METHODS: Between January 2022 and January 2023, a prospective study was conducted involving 300 AMI patients at Union Hospital, Tongji Medical College, Huazhong University of Science and Technology. Participants were divided into a control group and a study group, with 150 patients in each. The control group received standard treatment and rehabilitation guidance, while the study group also received interventions based on action research theory and focus-solving short-term psychotherapy. Outcomes measured included scores from the Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Mental Health Inventory (MHI), National Institutes of Health Stroke Scale (NIHSS), Fugl-Meyer Assessment (FMA), Essential Skills for Caregivers Assessment (ESCA), and patient satisfaction. Prognostic factors were also analyzed.
RESULTS: Post-intervention, the study group demonstrated significantly lower scores in HAMA and HAMD and reported less psychological pain, alongside higher scores in psychological well-being, compared to the control group (all P < 0.05). Additionally, the study group showed improved neurological function (NIHSS scores) and motor skills (FMA scores) as well as enhanced self-care abilities (higher ESCA scores) (all P < 0.05). Patient satisfaction was also notably higher in the study group (P < 0.05). Key prognostic factors included history of diabetes, Killip classification, and door-to-balloon (DTB) time.
CONCLUSIONS: The integration of action research theory with focus-solving short-term psychotherapy significantly alleviated anxiety and depression in AMI patients post-PCI, enhanced their psychological adjustment, and facilitated the recovery of neurological and motor functions. This approach also improved self-care capabilities. Effective management of underlying conditions, vigilant monitoring of Killip classification, and minimization of DTB time are critical to reducing major adverse cardiac events and improving patient outcomes.
方法:在2022年1月至2023年1月之间,在协和医院进行了一项涉及300名AMI患者的前瞻性研究。同济医学院,华中科技大学.参与者被分为对照组和研究组,每人150名患者。对照组给予规范治疗和康复指导,同时,研究组还接受了基于行动研究理论和解决焦点的短期心理治疗的干预措施。测量的结果包括汉密尔顿焦虑量表(HAMA)的得分,汉密尔顿抑郁量表(HAMD),心理健康量表(MHI),美国国立卫生研究院卒中量表(NIHSS),Fugl-Meyer评估(FMA),照顾者评估基本技能(ESCA),患者满意度。还分析了预后因素。
结果:干预后,研究组在HAMA和HAMD中表现出明显较低的得分,并且报告了较少的心理疼痛,在心理健康方面得分更高,与对照组比较(均P<0.05)。此外,研究组患者神经功能(NIHSS评分)、运动技能(FMA评分)改善,自理能力增强(ESCA评分较高)(均P<0.05)。研究组患者满意度明显高于对照组(P<0.05)。关键预后因素包括糖尿病病史,Killip分类,和门到气球(DTB)时间。
结论:行动研究理论与聚焦解决短期心理治疗相结合,可显著缓解AMI患者PCI术后焦虑和抑郁情绪,增强其心理调适,促进神经和运动功能的恢复。这种方法也提高了自我护理能力。有效管理基本条件,警惕监控Killip分类,和最小化DTB时间对于减少主要不良心脏事件和改善患者预后至关重要。