目的

研究脑心健康管理师主导的认知行为疗法对脑卒中后并发轻中度焦虑、抑郁患者的影响。

方法

采用便利抽样法，将2023年6月至12月南通市第一人民医院神经内科收治的脑卒中后并发轻中度焦虑、抑郁患者98例纳入研究，其中神经内科一区住院的49例患者作为对照组，神经内科二区住院的49例患者作为干预组。对照组实施常规治疗、护理及心理干预，干预组在常规护理基础上实施以脑心健康管理师主导的基于网络的认知行为疗法。采用t检验比较2组在干预前与干预3个月后汉密尔顿焦虑量表（HAMA）评分、汉密尔顿抑郁量表（HAMD）评分、健康状况调查简表（SF-36）评分、生活自理能力（BI）评分的差异。

结果

干预后干预组HAMA评分、HAMD评分均低于对照组［（7.83±4.85）分vs（9.08±4.58）分；（8.26±3.04）分vs（9.28±4.67）分］，干预组SF-36评分、BI评分均高于对照组［（498.00±31.02）分vs（438.41±28.68）分；（80.11±3.35）分vs（70.23±3.01）分］，差异均具有统计学意义（t=1.023、2.672、-9.378、-15.765，P均＜0.001）。

结论

脑心健康管理师主导下的基于网络的认知行为疗法能减轻患者焦虑、抑郁症状，提高患者的生理和心理健康、生活自理能力，最终提高其生活质量。

Objective

To investigate the impact of cognitive behavioral therapy led by brainheart health management specialists on patients with mild to moderate anxiety and depression following stroke.

Methods

A convenience sampling method was employed to include 98 patients with mild to moderate anxiety and depression after stroke admitted to the Department of Neurology at Nantong First People's Hospital from June to December 2023. Among them, 49 patients admitted to the first ward of the neurology department were assigned to the control group, while 49 patients admitted to the second ward were assigned to the observation group. The control group received conventional treatment, care, and psychological intervention, whereas the observation group received additional internet-based cognitive behavioral therapy led by brain-heart health management specialists. Pre- and post-intervention differences in Hamilton Anxiety Scale （HAMA） scores, Hamilton Depression Scale （HAMD） scores, Short Form 36 Health Survey （SF-36）scores, and Barthel Index （BI） scores were compared between the two groups using t-tests.

Results

After the intervention, the HAMA and HAMD scores of the observation group were lower than those of the control group ［（7.83±4.85） vs （9.08±4.58）； （8.26±3.04） vs （9.28±4.67）］, and the SF-36 and BI scores of the observation group were higher than those of the control group ［（498.00±31.02） vs （438.41±28.68）； （80.11±3.35）vs （70.23±3.01）］, with all differences being statistically significant （t=1.023, 2.672, -9.378, -15.765, all P＜0.001）.

Conclusion

Internet-based cognitive behavioral therapy led by brain-heart health management specialists is effective in alleviating anxiety and depression symptoms in stroke patients. It also improves their physical and mental health, self-care ability, and overall quality of life.