Cognitive behavioral therapy for depression improves pain and perceived control in cardiac surgery patients.
Cognitive behavioral therapy for depression improves pain and perceived control in cardiac surgery patients.
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DOI：
10.1177/1474515115592292
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发表时间：
2016-10
影响因子：
2.9
通讯作者：
Irwin MR
中科院分区：
文献类型：
--
作者：
Doering LV;McGuire A;Eastwood JA;Chen B;Bodán RC;Czer LS;Irwin MR
心脏手术（CS）后的抑郁症与疼痛增加和睡眠质量下降有关。虽然针对抑郁症的认知行为疗法（CBT）可有效缓解心脏手术后的抑郁症状，但对其改善影响恢复和生活质量的其他常见术后问题的能力知之甚少。本研究的目的是评估认知行为疗法对抑郁症患者疼痛严重程度、疼痛干扰、睡眠和知觉控制的影响。从CS中恢复的抑郁患者随机接受8周的CBT或常规护理。在基线和干预后，患者完成了抑郁症状，疼痛，睡眠和感知控制的问卷调查。使用t检验或卡方分析进行组比较。重复测量分析用于评估干预措施随时间变化的效果。样本（n=53）包括16.9%的女性，平均年龄为67.8±9.2岁。抑郁症的CBT增加了感知控制（p<0.001），降低了疼痛干扰（p=0.02）和疼痛严重程度（p=0.03）。在控制了基线时不同的变量后，观察到感知控制和疼痛干扰的组效应仍然显著（p <0.05），疼痛严重程度的趋势（p<0.10）。随着时间的推移，睡眠障碍没有组间差异。以抑郁为重点的CBT干预在其他常见的术后问题中产生益处，特别是改善了抑郁心脏手术患者的感知控制和减少疼痛。
Depression after cardiac surgery (CS) is associated with increased pain and decreased sleep quality. While cognitive behavioral therapy (CBT) aimed at depression is effective in relieving depressive symptoms after cardiac surgery, little is known about its ability to ameliorate other common postoperative problems that affect recovery and quality of life. The purpose of this study was to evaluate the effects of CBT for depression on pain severity, pain interference, sleep, and perceived control in patients recovering from CS. Depressed patients recovering from CS were randomized to receive either eight weeks of CBT or usual care. At baseline and post-intervention, patients completed questionnaires for depressive symptoms, pain, sleep, and perceived control. Group comparisons were conducted using t-tests or chi square analysis. Repeated measures analysis was used to assess the effect of the intervention in changes over time. The sample (n=53) included 16.9% women and had a mean age of 67.8±9.2 years. CBT for depression increased perceived control (p<0.001) and decreased pain interference (p=0.02) and pain severity (p=0.03). Group effects remained significant (p<0.05) for perceived control and pain interference and a trend was observed for pain severity (p<0.10) after controlling for variables that differed at baseline. There were no group differences in sleep disturbance over time. A depression-focused CBT intervention yields benefits in other common postoperative problems, specifically improved perceived control and decreased pain in depressed cardiac surgery patients.