| Objective:(1)To obtain the epidemiological data of vestibular function,anxiety and depression status and the quality of life in patients with residual symptoms(RD)after successful canalith repositioning procedure on benign paroxysmal positional vertigo(BPPV).Analysis of the correlation between anxiety,depression and quality of life,the factors affecting the quality of life of the patients.(2)The main nursing interventions were cognitive behavioral therapy,vestibular rehabilitation therapy and Brandt-Daroff exercise,then evaluate the effectiveness of nursing intervention in patients with residual symptoms and to provide clinical reference for nursing intervention on patients with residual symptoms.Methods:(1)Using convenient sampling method,141 BPPV patients with residual symptoms were selected after diagnosis and treatment at ENT outpatient department in hospital.Patients were investigated by Self-designed questionnaire,dizziness handicap invertory hospital and anxirty and depression scale,descriptive analysis was used to describe the vertigo disability,anxiety and depression,using factor analysis of variance and multiple linear regression to analysis the factors influence one DHI score.Using Spearman rank correlation to analysis the relationship between anxiety,depression and DHI scores.(2)In this study,141 BPPV patients with residual symptoms were randomly divided into three groups,A,B,and C,for intervention and follow-up.The group A was the control group,and the routine nursing measures were taken,the group B was the test group,and the vestibular rehabilitation therapy combined with cognitive behavioral therapy were taken on the basis of group A,the group C was the test group,and Brandt-Daroff exercise combined with cognitive behavioral therapy on the basis of group A.The intervention time was 30 days.The patients were evaluated by DHI and HADS at begin,10,20,and 30 days.SPSS 22 software was used for statistical analysis.The statistical methods included chi square test,independent sample t test,nonparametric test,one-way ANOVA,and repeated analysis of variance.Results:(1)The survey found that: 141 cases of BPPV patients with residual symptoms,the total score of DHI is(75.05 ± 11.35),the influence on the quality of life extent,1 cases(0.71%)are mild,13 cases(9.22%)are moderate,and 127 cases(90.07%)are severe.The HADS score was(18.06 ± 6.34),anxiety(HADA-A)score was(8.56 ±4.65),depression(HADA-D)scores for the dimensions was(9.50 ± 2.94),63 patients without anxiety symptoms(44.68%),43 cases of suspected anxiety symptoms(30.50%),35 cases determine the presence of anxiety symptoms who(24.82%).There were 42 cases(29.79%)without depression,52 cases(36.88%)suspected to be depressive,and 47 cases(33.33%)with depressive symptoms.(2)The influence factors of the residual symptoms in patients with DHI scores: single factor analysis showed that patients with different age,educational level,hobbies,outdoor activities,temperature test results,disease duration,comorbid chronic disease,the difference was statistically significant(P < 0.05);multivariate linear regression analysis showed that: factors of age,comorbid chronic diseases,the number of outdoor activities,duration,temperature test results were influence of the DHI scores.Spearman rank correlation analysis showed that DHI-E,DHI-F,DHI-Twas positively correlated with the HADS-A score;DHI-E,DHI-F was positively correlated with the HADS-D score;DHI-E,DHI-F,DHI-T was positively correlated with the HADS-T score.(3)Patients involved in this study :after 30 d ursing intervention,43 cases of A group,40 cases of B group,41 cases of C group,the total retention rate was 87.94%;There was no statistically significant difference in baseline data between the lost people and the completed staff(P > 0.05).There was no statistically significant difference in baseline data between the three groups(P >0.05)。(4)The effect of different nursing intervention: the patients’ DHI-T score,HADS-A score,and HADS-D score were analyzed by repeated measurements of variance,The result was different nursing intervention methods had different effects on DHI-T,HADS-A and HADS-D scores without considering the time factor,and the difference was statistically significant(P < 0.05),the effects of DHI-T,HADS-A and HADS-D scores at different time points were different without considering the intervention factors,,and the differences were statistically significant(P < 0.05).The DHI-T,HADS-A and HADS-D scores of patients with residual symptoms were interacted with intervention factors and time factors(P < 0.05).The LSD tests or Bonferroni correction tests were used to compare the differences of DHI-T,HADS-A and HADS-D scores between the three groups before and after the intervention,The results showed that the differences of DHI-T,HADS-A and HADS-D scores before and after intervention in group B and C were significantly different from those in group A(P <0.05),and there was no significant difference between group B and C(P> 0.05),that B,C group of patients with nursing intervention DHI-T,HADS-A,HADS-D scores decreased more than A group.Conclusion:(1)The incidence of anxiety and depression in BPPV patients with residual symptoms is high,and psychological nursing can not be ignored.(2)Patients with residual symptoms of Quality of life problem should not be ignored,The main factors affecting the quality of life were: age,outdoor exercise,disease duration,temperature test results,comorbid chronic diseases.(3)There is a correlation between anxiety,depression and the quality of life.(4)Appropriate amount of vestibular rehabilitation exercises or Brandt-Daroff exercises combined with cognitive behavioral intervention can relieve negative emotions and improve the quality of life of Patients with residual symptoms. |
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