The Study Of The Effect Cognitive-Behavioral Treatment On Anxiety And Depression Among Operative Patients With Lumbar Disc Herniation

ObjectivesTo explore the factors related to anxiety and depression by investigate the status of anxiety and depression among patients with Lumber Disc Herniation, and study the effect of Cognitive-Behavioral Treatment on depression and anxiety among patients with Lumber Disc Herniation.MethodFrom November 2008 to November 2009,120 patients with Lumber Disc Herniation in Tianjin Medical University General Hospital were analyzed. The patients were divided into control group (n=59) and intervention group (n=61) randomly. The control group was given conventional care, and Cognitive Behavioral Treatment was carried out in intervention group. Before and after intervention, both of groups were tested on SAS and SDS, and evaluated the effect of Cognitive-behavioral treatment. The survey tools include Demographic Data Recording Form, Self-Rating Anxiety Scale, Self-Rating Depression Scale, Japanese Orthopaedic Association and Visual Analog Scale. T-test, chi-square test, Multiplelinear regression analysis and repeated measures analysis were performed throughout the research.Results1. The base line results showed that the score of anxiety and depression in Lumber disc herniation patients was 53.85±10.15 and 47.67±7.16 separately. The patients with anxiety accounted for 65.8% (79cases), While the Patients with depression accounted for 46.7%(43cases).2. Multiplelinear regression analysis for the Lumber disc herniation Patients the gender (Bata=0.320, P<0.01),sick time(Bata=0.371, P<0.05),pain (Bata =-0.134, P<0.01);, JOA score(Bata=-0.191, P<0.01)and SDS score (Bata =0.227, P<0.01) were significantly related to anxiety,and the sick time (Bata= 0.647, P< 0.05),pain (Bata=0.125, P<0.01); and SAS score(Bata=0.204, P <0.01) were significantly related to depression 3. Repeated measures analysis of variance showed that the main effects of intervention on anxiety and depression was statistical significant (P<0.01).Scores of anxiety and depression were significant different with the change of the intervention level without considering time. The main effects of time on anxiety and depression were statistical significant (P<0.05). Scores of anxiety and depression were significantly different with the change of the time without considering intervention. There were significant interactions between time and intervention on the anxiety and depression. Interaction diagram indicated that the decreased degree of anxiety and depression were higher in intervention group than that of control group.4. After the intervention, during the three month after surgery that the improve rate of surgery of test group is higher than that of control group. Byχ2 test, the difference was statistically significant. (P＜0.01)Conclusion1. Anxiety and depression existed in patients with Lumber disc herniation, and anxiety and depression were related to gender, sick time, pain and JOA score.2. Cognitive-behavioral treatment could reduce anxiety and depression for patients with Lumber disc herniation, and increase the effect of surgery.