JURNAL
A.
JUDUL
PENELITIAN
Comprehensive
psychological intervention in bronchial
asthma
B. PENELITI
1.
Yujing Zhang
2.
Mei Song
3.
Yuzhen Zhao
4.
Hanmei Li
C.
TUJUAN
PENELITIAN
To investigate the effect of comprehensive psychological
interventions on asthma-specific anxiety, depression, pulmonary function,
quality of life (QOF) and asthma control level in patients with asthma
D.
METODE
They were randomly assigned to the control group and the
comprehensive psychological intervention group (the CPI group) in terms of the received
care programs
E.
SAMPLING
A total of 156 patients
with bronchial asthma were admitted to Yucheng
People’s Hospital from February 2014
through November 2015.
F.
KESIMPULAN
The SAS score, the SDS score, pulmonary function and the
difference in AQLQ in the CPI group were significantly higher than those in the
control group (all P<0.05). At 1 month after discharge, the rates of
uncontrolled asthma were 5.1% in the CPI group and 19.1% in the control group;
the rates of complete control were 50.0% and 39.7%, respectively. The asthma
control level was better in the CPI group than in the control group (P=0.029).
Comprehensive psychological interventions can effectively relieve the symptoms
of anxiety and depression, and improve the pulmonary function, the quality of
life of patients and the clinical efficacy.
G.
KELEBIHAN
1. Ada
kelompok kontrol dan kelompok perlakuan (CPI group)
2. Intervensi
ini dilakukan secara komprehensif sehingga bermanfaat untuk memperbaiki masalah
pada pasien Asma seperti kecemasan,
depresi, fungsi Pulmonal, dan kualitas hidup pasien
H.
KEKURANGAN
1. Jika
ingin hasil yang maksimal, intervensi ini mmbutuhkan waktu yang lama
PEMBAHASAN JURNAL (PICO)
A.
PROBLEM
1. DS:
a.
Pasien mengatakan tidak bisa tidur
karena sesak nafas
b.
Pasien mengeluh cemas akan penyakitnya
c.
Pasien mengatakan tidur hanya 2-4 jam
saat malam
2. DO:
a.
Pasien tampak lemas
b.
Kelopak mata pasien tampak menghitam
c.
TD: 150/100mmHg
d.
N: 96 x/mnt
B.
INTERVENTION
cognitive
behavior interventions: the caregivers helped the patients to identify, and
correct their wrong recognitions through one-to-one commu- nication, enabling
the patients to rebuild their cognitive structure. They also instructed the patients
to take part in progressive relaxation trainings . Placed in a supine position,
the patients closed their both eyes while gradually relaxing the muscles from
the head to the feet under the voice guidance. In this manner, the patients
were involved in active self-relaxation, promoting their emotional stability.
Moreover, the caregivers carefully listened to the patients’ talking about their
anxiety, fear and other emotional problems, induced them to speak out their
inner thoughts and encouraged them to establish confidence in the fights
against the disease, helped them to get deep self-concepts and be aware of
their self-values and self- demands; encouraged them to realize their own
ideals. During the entire period of hospitalization, all the patients were
given comprehensive psychological interventions
C.
COMPARATION
1.
Psychological
and emotional status before and after interventions/care of the two groups
The SAS
scores of the CPI group and the control group were 47.5±7.9 and 46.2±6.9,
respective- ly while the SDS scores were 43.6±6.3 and 42.1±5.7, respectively.
The above mentioned scores did not show significant differences between the two
groups (all P>0.05). At one month after discharge, the SAS scores and the
SDS scores decreased in the CPI group and in the control group (the paired
t-test before and after treatment, all P<0.001). The differences in the SAS
scores between before and after intervention/care were significantly greater in
the CPI group than in the control group, so were the difference in the SDS
scores (all P<0.001,).
2.
Comparison
of pulmonary functions before and after intervention/care between the two
groups
The comparison of the results of pulmonary function tests
between the two gr- oups at admission and at 1 month after dis- charge. The
levels of PEF, FEV1/FVC and FEV1 at admission were 58.37±5.89, 54.82±4.63 and
50.38±4.89, respectively in the CPI group while in the control group they were 57.61±6.89,55.29±5.02
and 51.71±5.89, respectively. And the difference was not statistically significant
(all P>0.05). At 1 month after discharge, the levels of PEF, FEV1/FVC and
FEV1 elevated in both groups (the paired t-test before and after treatment, all
P<0.001). The difference in the PEF levels before and after
intervention/care in the CPI group were significantly higher than those in the
control group, so were the differ- ences in the FEV1/FVC and FEV1 levels (all P<0.05).
3.
Comparison of the AQLQ scores before and af- ter intervention/care
between the two groups
There was no difference in AQLQ scores between the CPI group and
the control group (all P>0.05), but the scores were im- proved at 1 month
after discharge in both groups (Paired t-test before and after treatment, all
P<0.001). The comparison of the AQLQ scores before and after care/intervention
between the two groups showed that greater improvements in the categories
including activ- ity limitation, asthma symptoms, physiological condition,
response to stimulus sources and self-reported health concerns in the CPI group
(all P<0.05).
4.
Comparison of asthma
con- trol levels before and after intervention/care between the two groups
Shows
asthma control level of the two groups at 1-month follow-up after dis- charge.
The rates of uncon- trolled asthma observed in the CPI group and the control
group were 5.1% and 19.1, respectively whereas the rates of complete control
were 50.0% and 39.7%, respectively. Asthma control in the CPI group at one
month af- ter discharge was better than that in the control group (P=0.029).
D.
OUTPUT
1.
Psychological outcomes: The patients’ de- pression and anxiety
symptoms at admission and at 1-month follow up after discharge were assessed
using the Zung Self-Rating Anxiety Scale (SAS) and the Zung Self-Rating De-
pression Scale (SDS), respectively [15, 16]. The SDS score <50 points was
specified as no depression, 50-69 points as mild depression, 60-69 points as
moderate depression, and >70 points
as severe depression. On the other hand, the SAS scores less than 50 points
were defined as normal anxiety, 50-59 as mild anxiety, 60-69 as moderate
anxiety, and 70 or higher as severe anxiety.
2.
Pulmonary function outcome: the outcomes of pulmonary functions
included the peak expiratory flow (PEF), the forced expiratory volume ), and
the ratio of the forced expiratory volume (FEV) to forced vital capacity (FVC).
At admission and at 1-month follow up after discharge, all the patients in the
two groups received pulmonary function tests three times for each test, each
having at least a 5-minute interval. The best value for each test was taken as
the data for the session.
3.
Quality of life outcomes: The asthma quality of life
questionnaires (AQLQ) for adults were employed to measure the quality of life
in adult with asthma using five items of activity
limita- tion, asthma symptoms, physiological condi- tion, response to stimulus
sources and self- reported health concerns. Higher scores indicate better
quality of life in patients with asthma
4.
Asthma control level: An asthma control test (ACT) was used to
assess asthma control levels of the patients in the past four weeks. The test
consists of a scale of 25 points where 25 indi- cates complete asthma control,
20-24 good asthma control, and less than 20 points uncon- trolled asthma.
Higher score represents better asthma control
