【摘要】 目的 探讨老年抑郁症患者医院感染后心理变化分析及团体活动干预效果。方法 选择2019年4月～2021年5月无锡市精神卫生中心老年抑郁症患者320例为研究对象，根据是否发生医院感染分为感染组（n=78）和非感染组（n=242）。采用症状自评量表（SCL-90）分析患者心理变化情况；对感染组采用随机数字表法分为两组，各39例。对照组采用常规干预，观察组联合团体活动干预，4周干预后评估患者效果，比较两组应对方式问卷（CSQ）、焦虑自评量表（SAS）、抑郁自评量表（SDS）。正态计量资料采用t检验。结果 老年抑郁症患者感染组躯体化、人际关系敏感、强迫症状、敌对、抑郁、焦虑、偏执、恐惧、精神症状及总分均显著高于非感染组（P<0.05）；对照组和观察在干预4周后应对方式得到显著改善；观察组干预4周后解决问题、自责、退避、幻想评分低于对照组，求助与合理化评分对比无显著差异（P<0.05）；观察组干预4周后SAS、SDS评分显著低于对照组（P<0.05）。结论 老年抑郁症患者医院感染后心理变化较为明显，给予患者团体活动干预，有助于提升患者应对方式，能降低患者焦虑抑郁症状。更多还原

【Abstract】 Objective To explore the analysis of psychological changes in elderly patients with depression after nosocomial infection and the effect of group activity intervention. Methods A total of 320 elderly patients with depression in a mental hospital from April 2019 to May 2021were selected as the subjects, and they were divided into infection group(n=78) and non-infection group(n=242) according to whether there was nosocomial infection. Symptom check list-90(SCL-90) was used to analyze the psychological changes of patients; the infection group was divided into two groups by random number table method, with 39 cases in each group. The control group was given routine intervention, while the observation group was combined with group activity intervention. After 4 weeks of intervention, the effect of the patients was evaluated, and the coping style questionnaire(CSQ), self-rating anxiety scale(SAS) and self-rating depression scale(SDS) were compared between the two groups. The t test was used for normal measures. Results Somatization, interpersonal sensitivity, obsessive-compulsive symptoms, hostility, depression, anxiety, paranoia,fear, mental symptoms and total scores in the infected group were significantly higher than those in the non infected group(P<0.05); the coping styles of the two groups were significantly improved after 4 weeks of intervention; After 4 weeks of intervention, the scores of problem solving, self blame,withdrawal and fantasy in the observation group were lower than those in the control group, and there was no significant difference between help seeking and rationalization scores(P<0.05); the SAS and SDS scores in the observation group were significantly lower than those in the control group after 4 weeks of intervention(P<0.05). Conclusion The psychological changes of elderly patients with depression after nosocomial infection are more obvious. Intervention of group activities for patients can help to improve the coping style of patients and reduce the symptoms of anxiety and depression in patients.更多还原