Application Of Rational Emotive Behavior Therapy For Home Chronic Obstructive Pulmonary Disease Patients With Depression

ObjectiveThe purpose of this study was to investigate the relationship between sleep quality,self-efficacy,overall well-being,exercise capacity and depression on home chronic obstructive pulmonary disease(COPD)patients with depression,and to explore the application effects of rational emotive behavior therapy on depression,sleep quality,self-efficacy,overall well-being and exercise capacity of home COPD patients with depression,so as to provide a reference for building a psychological intervention model for home COPD patients with depression,and to help patients to improve depression and quality of life better.MethodsRandomized controlled trial was designed.A total of 76 home COPD patients with depression were selected from December 2016 to June 2017 after discharging from a third grade A hospital in Qingdao,were randomly divided into the experimental group(38 cases)and the control group(38 cases).Except for patients lost to follow-up,the experimental group actually intervened in 36 cases,and the control group actually intervened in 36 cases.The patients in experimental group(36 cases)were given rational emotive behavior therapy for 6 weeks,while the patients in control group(36 cases)were given conventional telephone follow-up.The Self-Rating Depression Scale(SDS),Pittsburgh Sleep Quality Index(PSQI),COPD Self-Efficacy Scale(CSES),General Well-Being Schedule(GWB)and 6-minute walk test(6MWT)were used to evaluate the effect of rational emotive behavior therapy.Pearson correlation analysis were performed on depression,sleep quality,self-efficacy,overall well-being and 6-minute walk distance(6MWD)on home COPD patients with depression.For both groups of patients,intragroup and intergroup comparisons were made by paired-samples t test and independent-samples t test regarding the depression,sleep quality,self-efficacy,overall well-being and 6MWD before and after intervention,respectively.Results(1)Before intervention,in 72 home COPD patients with depression,their depression scores were positively correlated with sleep quality and its factors scores except hypnotic drugs scores(P<0.05);the depression scores were negatively correlated with self-efficacy and its factors scores,overall well-being and its factors scores,6MWD(P<0.01);the sleep quality scores were negatively correlated with self-efficacy scores,overall well-being scores and 6MWD(P<0.05),the self-efficacy scores was positively correlated with overall well-being scores and 6MWD(P<0.05),the overall well-being scores was positively correlated with 6MWD(P<0.01).(2)Before intervention,there were no significant differences in depression scores,sleep quality and its factors scores,self-efficacy and its factors scores,overall well-being and its factors scores,6MWD between the two groups(P>0.05);after intervention,the depression scores,the sleep quality and its factors scores in experimental group were significantly lower than those in control group,the self-efficacy and its factors scores,the overall well-being and its factors scores,6MWD in experimental group were significantly higher than those in control group,the differences were statistically significant(P<0.05);in control group,there were no significant differences in depression scores,sleep quality and its factors scores,self-efficacy and its factors scores,overall well-being and its factors scores,6MWD before and after intervention(P > 0.05);in experimental group,the depression scores,the sleep quality and its factors scores except hypnotic drugs scores were significant lower after intervention than those before intervention,the self-efficacy and its factors scores,the overall well-being and its factors scores,6MWD were significant higher after intervention than those before intervention,the differences were statistically significant(P<0.05).Conclusions(1)In home COPD patients with depression,depression was negatively correlated with sleep quality,self-efficacy,overall well-being and exercise capacity;the sleep quality,self-efficacy,overall well-being and exercise capacity were positively correlated with each other.(2)Rational emotive behavior therapy for home COPD patients with depression can help patients to establish a reasonable cognitive model to relieve depression,improve sleep quality,improve self-efficacy,overall well-being and exercise capacity,providing a reference for building a psychological intervention model for home COPD patients with depression.