| ObjectivesTo understand the occurrence of anxiety and depression in young and middle-aged hypertensive patients,analyze the main influencing factors of anxiety and depression in young and middle-aged hypertensive patients;to explore the influence of Mindfulness-based stress reduction on blood pressure value,anxiety and depression symptoms,psychological flexibility level and medication compliance of young and middle-aged hypertensive patients,so as to provide theoretical basis for promoting blood pressure control and mental health work of young and middle-aged hypertensive patients.MethodsPartⅠ: The convenient sampling method was used in this research.From December 2018 to December 2019,the patients aged in18-59 in four hospitals in Shandong Province were selected for a questionnaire survey.The general information questionnaire,GAD-7 and PHQ-9 were used to investigate.Spss26.0 was used to analyze the data.All the statistical tests were double-sided.The significance level,α=0.05,P< 0.05,was considered statistically significant.Among them:(1)general demographic data were described by frequency and composition ratio;(2)t-test / Mann Whitney U test or chi square test of independent samples were used to analyze and compare the differences of anxiety and depression scores of young and middle-aged hypertensive patients with different demographic characteristics;(3)logistic regression method was used to analyze the main influencing factors of anxiety and depression of young and middle-aged hypertensive patients.Part Ⅱ: The random number table was used in this part.84 young and middle-aged patients with hypertension and anxiety were randomly divided into control group(n=42)and test group(n=42);76 young and middle-aged patients with hypertension and depression were randomly divided into control group(n=38)and test group(n=38).The control group received weekly health education hypertension related knowledge and drug treatment;the intervention group received weekly Mindfulness-based stress reduction beyond of theintervention to control group,and the whole intervention cycle extended to 8 weeks.Blood pressure,anxiety and depression level,the CD-RISC score and medication compliance assessment of the hypertension patients with anxiety and depression in control group and intervention group were evaluated and compared between groups before and after the 8weeks intervention,and 1 month later.ResultsPartⅠ:(1)A total of 2,500 questionnaires were distributed in this study,and 2,466 questionnaires were effectively recovered.A total of 815 cases(33.0%)of anxiety symptoms and 530 cases(21.5%)of depression symptoms were detected in middle-aged and young patients with hypertension.657(26.6%)had mild anxiety symptoms,132(5.4%)had moderate anxiety symptoms,and 26(1.1%)had severe anxiety symptoms.431(17.5%)had mild depressive symptoms,76(3.1%)had moderate depressive symptoms,15(0.6%)had moderate and severe depressive symptoms,and 8(0.3%)had severe depressive symptoms.(2)The multi-factor logistic regression analysis was used to analysis the influencing factors of young and middle-aged hypertensive patients with anxiety depression.The results showed that: gender,age,income level,history of smoking,drinking,sleep time is the main influencing factors of anxiety;gender,income level,history of smoking,drinking,exercise,sleep time is the main influencing factors of depression.Part Ⅱ:(1)Before intervention,there was no statistically significant difference in systolic blood pressure,diastolic blood pressure,anxiety score,mental resilience score and medication compliance between the intervention group and the control group(P > 0.05).After 8 weeks of intervention and after 1 month of follow-up:(1)both the systolic and diastolic blood pressure of the intervention group and the control group were significantly reduced(P <0.05),but the effect of the intervention group on blood pressure control was significantly better than that of the control group,with statistically significant differences(P<0.05);(2)the anxiety scores of patients in both groups were reduced,but the anxiety scores in the intervention group were significantly lower than those in the control group,with statistically significant differences(P < 0.05);(3)there was no significant change in the mental resiliencescore of the patients in the control group compared with that before the intervention(t=-1.464、P=0.152;t=-1.575、P=0.124),but the mental resilience score of the patients in the intervention group was significantly higher than that before the intervention,with statistically significant differences(P < 0.05);(4)the medication compliance of both groups was improved,but the medication compliance of the intervention group was significantly better than that of the control group,and the difference was statistically significant(P <0.05).(2)Before intervention,there were no statistically significant differences in systolic blood pressure,diastolic blood pressure,depression score,mental resilience score and medication compliance between the intervention group and the control group(P > 0.05).After 8 weeks of intervention and after 1 month for follow-up:(1)both the systolic and diastolic blood pressure of the intervention group and the control group were significantly reduced(P < 0.05),but the effect of the intervention group on blood pressure control was significantly better than that of the control group,with statistically significant differences(P<0.05);(2)the depression scores of patients in both groups were reduced,but the scores in the intervention group were significantly lower than those in the control group,with statistically significant differences(P < 0.05);(3)there was no significant change in the mental resilience score of the patients in the control group compared with that before the intervention(t=-1.568、P=0.128;t=-1.452、P=0.157),but the mental resilience score of the patients in the intervention group was significantly higher than that before the intervention,with statistically significant differences(P < 0.05);(4)the medication compliance of both groups was improved,but the medication compliance of the intervention group was significantly better than that of the control group,and the difference was statistically significant(P < 0.05).Conclusions(1)The detection rate of anxiety and depression in middle-aged and young patients with hypertension is higher than that of the general population in China.Gender,age,income level,smoking history,drinking history and sleep time were the main influencing factors ofanxiety in middle-aged and young patients with hypertension.Gender,income level,smoking history,drinking history,exercise,sleep time are the main influencing factors of depression in middle-aged and young patients with hypertension.(2)Mindfulness-based stress reduction can significantly reduce the clinical measurement levels of systolic and diastolic blood pressure in patients with mild to moderate hypertension,reduce anxiety and depressive symptoms in patients with hypertension,and improve the mental resilience and medication compliance of patients with hypertension.Mindfulness stress reduction therapy is a healthy,safe and effective intervention method,which can significantly improve the blood pressure management and mental health status of young and middle-aged patients with hypertension,and improve the quality of patients’ life. |
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