| Background Glaucoma is a group of ophthalmopathy characterized by acute or chronic elevated intraocular pressure(IOP),which leads to optic nerve depression and visual field defect.The World Health Organization has listed it as the second largest cause of blindness and the main reason for the irreversible blindness.With the development of society and the improvement of the living standard,more and more glaucoma patients require higher requirements for the preservation and protection of vision and visual field.The patients bear great pain and psychological pressure in the course of treatment which is easy to induce all kinds of psychological problems and affect the quality of sleep.In China,primary angle closure glaucoma is the most common type of glaucoma,is a typical psychosomatic disease,patients emotional performance,personality traits,behavior types and other aspects are different from healthy people,although the existing intervention measures have a certain effect.But at the same time,there are some defects,and positive training is a combination of a series of psychotherapy based on "mindfulness".In view of its good intervention effect in other fields and other diseases,this study will use mindfulness training as an intervention means.The investigation and research of this kind of patients were carried out.Objectives(1)To investigate the level of anxiety and depression,sleep quality and mindfulness in patients with primary angle closure glaucoma.(2)In order to provide guidance and help for nurses in nursing the patients with primary angle-closure glaucoma,the intervention effect of mindfulness training was analyzed by making a mindfulness training program suitable for the patients with primary angle-closure glaucoma.Methods(1)Our study is a randomized controlled trial(Randomized Controlled Trial,RCT).102 patients with primary angle-closure glaucoma were recruited from August 2017 to August 2018 in the ophthalmic ward of a tertiary hospital in Xinxiang City.Using the General data questionnaire,the self-rating anxiety scale(Self-rating anxiety scales,SAS),the self-rating Depression scale(Self-rating depression scale,SDS)and the Pittsburgh Sleeping quality Index(Pittsburgh Sleep Quality Index,).PSQI and(Five Facet Mindfulness Questionnaire,FFMQ were used as research tools to investigate the status of anxiety,depression and sleep quality in patients with primary angle closure glaucoma and the results of intervention(2)A total of 102 patients with negative emotion(SAS≥50 or SDS≥50),sleep problems(PSQI>7)and primary angle closure glaucoma were selected.102 random numbers were generated by other personnel in the research group outside the intervention group,and the random numbers were arranged from small to large to obtain the serial number R,and R=1～51 was assigned as mindfulness training group(n=51)and R=52～102 as routine nursing group(n=51).Routine nursing was adopted in the routine nursing group,and the corresponding guidance was given according to the patient’s condition development.The contents were as follows:medication guidance,diet management,psychological counseling and health education.On the basis of this,the mindfulness training group conducted four weeks of mindfulness training,including:mindfulness breathing,body scan,compassion exercise,mindfulness walking,mindfulness diet,forgiveness exercise,R.A.I.N.Practice and mindfulness exercise(Ba Duan Jin).(3)Statistical Analysis:Our study used SPSS 21.0 statistical software for data processing and analysis.Statistical methods include:Chi-square test,U test,paired sample t test.Results(1)A total of 145 subjects were recruited in this study.75%of the patients had anxiety,depression and sleep problems.The levels of anxiety and depression were mainly mild,sleep quality was general,and the total score of mindfulness level was low(2)There was no significant difference between mindfulness training group and routine nursing group in each factor score and total score of FFMQ before intervention,but there was significant difference between the two groups after intervention in each factor score and total score of FFMQ.The results showed that the scores and total scores of FFMP in mindfulness training group were significantly increased after intervention.(3)Before intervention,there was no statistical significance in the scores and total scores of PSQI between mindfulness training group and routine nursing group.After intervention,all the other factors and total scores of the two groups were P<0.05 except the time of falling asleep(P>0.05).The two groups have significant difference(P<0.05).Comparing with the scores and total scores of PSQI in the mindfulness training group,it has statistical significance before and after the intervention.There was a significant difference in the time of falling asleep between mindfulness training group and routine nursing group before and after intervention.The difference was statistically significant in the mindfulness training group(P<0.05),and there was no significant difference in the routine nursing group(P>0.05).The results showed that the scores and total scores of sleep factors in mindfulness training group decreased significantly after intervention(4)There was no significant difference in SAS,SDS scores between mindfulness training group and routine nursing group before intervention(P>0.05).The SAS and SDS scores was significant difference between the two groups after intervention(P<0.05).The scores of anxiety and depression before and after intervention were statistically significant in the mindfulness training group(P>0.05).The scores of anxiety and depression in the mindfulness training group were significantly lower than those in the routine nursing group after intervention,and the difference has statistically significant,indicating that the intervention effect of mindfulness training on anxiety and depression was better than that of health education.Before intervention,the degree of anxiety and depression in both of the two groups were relatively mild which shows no significant difference in the two groups.After intervention,the anxiety and depression in the mindfulness training group were mainly non-anxiety and no depression,while the routine nursing group was still mild.There was significant difference in the degree of anxiety and depression between the two groups after intervention(P>0.05),and there was a significant difference in the degree of anxiety and depression between the two groups(P<0.05).The results showed that anxiety and depression in mindfulness training group were significantly decreased in both scores and degrees.Conclusion(1)Anxiety and depression and sleep quality problems are common in patients with primary angle closure glaucoma,in which anxiety and depression are mainly mild,sleep quality is general,and the total score of mindfulness level is low.(2)Mindfulness training can improve the mindfulness level of primary angle closure glaucoma patients,improve sleep quality,and effectively alleviate the level of anxiety and depression. |
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