| Objective:To study the effect of group cognitive-behavioral therapy on anxiety ,depression ,the quality of life and nutritional status .Methods: The patients come from blood purification center of one Class 3-A hospital, 60 patients with end-stage renal disease were randomly selected for this study from July to October in 2010. They were randomly divided into control group or experimental group. It is no significant different in gender, age, marital status, dialysis time, education level, occupation, primary disease (P>0.05). The control group was received routine nursing care of hemodialysis; the experimental group was received routine care plus group cognitive-behavioral intervention. The methods of group cognitive-behavioral intervention include that: group establishing, cognition rebuilding, explaining knowledge, preaching example, enjoying music, relaxation training and health education. Group was divided into 4 groups and each group 7-8 patients , once a week, 60min, for 12 times. The patients were investigated by the general conditions questionnaire, SAS, SDS and SF-36, and were detected the SGA, BMI, PA. SPSS 13.0 software package was used for statistical description and analysis. Chi square test or independent sample were used to analysis the date,value of P<0.05 were considered to be significant.Results:(1)Before mental intervention, There is no significantly statistic differences in the total score of SAS and SDS scores. (P> 0.05),but After 12 weeks of intervention, SAS and SDS score of experimental groups decreased more significantly than the control group, The difference was significant (P <0.05);And the two groups of patients before and after the intervention, which in itself control group have obvious improvement, a statistically significant difference (P<0.05), and the difference of control group was not statistically significant(P>0.05). (2) Before the intervention, there is no significant difference in the percentage pose of anxiety and depression degree between groups, but after the intervention ,the percentage of degree of anxiety and depression were better than the control group,the difference was statistically significant (P <0.05); And the two groups of patients before and after the intervention, which in itself control group have obvious improvement, a statistically significant difference (P<0.05), and the difference of control group was not statistically significant(P>0.05).(3) Before intervention, There were no significant differences in various dimensions scores of quality of life between two groups patients. But a various points after the intervention were higher, the difference was statistically significant (P<0.05); And the two groups of patients before and after the intervention, which in itself compared group have obvious improvement, a statistically significant difference (P<0.05), and the difference of control group was not statistically significant(P>0.05).(4) Using SGA method to assess nutritional status of patients, before the intervention,the difference of control group was not statistically significant(P>0.05);But after the intervention the normal nutritional status, mild-moderate malnutrition, severe malnutrition cases in the treatment group improved more significantly than in the control group,and the difference was statistically significant (P <0.05); And two groups in before and after the intervention, the malnutrition number of control group was increasd and the malnutrition number of experimental group was reduced, but the differences were not statistically significant (P>0.05). (5) After mental intervention, by human studies measurements on MHD patients, BMI of the experimental group has significantly improved more than the control group, the difference was statistically significant (P<0.05). Biochemical PA in the trested group increased in varying degrees than the control group,the difference was statistically significant (P<0.05). And the two groups of patients before and after the intervention, BMIand PA of experimental group have obvious improvement, a statistically significant difference (P<0.05), and the difference of control group was not statistically significant (P>0.05).Conclusions:(1) Group cognitive-behavioral psychological intervention can significantly ease negative feelings of anxiety and depression with the MHD patients;(2) Group cognitive-behavioral psychological interventions can improve the life quality of MHD patients;(3) Group cognitive behavioral psychology interventions can significantly improve the nutritional status of patients and reduce the incidence of malnutrition.
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