新冠疫情期间基于微信公众号的医学科普对维持性血液透析患者焦虑抑郁的干预作用

基础医学与临床 ›› 2021, Vol. 41 ›› Issue (8): 1224-1230.

新冠疫情期间基于微信公众号的医学科普对维持性血液透析患者焦虑抑郁的干预作用

陈罡^1#, 韩建芳^1,2#, 周央中¹, 宋丹¹, 夏京华¹, 秦岩¹, 陈丽萌¹, 李雪梅^1*

1.中国医学科学院北京协和医学院北京协和医院肾内科, 北京 100730;
2.青海省人民医院肾内科,青海西宁 810007

收稿日期:2020-10-09 修回日期:2021-01-04 出版日期:2021-08-05 发布日期:2021-07-21
通讯作者: *lixmpumch@126.com
作者简介:#对本文有相同贡献
基金资助:
北京协和医学院教改项目(2020ZLGC0106);三生TCP中青年科研基金

Effects of WeChat-based medical popular science on anxiety and depression of hemodialysis patients during the COVID-19 pandemic

CHEN Gang^1#, HAN Jian-fang^1,2#, ZHOU Yang-zhong¹, SONG Dan¹, XIA Jing-hua¹, QIN Yan¹, CHEN Li-meng¹, LI Xue-mei^1*

1. Department of Nephrology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730;
2. Department of Nephrology, People's Hospital of Qinghai Province,Xining 810007, China

Received:2020-10-09 Revised:2021-01-04 Online:2021-08-05 Published:2021-07-21
Contact: *lixmpumch@126.com

摘要/Abstract

摘要： 目的评估基于微信的医学科普对新冠疫情期间透析患者焦虑和抑郁状态的缓和作用。方法以2020年4月北京协和医院血透患者作为研究对象,基线问卷获得患者人口学资料和心理评测;将患者分成自行查阅组和微信干预组,微信组每日推送新冠科普,14 d后重复进行心理评测,比较干预前后的患者焦虑、抑郁评分。结果获得有效问卷106例,自行查阅组29例,微信干预组77例。除平均年龄在自行查阅组稍高(P＜0.01)外,两组透析龄、职业类别、教育程度和婚姻状况等资料无显著差异。微信科普干预后,患者焦虑和抑郁评分较前均显著下降(P＜0.001),且干预后无焦虑状态患者的百分比较前显著增加(P＜0.05);自行查阅科普组抑郁评分较前也显著下降(P＜0.01),但焦虑评分无显著下降。新冠期间患者基线抑郁评分和透析龄呈现显著正相关性(P＜0.05)。结论相关医学科普能降低血透患者的焦虑和抑郁程度;医生主动开展科普的方式相比鼓励患者自行查阅能更有效地改善患者焦虑状态。

关键词: 医学科普, 微信, 血液透析, 焦虑, 抑郁

Abstract: Objective To evaluate the impact of WeChat-based medical popular science on the mitigation of anxiety and depression in hemodialysis patients during the COVID-19 pandemic. Methods One hundred and eleven cases of hemodialysis patients from Peking Union Medical College Hospital in April 2020 were recruited. After obtaining the baseline demographic data and psychological evaluation, patients were divided patients into self-reading group and WeChat group. A daily education of popular science of COVID-19 was introduced for the WeChat group. After 14 days, psychological evaluation was repeated to compare the anxiety and depression scores before and after inter- vention. Results One hundred and six valid questionnaires were obtained including 29 in the self-reading group and 77 in the WeChat group. Besides average age (higher in self-reading group, P＜0.05), there was no significant difference in dialysis vintage, occupation, education level and marital status between the two groups. After the intervention of WeChat science popularization, the scores of anxiety and depression of patients were significantly lower than before (P＜0.001), and the percentage of patients without anxiety increased significantly (P＜0.05); the depression score of the self-reading group was also higher than before (P＜0.01), but the anxiety score did not decrease. The patients' baseline depression scores is positively correlated with the dialysis vintage (P＜0.05). Conclusions Medical science popularization reduces thes anxiety and depression in hemodialysis patients; doctors-motivated science popularization can improve patients' anxiety more effectively than encouraging patients to check information of their own.

Key words: medical popular science, WeChat, hemodialysis, anxiety, depression

中图分类号:

R692.5

陈罡, 韩建芳, 周央中, 宋丹, 夏京华, 秦岩, 陈丽萌, 李雪梅. 新冠疫情期间基于微信公众号的医学科普对维持性血液透析患者焦虑抑郁的干预作用[J]. 基础医学与临床, 2021, 41(8): 1224-1230.

