Clinical study of cognitive behavioral therapy on patients with chronic refractory wounds complicated with anxiety

Abstract

Objective To investigate the effect of cognitive behavioral therapy on wound healing in patients with chronic refractory wounds with anxiety. Methods From February 2018 to September 2018, 40 cases of patients with chronic refractory wounds combined with anxiety who were hospitalized in Department of Burns and Plastic Surgery, Linyi Central Hospital and meeted the inclusion criteria were selected. All patients were randomly numbered, the odd number was set as the intervention group, and the even number was set as the control group, 20 cases in each group. Patients in both groups received conventional treatment and nursing care of chronic refractory wounds. On this basis, patients in the intervention group were given cognitive behavioral therapy intervention, including talk therapy, music therapy and abdominal breathing relaxation therapy, for a total of 4 weeks. The control group received no psychological intervention. Self-rating anxiety scale (SAS) and Hamilton anxiety scale (HAMA) were used to score the 2 groups at admission, 2 weeks of treatment and 4 weeks of treatment respectively. The wound area at admission, 2 weeks of treatment and 4 weeks of treatment were measured by using mm mesh paper method, and wound healing rate was calculated. Data were compared with t test. Results At admission, the SAS score of patients in the intervention group was (67.1±2.4) points and those in the control group was (65.9±2.2) points, there was no statistically significant difference between the two groups (t=0.49, P=0.65). After 2 and 4 weeks of cognitive behavioral therapy, the SAS scores of the intervention group were (55.6±1.9) and (49.3±2.6) points, respectively, which were lower than those of the control group [(59.8±2.1) and (53.5±2.7) points], the differences were statistically significant (t=2.17, 2.54; P=0.04, 0.02). At admission, the intervention group had a HAMA score of (23.8±3.3) points, and the control group was (24.1±3.6) points, there was no significant difference between the two groups (t=0.96, P=0.34). After 2 and 4 weeks of intervention, HAMA scores of patients in the intervention group were (17.2±2.7) and (11.9±2.1) points, respectively, lower than those of the control group [(20.8±3.4) and (15.3±3.0) points], the differences were statistically significant (t=2.23, 2.86; P=0.03, 0.01). After 2 and 4 weeks of treatment, the wound healing rates of the intervention group were (26.2±2.4)% and (80.5±4.2)%, which were higher than those of the control group (22.3±2.1)% and (59.2±3.9)%, the differences between the two groups were statistically significant (t=2.54, 2.86; P=0.02, 0.01). Conclusion Cognitive behavioral therapy intervention can relieve anxiety in patients with chronic refractory wounds and improve the healing rate of chronic refractory wounds. Key words: Cognitive therapy; Wound healing; Anxiety; Chronic refractory wound