| Background :Post Stroke Depression(PSD)is among the most common emotion disorders afflicting stroke sufferers.Approximately one third of stroke survivors experience an early or late onset of depression,a meta-analysis in 2014 found that the incidence of PSD was nearly 31%,while a narrative review reported that PSD prevalence ranged from 50% to 67% among all types of strokes.According to a correlative study in China,PSD prevalence was 45.79%,including 34.21% early-onset PSD and 11.58% late-onset PSD(occurring at least two weeks after a stroke).PSD impedes rehabilitation and recovery process,jeopardizes quality of life and increase mortality.There are two PSD treatments,one is antidepressant treatment and the other is cognitive behavior therapy.Compared with antidepressant treatment,CBT has been found to be more effectiveness in PSD treatment.However,implement of traditional CBT treatment is often limited by time,place and economic factors.With the development of internet,more and more electronic technique has been used to carry out psychological therapies.Numerous studies have proved the effectiveness in PSD patients.Therefore,it is imperative to develop an internet-based cognitive behavioral therapy for patients with post-stroke depression.Objective: Based on the evaluation of depression,anxiety and quality of life of PSD patients,this study aimed to developing the internet based cognitive behavioral therapy and verify its effectiveness in post-stroke depression patients.The overall purpose is to reduce depression and anxiety,improve quality of life for PSD patients,and carry out effective intervention measures for the clinical nurse.Methods: This study is a clinical experimental trail,We adopts the purposive sampling method to select the subjects from the first affiliated hospital of Xi ’an Jiao Tong university from April 2017 to November 2017,the total number of subjects is 67,and they were randomly divided into experimental group(n =34)and the control group(n =33),the experimental group was given 8 weeks internet based cognitive behavioral therapy and control group patients given 8 weeks regular CBT.The outcomes were presented as scores of depression,anxiety and quality of life.We evaluated all subjects with Patient Health Questionnaire 9(PHQ-9),7-items Generalized Anxiety Disorder Scale(GAD-7)and Life Quality Scale(SF-36)before the intervention,4weeks and 8 weeks after the intervention.Results:1.There was no significant difference between experimental group and control group in demographic and disease related data(P>0.05).2.Before the intervention,The scores of depression in experimental group and the control group were 13.10±4.01 and 12.15±1.84,and the anxiety scores of the two groups were 10.25±5.02 and 7.90±4.40,There were no significant difference between the depression and anxiety scores of the two groups(P > 0.05).The score of life quality had no significant differences between the two groups(P>0.05).3.After 4 weeks intervention,the depression scores of the experimental group and the control group were 10.85±3.03 and 10.30±2.81.The anxiety scores were 5.55±2.41 and 5.45 ±3.10,and there was no significant difference between the two groups(P>0.05).The life quality scores of the physical pain dimensions was statistically significant(P < 0.05),and other dimensions of life quality scores were no significant difference(P > 0.05).4.After 8 weeks of intervention,the depression scores of the two groups were 10.40±2.95 and 9.70±2.56.The anxiety scores of the two groups were 4.20±2.62,and 6.65±3.63.There was significant differences in anxiety(P < 0.05),and no significant difference in depression(P>0.05).As for life quality part,the highest score of each dimension of the two groups was physical pain,and the lowest score was physiological functions(P < 0.05).Among the two groups,the energy and mental health scores were statistically significant,and the scores of the other dimensions were not statistically significant(P>0.05)Conclusion: The internet based cognitive behavioral therapy could decrease the symptom of anxiety in PSD patients,but could not decrease symptoms of depression or improve the quality of life.We suggested that the intensity and frequency of internet-based CBT should be increased in the future studies in order to get an effective result. |
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