| Objective The purpose of this study was to investigate the effect of psycho-cardiology model on improving the psychological,cardiac function and quality of life of patients with anxiety and depression after acute myocardial infarction PCI in the cardiovascular department of the Central Hospital of Shenyang Medical College.The application of the psycho-cardiology medical model in these patients will provide experience for clinical application of the psycho-cardiology model,improve patients’ anxiety and depression symptoms,improve patients’ quality of life,improve cardiac function,reduce the risk of complications after myocardial infarction,and help patients reintegrate into their families,communities and working and living environments.So as to realize the transformation of "biological-mental health-social medicine model".Methods This is a prospective randomized controlled study.Patients with acute myocardial infarction(AMI)who underwent percutaneous coronary intervention(PCI)and scored 7-29 in HAMA and 8-35 in HAMD from November 2021 to November 2022 were selected as the study objects.A total of 98 patients were included in the study.These patients were randomly divided into a trial group and a control group.After screening according to the exclusion criteria and shedding criteria,88 patients were finally completely involved in this study.The control group was given traditional cardiovascular medicine treatment,and the experimental group was given psycho-cardiology model intervention on the basis of the control group.The duration of intervention was 3 months.The results were to evaluate the improvement of anxiety and depression by comparing the total score and factor score of HAMA and HAMD before and after treatment in the two groups,to evaluate the improvement of quality of life in the two groups,and to evaluate the improvement of cardiac function by comparing the 6-minute walking distance(6MWD).Results 1.The improvement of anxiety state was evaluated by Hamilton Anxiety Scale(HAMA):The total score of HAMA in the control group treated with traditional medicine alone was 19.89±2.935 points before treatment and 16.95±3.410 points after treatment.The total score of HAMA in the experimental group treated with traditional medicine combined with psycho-cardiology mode was 20.39±2.48 points before treatment.After treatment,the score was 11.86±2.664,which decreased significantly in both groups.The decrease of the experimental group was more obvious,and the difference was significant(P < 0.05).It can be considered that after 3 months,the overall anxiety of patients in both groups improved,but the improvement effect of the anxiety state of patients with psychocardiology medical intervention was more significant.HAMA divided anxiety into physical anxiety and mental anxiety.The scores of the two factors in HAMA were analyzed.The scores of the mental anxiety factor in the control group were 1.36±0.240 points before treatment and 1.27±0.275 points after treatment.The score of somatic anxiety factor was 1.48±0.322 before treatment and 1.16±0.332 after treatment.The score of somatic anxiety factor decreased before and after treatment,and the difference was significant(P<0.05),while the score of mental anxiety factor had no significant difference(P>0.05).The score of physical anxiety in the experimental group was 1.46±0.264 points before treatment and 0.97±0.259 points after treatment;the score of mental anxiety was 1.45±0.258 points before treatment and 0.72±0.296 points after treatment.The scores of the two factors were significantly decreased,and the degree of decline was higher than that of the control group,the difference was statistically significant(P<0.05).It is suggested that the patients who underwent the intervention of psycho-cardiology model have better improvement effect on mental anxiety and physical anxiety than the patients treated with traditional drugs.2.The improvement of depressive state was evaluated by Hamilton Depression Scale(HAMD):The total score of HAMD in the control group treated with traditional medicine alone was 28.39±4.746 points before treatment,and 18.45±4.037 points after treatment,and the total score of HAMA in the experimental group treated with traditional medicine combined with psycho-cardiology medicine mode was 27.89±3.762 points before treatment.After treatment,the total score of HAMD was 13.41±3.098 points,both the control group and the experimental group were reduced after 3 months,and the score of the experimental group was lower than that of the control group,the difference was significant(P < 0.05),suggesting that the depression symptoms in both groups were improved,but the effect of bicardial medical intervention on the improvement of depression symptoms was better than that of the control group.HAMD generalizes depression into a seven-factor structure,including anxiety/somatization,block,sleep disturbance,feelings of