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山东大学学报（医学版） ›› 2015, Vol. 53 ›› Issue (5): 89-94.doi: 10.6040/j.issn.1671-7554.0.2014.568

• 医学心理学 • 上一篇    下一篇

团体心理干预对糖尿病患者心理和生理状况的影响

余慧慧1, 雷震2, 路翠艳1, 江虹1, 王淑康1, 潘芳1   

  1. 1. 山东大学医学院医学心理系, 山东 济南 250012;
    2. 莱芜市人民医院, 山东 莱芜 271100
  • 收稿日期:2014-09-02 修回日期:2014-12-23 出版日期:2015-05-10 发布日期:2015-05-10
  • 通讯作者: 潘芳。E-mail:panfang2003@hotmail.com E-mail:panfang2003@hotmail.com
  • 基金资助:
    2012年山东大学自主创新基金(2012JC035);高校院所自主创新基金(201202051)

Effects of group psychological intervention on the physiological and psychological state of elderly patients with diabetes

YU Huihui1, LEI Zhen2, LU Cuiyan1, JIANG Hong1, WANG Shukang1, PAN Fang1   

  1. 1. Department of Medical Psychology, School of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. Laiwu City People's Hospital, Laiwu 27110, Shandong, China
  • Received:2014-09-02 Revised:2014-12-23 Online:2015-05-10 Published:2015-05-10

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摘要： 目的 探讨团体心理干预对社区老年糖尿病患者心身状况的影响。方法 采用老年焦虑量表(GAI),老年抑郁量表(GDS),D型人格量表(DS)和社会支持量表(SSRS)对71例患者进行焦虑、抑郁、D型人格和社会支持状况测评,同时检测血糖(FBG)和唾液皮质醇(SC)水平。患者随机分为干预组和对照组,干预组进行5次以心身放松为主要内容的团体心理干预,对照组不干预。干预后即刻测试上述指标,6个月后随访测试心理指标。结果 与对照组相比,干预组GAI、GDS、消极情绪(NA)和SC水平显著低于对照组,SSRS总分显著高于对照组。干预组干预后即刻和6个月随访时GAI、GDS、DS得分显著低于干预前,SSRS总分显著高于干预前。干预6个月后GAI、GDS和SSRS 得分明显好于干预后即刻。FBG与DS显著正相关;SC与GAI显著正相关,与SSRS显著负相关。结论 心身放松明显改善老年糖尿病患者的心理和生理状况,且对焦虑、抑郁和社会支持的改善可维持6个月。

关键词: 老年人, 团体心理干预, 心理状况, 糖尿病, 皮质醇

Abstract: Objective To explore the effects of group psychological intervention on physiological and psychological state of elderly patients with diabetes. Methods A total of 71 elderly patients with diabetes living in one community were randomly divided into the intervention group and control group. The intervention group received 5 sessions of group psychological intervention, while the control group had no intervention. All patients were assessed with rating scales including the Geriatric Anxiety Inventory (GAI), Geratric Depression Scale (GDS), Social Support Rating Scale (SSRS) and Type D personality scale (DS). Fasting blood-glucose (FBG) and saliva cortisol (SC) before and after intervention were detected. All patients were retested with mental rating scales 6 months after intervention. Results After intervention, the scores of GDS, GAI, negative affectivity (NA) and SC level were significantly lower, while SSRS score was higher than that of the control group. Immediately after intervention, the scores of GAI, GDS and two dimensions of DS decreased and the SSRS score increased. Furthermore, the decreased negative emotions and increased social support of the intervention group persisted after 6 months. The level of blood glucose was positively related with DS score, and SC level was significantly positively correlated to GAI but negatively to SSRS score. Conclusion Group psychological intervention can improve the mental and physiological status of elderly diabetic patients, and the improved state can maintain at least six months.

Key words: Diabetes, Elderly, Group psychological intervention, Psychological state, Cortisol

中图分类号: 