CHEN Gang, HAN Jian-fang, ZHOU Yang-zhong, SONG Dan, XIA Jing-hua, QIN Yan, CHEN Li-meng, LI Xue-mei. Effects of WeChat-based medical popular science on anxiety and depression of hemodialysis patients during the COVID-19 pandemic[J]. Basic & Clinical Medicine, 2021, 41(8): 1224-1230.

参考文献

[1]Chakraborty I, Maity P. COVID-19 outbreak: Migration, effects on society, global environment and prevention[J]. Sci Total Environ, 2020, 728:138882. doi: 10.1016/j.scitotenv.2020.138882.
[2]The Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) — China, 2020[J]. China CDC Weekly, 2020,2:113-122.
[3]Richardson S, Hirsch JS, Narasimhan M, et al. Present-ing characteristics, comorbidities, and outcomes among 5700 patients hospitalized with COVID-19 in the New York City area[J]. JAMA, 2020,323:2052-2059.
[4]Guan WJ, Ni ZY, Hu Y, et al. Clinical characteristics of coronavirus disease 2019 in China[J]. N Engl J Med, 2020,382:1708-1720.
[5]Ikizler TA. COVID-19 and dialysis units: What do we nnow now and what should we do?[J].Am J Kidney Dis, 2020,76:1-3.
[6]Chen G, Zhou Y, Zhang L, et al. Core principles for infection prevention in hemodialysis centers during the COVID-19 pandemic[J]. Infect Control Hosp Epidemiol, 2020,41:865-866.
[7]Chen G, Hu R, Wang Y, et al. Recommendation from Peking Union Medical College Hospital for urgent hemodialysis during the COVID-19 pandemic[J]. Int Urol Nephrology, 2020,52:1809-1810.
[8]Zhao R, Zhou Q, Wang XW, et al. COVID-19 outbreak and management approach for families with children on long-term kidney replacement therapy[J]. Clin J Am Soc Nephrol, 2020,15:1259-1266.
[9]Wang C, Pan R, Wan X, et al. Immediate psychological responses and associated factors during the initial stage of the 2019 coronavirus disease (COVID-19) epidemic among the general population in China[J]. Int J Environ Res Public Health, 2020,17:1728-1753.
[10]Dong Y, Wang P, Dai Z, et al. Increased self-care activities and glycemic control rate in relation to health educa-tion via Wechat among diabetes patients: a randomized clinical trial[J]. Medicine (Baltimore), 2018,97:e13632. doi: 10.1097/MD.0000000000013632.
[11]Yu Q, Xu L, Li L, et al. Internet and WeChat used by patients with Crohn's disease in China: a multi-center questionnaire survey[J]. BMC Gastroenterol, 2019,19:97-105.
[12]Dunstan DA, Scott N, Todd AK. Screening for anxiety and depression: reassessing the utility of the Zung scales[J]. BMC Psychiatry, 2017,17:329-337.
[13]Hackett ML, Jardine MJ. We need to talk about depres-sion and dialysis: but what questions should we ask, and does anyone know the answers?[J].Clin J Am Soc Nephrol, 2017,12:222-224.
[14]Zalai D, Szeifert L, Novak M. Psychological distress and depression in patients with chronic kidney disease[J]. Semin Dial, 2012,25:428-438.
[15]Cukor D, Coplan J, Brown C, et al. Depression and anxiety in urban hemodialysis patients[J]. Clin J Am Soc Nephrol, 2007,2:484-490.
[16]Thomas Z, Novak M, Platas SGT, et al. Brief mindful-ness meditation for depression and anxiety symptoms in patients undergoing hemodialysis: a pilot feasibility study[J]. Clin J Am Soc Nephrol, 2017,12:2008-2015.
[17]Pompili M, Venturini P, Montebovi F, et al. Suicide risk in dialysis: review of current literature[J]. Int J Psychiatry Med, 2013,46:85-108.
[18]Schouten RW, Haverkamp GL, Loosman WL, et al. Anxiety symptoms, mortality, and hospitalization in patients receiving maintenance dialysis: a cohort study[J]. Am J Kidney Dis, 2019,74:158-166.
[19]邓素容. 新冠肺炎定点收治医院重庆医科大学附属永川医院医护人员心理状态调查[J]. 基础医学与临床, 2020, 40: 601-603.
[20]Attai DJ, Cowher MS, Al-Hamadani M, et al. Twitter social media is an effective tool for breast cancer patient education and support: patient-reported outcomes by survey[J]. J Med Internet Res, 2015,17:e188. doi: 10.2196/jmir.4721.