Construction Of Functional Variable Graph Model Of Depression Based On ICF And A Case Study Of Individualized Intervention

Objective:At present,depression is one of the diseases with the greatest impact on the disease burden in the world.It has become the focus of attention and research that how to evaluate and treat the functional status of patients with depression more systematically and comprehensively,improve their psychosocial function on the basis of helping them achieve clinical cure,and then help patients better return to society.ICF is an international classification system describing health and its related factors.It can not only reflect the overall functional level of patients,but also show the interactive relationship between individuals and the environment.Individualized treatment in the context of precision medicine advocates the diagnosis and targeted intervention of patients according to individual differences,which is of great significance to the current clinical diagnosis and treatment of depression.Based on this,this study describes and analyzes the functional state of patients with depression from three aspects:physical function and structure,activity and participation,environment and personal factors by using the relevant theoretical framework of ICF,and establishes the functional variable graph model through the network science theory,so as to provide the basis of intervention target and intervention path for the diagnosis and treatment of depression;Based on the functional evaluation and description of ICF,the basic principles and ideas of individualized diagnosis and treatment scheme design are discussed,and typical cases are selected to formulate corresponding intervention schemes and verify their effects.Methods:In this study,ICF knowledge system was used to conduct theoretical system analysis on the overall function of depression patients.In the first study,R software was used to construct the functional variable graph model of depression ICF,and network analysis was conducted based on attribute and relational data,so as to extract key target items and explore intervention paths.In the second part,by analyzing the relationship between ICF and dysfunction in patients with depression,a patient with depression was selected and his overall functional state was described by using ICF functional category.Based on the functional description,a scheme based on ICF theoretical framework and related principles was designed and individualized intervention was carried out.Results:(1)A total of 175 patients with depression were selected in the study,including 64 men(37%)and 111 women(63%).Patients with college degree or below accounted for 35.7%,patients with bachelor degree accounted for 53.2%,and patients with master degree or above accounted for 11.1%.Married patients accounted for 26.1%,unmarried patients accounted for 70.6%,other situations accounted for 3.2%.(2)The modeling results showed that a total of 62 items were located in the main island structure of depression functional variables,among which 27 items were in the 4-nucleus structure,30 items were in the 3-nucleus structure,and 5 items were in the 2-nucleus structure.(3)There was no significant correlation between obstacle rate and network parameters(P>0.05).(4)From the attribute data,the four nuclei items in the main island structure mainly include physical function and activity and participation,which are manifested as thinking function,optimism,mental stability,motivation,digestive system related,temperament and personality function,etc.(5)From the perspective of relational data,according to the risk correlation among items,optimism,thinking function,motivation,feeling related to digestive system,pain sensation and other items are found to be highly risk correlated with multiple items.(6)Before and after the intervention of individualized treatment program,the score of the mood scale and the limit value of ICF components decreased,and the depression of the individual was significantly improved.Conclusion:(1)Based on the ICF theoretical framework,the network analysis of the functional status of patients with depression from the three levels of physical function,activity and participation,environment and individual factors can comprehensively describe the overall functional status of patients with depression,and extract key intervention targets and intervention paths to provide basis for clinical diagnosis and treatment of depression.(2)The individualized scheme of depression can adopt ICF theoretical framework and design from the functional characteristics of depression patients.Specific intervention contents were determined according to different social function recovery purposes and the functional status of patients with depression.