  • R395.1
[1] 姚树桥, 戴晓阳, 高北陵. 应激在糖尿病发生中的作用与机理[J]. 中国临床心理学杂志, 1995, 3(4):249-252. YAO Shuqiao, DAI Xiaoyang, GAO Beiling. The role and mechanism of stress in diabetes[J]. Chinese Journal of Clinical Psychology, 1995, 3(4):249-252.
[2] 蔡太生, 龚耀先, 高北陵, 等. 生活事件在2型糖尿病发病中作用的追踪研究[J]. 中国临床心理学杂志, 2002, 10(4):249-251. CAI Taisheng, GONG Yaoxian, GAO Beiling, et al. The Role of life events in the onset of type 2 diabetes mellitus: the outcomes of four-year follow-up survey[J]. Chinese Journal of Clinical Psychology, 2002, 10(4):249-251.
[3] 赵真, 王淑萍. 老年2型糖尿病患者焦虑和抑郁的患病率及其危险因素[J]. 实用老年医学, 2006, 20(5):322-324. ZHAO Zhen, WANG Shuping. Prevalence of anxiety and depression and its risk factors in elderly patients with type 2 diabetes[J]. Practical Geriatrics, 2006, 20(5):322-324.
[4] 许曼音. 糖尿病学[M]. 上海: 上海科学技术出版社, 2003: 54-81.
[5] 钟明天, 蚁金瑶, 凌宇, 等. D型人格个体的情绪反应强度与认知性调节特征[J]. 中国临床心理学杂志, 2011, 19(1): 96-99. ZHONG Mingtian, YI Jinyao, LING Yu, et al. Characteristics of emotion intensity and cognitive regulation in subjects with type D personality[J]. Chinese Journal of Clinical Psychology, 2011, 19(1):96-99.
[6] 于肖楠, 张建新. D型人格量表(DS14)在中国两所大学样本中的试用[J]. 中国心理卫生杂志, 2006, 20(5):313-316. YU Xiaonan, ZHANG Jianxin. Type D personality scale (DS14) trial of two universities in China[J]. Chinese Mental Health Journal, 2006, 20(5):313-316.
[7] 王晓英, 陈亚宁, 王世娇, 等. 2型糖尿病D型性格患者的疾病特点及其对血糖控制的影响[J]. 海军总医院学报, 2011, 24(2): 76-78. WANG Xiaoying, CHEN Yaning, WANG Shijiao, et al. The impact of Type D personality on blood glucose control in patients with Type 2 Diabetic[J]. Journal of Naval General Hospital, 2011, 24(2):76-78.
[8] 马元广, 李月, 李寿欣. D型人格与冠心病: 消极情绪和社会支持的中介效应[J]. 中国临床心理学杂志, 2013, 21(2):224-228. MA Yuanguang, LI Yue, LI Shouxin. Type D personality and coronary heart disease: mediating effect of negative emotion and social support[J]. Chinese Journal of Clinical Psychology, 2013, 21(2):224-228.
[9] Tziallas D, Kostapanos MS, Skapinakis P, et al. The association between Type D personality and the metabolic syndrome: a cross-sectional study in a University based outpatient lipid clinic[J]. BMC Res Notes, 2011, 4:105.
[10] 田萍, 王梅新. 心理干预中放松训练的研究进展[J]. 护理研究, 2008, 22(12): 3293-3294. TIAN Ping, WANG Meixin. Research progress on relaxation training in psychological intervention[J]. Chinese Nursing Research, 2008, 22(12):3293-3294.
[11] Hegde SV, Adhikari P, Subbalakshmi NK, et al. Diaphragmatic breathing exercise as a therapeutic intervention for control of oxidative stress in type 2 diabetes mellitus[J]. Complement Ther Clin Pract, 2012, 18(3):151-153.
[12] Sheu S, Irvin BL, Lin HS, et al. Effects of progressive muscle relaxation on blood pressure and psychosocial status for clients with essential hypertension in Taiwan[J]. Holist Nurs Pract, 2003, 17(1):41-47.
[13] Castillo-Richmond A, Schneider RH, Alexander CN, et al. Effects of stress reduction on carotid atherosclerosis in hypertensive African-Americans[J]. Stroke, 2000, 31(3):568-573.
[14] 朱禧星. 现代糖尿病学[M]. 上海: 上海医科大学出版社, 2001: 218-223.
[15] Weeks SK, McGann PE, Michaels TK, et al. Comparing various short-form geriatric depression scales leads to the GDS-5/15[J]. Journal of Nursing Scholarship, 2003, 35(2):133-137.
[16] Cully JA, Jimenez DE, Ledoux TA, et al. Recognition and treatment of depression and anxiety symptoms in heart failure[J]. Prim Care Companion J Clin Psychiatry, 2009, 11(3):103-109.