hopelessness,cognitive impairment,weight,and day-night changes.According to the analysis of HAMD factor scores,the scores of anxiety/somatization,cognition disorder,sleep disorder and feeling of hopelessness in the control group were significantly reduced,with statistical significance(P<0.05).In addition to the insignificant change of body weight factor(P>0.05),the scores of other factors in the experimental group were all decreased,all with P<0.05,the difference was significant,and the scores of cognitive disorders,block,sleep disorders and despair factors were smaller than those in the control group,the difference was statistically significant(P<0.05).The results showed that the intervention of psycho-cardiology could improve the symptoms of cognition disturbance,block,sleep disturbance and hopelessness.3.Improvement of quality of lifeSF-36 evaluated the quality of life of patients from two aspects,general physical health assessment(PCS)and general mental health assessment(MCS),the higher the score,the better the quality of life.The improvement of quality of life of the two groups was evaluated by the brief form of health survey(SF-36): PCS score of the control group before treatment was 39.60±6.644.After treatment,the score was 41.44±6.893.It was 40.31±6.253 before treatment and 57.89±8.643 after treatment.The SF-36 scores of PCS and MCS in both the experimental group and the control group were increased,and the improvement in the experimental group was more obvious than that in the control group,with statistical significance(P<0.05).After 3 months,the mental and physical health status of patients in both groups were improved.But the improvement in quality of life was more pronounced in the patients who underwent the intervention than in the control group.The brief Form SF-36 of the Health survey evaluated quality of life by dividing it into several dimensions,including physical function(PF),physiological function(RP),physical pain(BP),general sense of well-being(GH),vitality(VT),social function(SF),emotional function(RE),and mental health(MH).After three months of treatment,the scores of PF and MH in the control group increased,and the difference was statistically significant(P<0.05),while the scores of other dimensions of RP,BP,RP,GH,VT,SF and RE had no significant difference(P>0.05).The scores of all dimensions in the experimental group increased,and were significantly higher than those in the control group,the difference was significant(P<0.05).The results showed that psychocardiology medical intervention can improve the quality of life in physical function,physiological function,physical pain,general sense of health,vitality,social function,emotional function and mental health of patients with anxiety and depression after PCI.4.Improvement of cardiac functionThe improvement of cardiac function of the two groups was evaluated by the 6-minute walking distance.In the control group,the improvement of cardiac function was 439.32±67.77 m before 6MWD treatment and 481.59±59.22 m after 6MWD treatment.The 6MWD in the experimental group was 446.14±75.1m before treatment and 531.25±50.75 m after treatment,and the 6MWD in the experimental group was higher than that in the control group,the difference was statistically significant(P<0.05).The results indicated that after three months of treatment,both the patients treated with traditional medicine and those treated with psycho-cardiology medical intervention had improved cardiac function and activity ability,but the patients treated with psychocardiology medical intervention had better improvement effect.5.Safety evaluationThe prognosis of the two groups was evaluated by statistical analysis of adverse cardiovascular events after PCI in acute myocardial infarction.In the control group,there was 1 case of cardiac insufficiency and arrhythmia and 1 case of chest pain.There was 1 case of chest tightness in the experimental group,and no restenosis or death in both groups.There was no significant difference between the two groups(P>0.05),indicating that the intervention of psycho-cardiology mode was safe.Conclusions 1.In patients with acute myocardial infarction complicated with anxiety and depression after PCI,the intervention of psycho-cardiology model can significantly reduce the level of mental anxiety and physical anxiety,relieve the symptoms of cognition disorder,block,sleep disorder and despair,and thus improve the anxiety and depression of patients.2.The intervention of psycho-cardiology model for patients with anxiety and depression after PCI can improve the quality of life in physical function,physiological function,physical pain,overall sense of health,vitality,social function,emotional function and mental health.3.The intervention of psycho-cardiology model for patients with anxiety and depression after PCI can improve their cardiac function and exercise ability. |
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