《中国康复理论与实践》 ›› 2025, Vol. 31 ›› Issue (11): 1333-1341.doi: 10.3969/j.issn.1006-9771.2025.11.010

• 应用研究 • 上一篇    下一篇

生活重建训练对慢性期脊髓损伤患者及其照顾者焦虑和抑郁的效果

解海霞1, 胡心星2, 翟华1, 林佩佩1, 何建辉2, 张佳1, 董晓婉2, 苌凤水2()   

  1. 1.同济大学附属养志康复医院(上海市阳光康复中心),上海市 201619
    2.复旦大学公共卫生学院,上海市 200032
  • 收稿日期:2025-07-03 修回日期:2025-08-31 出版日期:2025-11-25 发布日期:2025-11-26
  • 通讯作者: 苌凤水 E-mail:changfsh@fudan.edu.cn
  • 作者简介:解海霞(1978-),女,汉族,河南周口市人,心理治疗师,主要研究方向:残疾人社会康复
    胡心星(2002-),女,汉族,安徽芜湖市人,硕士研究生,主要研究方向:卫生事业管理。
    第一联系人:解海霞和胡心星为共同第一作者。
  • 基金资助:
    1.上海市残疾人联合会康复政策研究专项项目(2023ZC1002);1.上海市残疾人联合会康复政策研究专项项目(2022ZC1011);2.复旦大学-中国人民健康保险股份有限公司重大课题(25);3.国家临床重点专科建设项目(Z155080000004);4.复旦大学公共卫生学院"德隆学者计划"项目

Effect of life reconstruction training on anxiety and depression among individuals with chronic spinal cord injury and their caregivers

XIE Haixia1, HU Xinxing2, ZHAI Hua1, LIN Peipei1, HE Jianhui2, ZHANG Jia1, DONG Xiaowan2, CHANG Fengshui2()   

  1. 1. Shanghai Yangzhi Rehabilitation Hospital (Shanghai Sunshine Rehabilitation Center), School of Medicine, Tongji University, Shanghai 201619, China
    2. School of Public Health, Fudan University, Shanghai 200032, China
  • Received:2025-07-03 Revised:2025-08-31 Published:2025-11-25 Online:2025-11-26
  • Contact: CHANG Fengshui E-mail:changfsh@fudan.edu.cn
  • Supported by:
    Research Project of the Shanghai Disabled Persons(2023ZC1002);Research Project of the Shanghai Disabled Persons(2022ZC1011);Project of Fudan University-PICC Health Insurance Company Limited (Major)(25);National Key Clinical Specialty Development Project(Z155080000004);Delong Scholars Program, School of Public Health, Fudan University

摘要:

目的 分析生活重建训练对慢性期脊髓损伤患者及其照顾者焦虑和抑郁的干预效果及其影响因素。

方法 2017年5月至2019年10月,在上海市养志康复医院脊髓损伤患者“希望之家”招募参与生活重建康复训练的慢性期脊髓损伤患者216例和照顾者79例。干预前后分别采用焦虑自评量表(SAS)和抑郁自评量表(SDS)测评焦虑和抑郁。

结果 干预后,脊髓损伤患者和照顾者SAS和SDS评分均下降(P < 0.05)。入院时有焦虑的脊髓损伤患者(OR = 2.315, 95%CI 1.328~4.033, P = 0.003)及其照顾者(OR = 3.632, 95%CI 1.270~10.390, P = 0.016) SAS评分下降的可能性更大;非农业户口脊髓损伤患者SAS评分下降可能性更大(OR = 1.908, 95%CI 1.074~3.391, P = 0.028);未婚、受伤年限≥ 21年、疾病原因损伤和入院时有抑郁是脊髓损伤患者SDS评分下降的独立影响因素(P < 0.05)。初中及以下学历照顾者SAS和SDS评分下降的可能性高于高学历照顾者(P < 0.05),照顾年限为5~15年的照顾者焦虑干预效果更好(OR = 7.155, 95%CI 1.806~28.342, P = 0.005)。

结论 生活重建训练能有效改善慢性期脊髓损伤患者及其照顾者的焦虑和抑郁状况。应加强对农业户口脊髓损伤患者焦虑干预,以及已婚/离异/丧偶、受伤年限< 21年、外伤导致脊髓损伤患者的抑郁干预。高学历照顾者的焦虑和抑郁情况,以及照顾年限< 5年和≥ 15年的照顾者焦虑情况需要重点关注。

关键词: 脊髓损伤, 焦虑, 抑郁, 生活重建训练, 影响因素

Abstract:

Objective To explore the effect of life reconstruction training on anxiety and depression among individuals with chronic spinal cord injury (SCI) and their caregivers, and to analyze the influencing factors.

Methods A total of 216 SCI patients and 79 caregivers who participated in life reconstruction training were recruited from the Hope House for SCI individuals in Shanghai Yangzhi Rehabilitation Hospital from May, 2017 to October, 2019. They were assessed with Self-Rating Anxiety Scale (SAS) and Self-Rating Depression Scale (SDS) before and after intervention.

Results After intervention, the scores of SAS and SDS decreased (P < 0.05) in both SCI patients and their caregivers. SAS scores were more likely to reduce in SCI patients who suffered anxiety at admission (OR = 2.315, 95%CI 1.328 to 4.033, P = 0.003) and their caregivers (OR = 3.632, 95%CI 1.270 to 10.390, P = 0.016), as well as non-agricultural-registered SCI patients (OR = 1.908, 95%CI 1.074 to 3.391, P = 0.028). Being unmarried, having an injury duration ≥ 21 years, injury due to disease, and having depression at admission significantly promoted the reduction in SDS scores among SCI patients (P < 0.05). Caregivers with a junior-high-school education or less were more likely to experience reductions in scores of SAS and SDS compared with those with higher education (P < 0.05). Caregivers with five to 15 years of caregiving experience achieved more anxiety reduction (OR = 7.155, 95%CI 1.806 to 28.342, P = 0.005).

Conclusion Life reconstruction training is effective on anxiety and depression among individuals with chronic SCI and their caregivers. It is recommended to prioritize anxiety interventions for patients with rural household registration in China, along with depression management for the married/divorced/widowed individuals, with < 21 years since injury, and trauma-induced lesions. For caregivers, it is needed to focus to anxiety and depression in better-educated individuals, as well as anxiety in those with either < 5 or ≥ 15 years of caregiving experience.

Key words: spinal cord injury, anxiety, depression, life reconstruction training, influencing factors

中图分类号: