of KDWT improved in both groups (Z > 1.970, P < 0.05), and improved more in the experimental group than in the control group (Z = -2.093, P < 0.05); the scores of HADS improved in both groups (t > 9.510, P < 0.001), the total scores and the subscale scores of anxiety and depression improved more in the experimental group than in the control group (t > 2.133, P < 0.05). Conclusion MBCT could increase the compliance in swallowing training for stroke patients with dysphagia to improve their swallowing function, anxiety and depression .

Key words: stroke, dysphagia, mindfulness-based cognitive therapy, compliance, anxiety, depression

中图分类号:

R743.3

张丽娟, 宋艳丽, 董博, 李魏, 何彦泽, 于睿. 正念认知疗法对脑卒中吞咽困难的效果[J]. 《中国康复理论与实践》, 2018, 24(11): 1361-1364.

ZHANG Li-juan, SONG Yan-li, DONG Bo, LI Wei, HE Yan-ze, YU Rui. Effect of Mindfulness-based Cognitive Therapy on Dysphagia after Stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2018, 24(11): 1361-1364.

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