CAJ | 학술논문

目的：探讨心理干预对老年慢性心衰患者运动康复治疗依从性的影响。方法112例老年慢性心衰患者随机分为对照组和心理干预组，均给与正规的心衰药物治疗及专业康复训练，干预组同时接受心理干预治疗，采用 HAMD、HAMA、社会支持量表进行评定，根据医嘱进行康复运动的情况分为高、低依从组，并监测血压、心率、血脂、常规心电图、左室射血分数、6 min 步行距离。结果入组时两组患者中抑郁者为64例（57.1%），焦虑者为51例（45.5%），4周及3个月后干预组 HAMD 评分均显著低于对照组；高依从组 HAMD 及 HAMA 评分明显低于低依从组，高依从组社会支持各分量表分明显高于低依从组，高依从组心率、低密度胆固醇、LVEF、6- min 步行距离均显著改善。结论心理治疗能有效改善老年冠心病心衰运动康复治疗中的负性情绪，提高依从性，改善心功能。
목적：탐토심리간예대노년만성심쇠환자운동강복치료의종성적영향。방법112례노년만성심쇠환자수궤분위대조조화심리간예조，균급여정규적심쇠약물치료급전업강복훈련，간예조동시접수심리간예치료，채용 HAMD、HAMA、사회지지량표진행평정，근거의촉진행강복운동적정황분위고、저의종조，병감측혈압、심솔、혈지、상규심전도、좌실사혈분수、6 min 보행거리。결과입조시량조환자중억욱자위64례（57.1%），초필자위51례（45.5%），4주급3개월후간예조 HAMD 평분균현저저우대조조；고의종조 HAMD 급 HAMA 평분명현저우저의종조，고의종조사회지지각분량표분명현고우저의종조，고의종조심솔、저밀도담고순、LVEF、6- min 보행거리균현저개선。결론심리치료능유효개선노년관심병심쇠운동강복치료중적부성정서，제고의종성，개선심공능。
Objective:To investigate the effect of psychological intervention on the treatment compliance of eldly pa-tients with chronic heart failure who underwent rehabilitation therapy. Methods:112 cases of elderly patients with chronic heart failure were randomly divided into control group and intervention group . All paients received drug therapy for heart failure and rehabilitation exercise training under the guidance of rehabilitation therapist. The intervention group also re-ceived psychological intervention. HAMD,HAMA and social support scale were evaluated. According to the doctorˊs orders for rehabilitation were divided into high,low compliance group. Blood pressure,heart rate,and blood lipid,ECG,left ventricular ejection faction(LVEF),6 - min walking distance were monitored at the baseline. Results:There were depres-sion cases(57. 1% )and Anxiety cases(45. 5% )in the two groups. After 4 weeks and 3 months of treatment ,the HAMD scores of the intervention group were significantly lower than those of the control group. HAMD and HAMA scores in the high compliance group were significantly lower than the low compliance group. Social support subscales scores of the high compliance group were higher than the low compliance group. In the high compliance group heart rate,low density lipopro-tein cholesterol,LVEF,6 - min walking distance were significantly improved . Conclusion:Psychotherapy can effectively improve the negative emotion of elderly chronic heart failure ,improve compliance,improve heart function.