关键词: 认知疗法, 治疗, 计算机辅助, 肺疾病, 慢性阻塞性, 情感症状, 随机对照试验

Abstract:

Objective: To explore the intervention effects of computerized cognitive behavioral therapy (CCBT) for patients with chronic obstructive pulmonary disease (COPD) in terms of the diversity of symptoms, the lack of self-management ability and the complexity of mental health. Methods: A single-center, double-blind, randomized controlled trial was conducted in this study. Seventy-two patients with acute exacerbation COPD who were admitted to the First Hospital of Shanxi Medical University from March to October 2023 were included in the study, and 72 patients were randomly assigned to the experimental group (n=37) and the control group (n=35) by using random number table method. The control group received conventional care and telephone follow-up, and the experimental group received CCBT for 6 weeks. Major indicators (anxiety and depression) and secondary indicators (dyspnea, 6-minute walking distance (6MWD), insomnia and fatigue) were used as evaluation indicators and were compared before, during and after treatment. Results: The anxiety score (55.14±2.37), depression score (58.55±2.33), dyspnea score (2.72±0.45), insomnia score (7.97±1.57) and fatigue score (46.09±0.26) after 3 weeks of CCBT intervention in the experimental group were higher than that of the anxiety score (53.64±1.46), depression score (56.59±3.52), dyspnea score (2.14±0.67), insomnia score (6.19±1.65), fatigue score (40.65±0.33) after 6 weeks of intervention. The 6MWD ((280.00±8.33) m) after 6 weeks of intervention was higher than the 6MWD (268.59±7.86) after 3 weeks of intervention, and the differences were statistically significant. The F values of experimental groups were 16.141, 76.745, 14.976, 46.250, 42.337, 11.700, respectively, and the P values were <0.001, <0.001, <0.001, <0.001, <0.001, 0.001. After 3 weeks of intervention, the anxiety score (57.43±2.33), depression score (62.46±2.39), dyspnea score (3.06±0.42), insomnia score (9.83±1.65) and fatigue score (47.49±0.33) of the control group were all higher than those of the experimental group, and 6MWD ((262.14±9.11) m) was lower than that of the experimental group, and the differences were statistically significant. The t values were ―4.564, ―7.673, ―3.200, ―4.881, ―3.334, 2.992, respectively, and the P values were <0.001, <0.001, 0.002, <0.001, <0.001, 0.004. The anxiety score (55.04±2.36), depression score (59.89±2.42), dyspnea score (2.74±0.56), insomnia score (9.00±1.77) and fatigue score (43.11±0.33) in the control group were all higher than those in the experimental group after 6 weeks of intervention ((53.64±1.46), (56.59±3.52), (2.14±0.67), (6.19±1.65), and (40.65±0.33) respectively), and 6MWD ((275.29±7.85) m) was lower than that of the experimental group ((280.00±8.33) m), the differences were all statistically significant, and the t values after 3 and 6 weeks of intervention were ―2.354, ―4.917, ―4.149, ―6.988, ―5.305, 2.467, respectively. The P values correspond to 0.021, <0.001, <0.001, <0.001, <0.001, 0.016. Conclusion: Non-drug-assisted treatment based on CCBT can significantly improve the symptoms related to COPD patients and effectively improve patients’ quality of life; increasing the duration of the intervention can significantly improve the patients’ treatment effect.

Key words: Cognitive therapy, Therapy, computer-assisted, Pulmonary disease, chronic obstructive, Affective symptoms, Randomized controlled trial