Effect of self-help mindfulness-based intervention on stigma and resilience in patients with depression
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摘要:
目的 抑郁症患者具有较高的病耻感及较低的心理弹性。正念干预是减轻抑郁症患者病耻感,提升其心理弹性的有效方式之一,本研究采用自助式正念课程进行干预,探讨其对抑郁症患者正念水平、病耻感及心理弹性的影响。 方法 选取2022年1—11月就诊于大庆市第三医院门诊的抑郁症患者为研究对象。以随机数字表法将招募的142例抑郁症患者分为对照组(71例)和实验组(71例),对照组给予常规药物治疗,实验组在常规药物治疗的基础上给予自助式正念干预。由于各种原因,实验组脱落15例,对照组脱落11例,最后完成实验的总人数为116例,实验组56例,对照组60例。于干预前及干预8周后用五因素正念度量表(FFMQ)、抑郁症病耻感量表(DSS)、心理韧性量表(CD-RISC)进行评估。 结果 干预后,实验组FFMQ量表总得分[(112.80±15.86)分]高于对照组[(98.97±15.42)分],CD-RISC量表总得分[(54.52±10.46)分]高于对照组[(47.23±9.71)分],而DSS量表总得分[(43.84±10.95)分]低于对照组[(48.28±11.00)分],差异均有统计学意义(t=4.764、3.889、2.179,均P<0.05)。实验组干预后FFMQ量表总得分、CD-RISC量表总得分均高于干预前,而DSS量表总得分低于干预前,差异均有统计学意义(均P<0.05)。 结论 自助式正念干预能有效提升抑郁症患者正念水平及心理弹性,减轻其病耻感。 Abstract:Objective Patients with depression have higher stigma and lower psychological resilience. Mindfulness intervention is one of the effective ways to reduce the stigma of patients with depression and improve their psychological resilience. This study used a self-help mindfulness course to intervene and explore its effects on the level of mindfulness, stigma, and psychological resilience of patients with depression. Methods Patients with depression who visited the outpatient department of the Third Hospital of Daqing from January 2022 to November 2022 were selected as the research subjects. One hundred and forty-two recruited depression patients were randomly divided into a control group (n=71) and an experimental group (n=71). The control group received routine drug treatment, while the experimental group received self-help mindfulness-based intervention based on routine drug treatment. Due to various reasons, 15 cases dropped out of the experimental group and 11 cases dropped out of the control group. Finally, the total number of patients who completed the experiment was 116, 56 cases in the experimental group and 60 cases in the control group. Five facet mindfulness questionnaire (FFMQ), depression stigma scale (DSS), and connor-davidson resilience scale (CD-RISC) were used before and after the intervention for 8 weeks. Results After intervention, the total score of the FFMQ in the experimental group [(112.80±15.86) points] was higher than that in the control group [(98.97±15.42) points], the total score of the CD-RISC [(54.52±10.46) points] was higher than that in the control group [(47.23±9.71) points], and the total score of the DSS [(43.84±10.95) points] was lower than that in the control group [(48.28±11.00) points], the differences were statistically significant (t=4.764, 3.889, 2.179; all P < 0.05). After the intervention, the total scores of FFMQ and CD-RISC in the experimental group were higher than before the intervention, while the total scores of DSS were lower than before the intervention, the differences were statistically significant (all P < 0.05). Conclusion Self-help mindfulness-based intervention can effectively improve the mindfulness level and resilience of patients with depression, and reduce their stigma. -
Key words:
- Mindfulness /
- Depression /
- Stigma /
- Resilience /
- Self-help
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表 1 8周正念课程表
Table 1. 8-week schedule for a mindfulness-based course
时间 内容 第1周 了解正念;抑郁症科普知识;身体扫描;正念呼吸;生活中的正念 第2周 身体扫描;正念瑜伽;摆脱反刍思维;停止思维的自动导航 第3周 身体扫描;正念冥想;正念呼吸;想法不等于事实;活在当下 第4周 身体扫描;正念瑜伽;正念冥想;觉察自己的情绪;提升专注力 第5周 身体扫描;正念瑜伽;正念冥想;接受负面情绪 第6周 身体扫描;正念冥想;正念呼吸;如何更好地关心自己 第7周 身体扫描;正念冥想;正念瑜伽;如何将正念融入生活 第8周 身体扫描;正念冥想;正念呼吸;如何保持正念 表 2 2组抑郁症患者干预前后FFMQ评分比较(x±s,分)
Table 2. Comparison of FFMQ scores between two groups of depression patients before and after intervention (x±s, points)
组别 例数 FFMQ总分 观察维度 描述维度 干预前 干预后 干预前 干预后 干预前 干预后 实验组 56 100.32±17.50 112.80±15.86a 21.86±5.35 24.27±4.82a 22.71±4.55 24.82±4.25a 对照组 60 99.28±16.30 98.97±15.42 21.42±5.02 21.27±4.90 22.47±4.34 22.40±4.28 t值 0.331 4.764 0.457 3.323 0.300 3.056 P值 0.741 <0.001 0.648 0.001 0.765 0.003 组别 例数 觉知地行动维度 不判断维度 不反应维度 干预前 干预后 干预前 干预后 干预前 干预后 实验组 56 20.02±5.20 22.52±4.83a 18.80±4.94 21.34±5.54a 16.93±4.36 19.86±4.61a 对照组 60 19.90±5.32 19.60±5.03 18.47±4.58 18.30±4.51 17.03±3.93 17.40±3.58 t值 0.121 3.183 0.381 3.224 0.136 3.218 P值 0.904 0.002 0.704 0.002 0.892 0.002 注:与同组干预前比较,aP<0.05。 表 3 2组抑郁症患者干预前后DSS得分比较(x±s,分)
Table 3. Comparison of DSS scores before and after intervention between two groups of depression patients (x±s, points)
组别 例数 DSS总分 个人病耻感维度 感知病耻感维度 干预前 干预后 干预前 干预后 干预前 干预后 实验组 56 49.14±11.41 43.84±10.95a 23.79±6.61 21.04±6.53a 25.36±5.14 22.80±4.90a 对照组 60 48.27±11.05 48.28±11.00 23.33±6.40 23.42±6.34 24.93±4.67 24.87±5.02 t值 0.420 2.179 0.452 1.993 0.374 2.239 P值 0.675 0.031 0.652 0.049 0.709 0.027 注:与同组干预前比较,aP<0.05。 表 4 2组抑郁症患者干预前后CD-RISC评分比较(x±s,分)
Table 4. Comparison of CD-RISC scores before and after intervention between two groups of depression patients (x±s, points)
组别 例数 CD-RISC总分 坚韧性维度 力量性维度 乐观性维度 干预前 干预后 干预前 干预后 干预前 干预后 干预前 干预后 实验组 56 48.04±10.23 54.52±10.46a 25.43±6.64 28.02±6.96a 15.08±4.27 17.64±4.36a 6.80±1.78 8.86±1.83a 对照组 60 47.47±10.21 47.23±9.71 24.98±6.79 24.55±6.15 15.72±4.13 15.77±4.18 6.77±1.72 6.92±1.87 t值 0.300 3.889 0.357 2.848 0.111 2.364 0.113 0.910 P值 0.765 <0.001 0.722 0.005 0.912 0.020 5.636 <0.001 注:与同组干预前比较,aP<0.05。 -
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