[17] Pachana NA, Byrne GJ, Siddle H, et al. Development and validation of the geriatric anxiety inventory[J]. Int Psychogeriatr, 2007, 19(1):103-114.
[18] 梅锦荣. 老年抑郁量表和普通健康问卷(简本)信度和效度的研究[J]. 中华精神科杂志, 1999, 32(1):41-42. Boey Kam Weng. Reliability and Validity of GDS and GHQ short form for the aged[J]. Chinese Journal of Psychiatry, 1999, 32(1):41-42.
[19] 肖水源.《社会支持评定量表》的理论基础与研究应用[J]. 临床精神医学杂志, 1994, 4(2):98-100. XIAO Shuiyuan. The theoretical basis and research applications of Social Support Rating Scale[J]. Journal of Clinical Psychological Medicine, 1994, 4(2): 98-100.
[20] 肖鑫和, 雷立屏. 腹式呼吸养生益寿的医学基础[J]. 按摩与导引, 1996, 4(4): 41-43. XIAO Xinhe, LEI Liping. The medicine foundation of abdominal breathing health and longevity[J]. Chinese Manipulation and Qi Gong Therapy, 1996, 4(4):41-43.
[21] 沈红五, 宋艳, 潘海燕, 等. 冥想对社区老年高血压病人肾上腺素和去甲肾上腺素水平的影响[J]. 护理研究, 2013, 27(10):3093-3095. SHEN Hongwu, SONG Yan, PAN Haiyan, et al. Influence of meditation on epinephrine and norepinephrine levels of elderly people with hypertension in community[J]. Chinese Nursing Research, 2013, 27(10):3093-3095.
[22] 杨放如. 心身放松疗法治疗广泛性焦虑症的疗效观察[J]. 中国医刊, 2005, 40(4):49-50. YANG Fangru. Effect of mind-body relaxing therapy in the patients with generalized anxiety disorder[J]. Chinese Journal of Medicine, 2005, 40(4):49-50.
[23] 张燕冰, 杨斯环, 张莉, 等. 放松训练对脑电、情绪的影响及与人格特征的关系[J]. 中国心理卫生杂志, 2004, 18(1):21-23. ZHANG Yanbing, YANG Sihuan, ZHANG Li, et al. Effects of relaxation on EEG, the personality and behavior pattern of medical students[J]. Chinese Mental Health Journal, 2004, 18(1):21-23.
[24] 卢勤, 张岚, 李旭, 等. 糖调节异常者认知行为团体心理治疗方案的编制及疗效[J]. 中国心理卫生杂志, 2012, 26(11):808-813. LU Qin, ZHANG Lan, LI Xu, et al. Development and efficacy of group cognitive behavioral therapy program in impaired glucose regulation patients[J]. Chinese Mental Health Journal, 2012, 26(11):808-813.
[25] 黄俭强, 陈琪尔, 舒小芳. 社区老年人生存质量与社会支持的相关性研究[J]. 中国行为医学科学, 2005, 14(8):725-726. HUANG Jianqiang, CHEN Qier, SHU Xiaofang. A study on the relationship between quality of life and social support of elder in community[J]. Chinese Journal of Behavioral Medical Science, 2005, 14(8):725-726.
[26] Mols F, Denollet J. Type D Personality in the general population: a systematic review of health status, mechanisms of disease and work-related problems[J]. Health Qual Life Outcomes, 2010, 8(1):9-18.
[27] 张苏霞, 张家兴. 老年女性首发抑郁症的心理社会因素研究[J]. 中国健康教育, 2011, 27(7):530-532. ZHANG Suxia, ZHANG Jiaxing. A study on psychosocial and personality factors of first episode depression in elderly w omen[J]. Chinese Journal of Health Education, 2011, 27(7):530-532.
[28] 刘克嘉, 邬勤娥. 应激与应激性疾病[M]. 北京: 人民军医出版社, 1991:3-11.
[29] 叶林秀, 郭昆全, 刘兴晖, 等. 初发2型糖尿病患者焦虑抑郁对皮质醇水平的影响[J]. 中国糖尿病杂志, 2010, 18(4):306-309. YE Linxiu, GUO Kunquan, LIU Xinghui, et al. The effect of anxiety and depressive disorders on cortisol secretion in newly diagnosed type 2 diabetes meilitus[J]. Chinese Journal of Diabetes, 2010, 18(4): 306-309.
[30] 宁艳花, 姚丽, 夏薇, 等. 老年糖尿病患者社会支持现状及影响因素分析[J]. 中国公共卫生, 2011, 27(7):834-836. NING Yanhua, YAO Li, XIA Wei, et al. Social support and its influence factors among aged patients with diabetes mellitus in urban area of Yinchuan[J]. Chinese Journal of Public Health, 2011, 27(7):834-836.
[31] 宋秀峰. 老年糖尿病患者生存质量和心理及社会支持现状[J]. 中国老年学杂志, 2012, 18:3985-3986. SONG Xiufeng. The quality of life and social support status in elderly patients with diabetes[J]. Chinese Journal of Gerontology, 2012, 18:3985-3986.
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