山东省农村老年高血压患者心理健康状况及其影响因素
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摘要
目的了解山东省农村老年高血压患者的心理健康状况及其影响因素。方法采用分层整群随机抽样的方法抽取样本,利用Kessler10量表和自制问卷对研究对象进行调查,数据分析采用了单因素分析和有序Logistic回归分析。结果本研究共纳入了农村老年高血压患者2 203人,K10分值均值为16.43±7.35,有序多分类Logistic回归分析显示男性、日常活动能力(ADL)无受损、自评健康状况好、高血压控制效果好、三餐规律、信任他人的农村老年高血压患者心理健康状况好;有欠款、性格内向、生活压力大、遭遇过重大挫折和不幸的患者心理健康状况差。结论农村老年高血压患者的心理健康状况较差,影响因素复杂多样,因此,应重点关注经济情况不佳、性格内向、生活压力大等相关危险因素突出的农村老年高血压患者的心理健康现状,并针对不同个体采取相应的心理干预措施。
Objective To investigate the mental health status and its influencing factors among rural elderly hypertensive patients in Shandong Province. Methods The objects were randomly chosen with cluster-based sampling method,who were then surveyed with Kessler Psychological Distress Scale 10( K10) and a self-made questionnaire. The data collected were analyzed with univariate analyses and ordinal polytomous Logistic regression analyses. Results A total of 2 203 rural elderly hypertensive patients were included in the study. The average K10 score was 16.43±7.35. Ordinal polytomous Logistic regression analyses showed that male,good activity of daily living( ADL),good self-rated health,controlled blood pressure,regularly diet and trust in others were significantly associated with sound mental health,while debts,introvert personality,high life pressure,past setbacks or accidents were associated with poor mental health.Conclusion The mental health of some rural elderly hypertensive patients is poor and its influencing factors are various. Risk factors such as poverty,introvert personality and high life pressure should be taken into concern,and individualized intervention should be adopted.
Objective To investigate the mental health status and its influencing factors among rural elderly hypertensive patients in Shandong Province. Methods The objects were randomly chosen with cluster-based sampling method,who were then surveyed with Kessler Psychological Distress Scale 10( K10) and a self-made questionnaire. The data collected were analyzed with univariate analyses and ordinal polytomous Logistic regression analyses. Results A total of 2 203 rural elderly hypertensive patients were included in the study. The average K10 score was 16.43±7.35. Ordinal polytomous Logistic regression analyses showed that male,good activity of daily living( ADL),good self-rated health,controlled blood pressure,regularly diet and trust in others were significantly associated with sound mental health,while debts,introvert personality,high life pressure,past setbacks or accidents were associated with poor mental health.Conclusion The mental health of some rural elderly hypertensive patients is poor and its influencing factors are various. Risk factors such as poverty,introvert personality and high life pressure should be taken into concern,and individualized intervention should be adopted.
引文
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[8]谢秀梅,余国龙,何劲,等.心理社会因素对老年人高血压疗效的影响[J].中华老年医学杂志,2003,22(7):4-6.XIE Xiumei,YU Guolong,HE Jin,et al. Influences of psycho-social factors in the treatment of the elderly patients with hypertension[J]. Chinese Journal of Geriatrics,2003,22(7):4-6.
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[10]王慧,张蕾蕾,隗冬艳,等.北京市空巢老年高血压患者心理健康状况及其影响因素[J].职业与健康,2018,34(1):60-66.WANG Hui, ZHANG Leilei, KUI Dongyan, et al.Mental health status and its influencing factors of empty nesters with hypertension in Beijing[J]. Occupation and Health,2018,34(1):60-66.
[11]李亚楠,张静,徐淑秀. 190例农村老年高血压患者治疗依从性影响因素的分析[J].中国护理管理,2015,15(3):304-308.LI Yanan,ZHANG Jing,XU Shuxiu. Analysis of influencing factors of the treatment compliance of the elderly hypertensive patients in the countryside[J]. Chinese Nursing Management,2015,15(3):304-308.
[12]张惠峰,沈月秀.社区干预对农村老年高血压患者服药依从性的影响[J].解放军护理杂志,2008,23(1):727-728.
[13]高红霞,张慧,徐娟,等.农村老年高血压患者治疗依从性的影响因素[J].公共卫生与预防医学,2017,28(1):35-38.GAO Hongxia,ZHANG Hui,XU Juan,et al. Effect factors analysis on the treatment compliance of hypertension of rural aged[J]. Journal of Public Health and Preventive Medicine,2017,28(1):35-38.
[14]赵积存,雷秉海.贫困地区农村60岁以上老年高血压患者高危因素调查结果分析[J].中国老年学,2009,29(23):3133.
[15]Kessler RC,Andrews G,Colpe LJ,et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress[J]. Psychol Med,2002,32(6):959-976.
[16]Kessler RC,Barker PR,Colpe LJ,et al. Screening for serious mental illness in the general population[J]. Arch Gen Psychiatry,2003,60(2):184-189.
[17]Andrews G,Slade T. Interpreting scores on the Kessler psychological distress scale(K10)[J]. Aust N Z J Public Health,2001,25(6):494-497.
[18]徐凌忠,王建新,孙辉,等. Kessler10在我国的首次应用研究及其重要意义[J].卫生软科学,2005,19(6):410-412.
[19]周成超,何江江,徐凌忠,等. Kessler10量表在我国老年人心理健康测评中的初次应用[J].中国临床心理学杂志,2009,17(6):761-763.ZHOU Chengchao,HE Jiangjiang,XU Lingzhong,et al. First application of Kessler 10 scale to measuring mental health status of the aged in China[J]. Chinese Journal of Clinical Psychology,2009,17(6):761-763.
[20]程杨杨,徐凌忠,许敏兰,等.基于Kessler10量表的山东省农村肺结核病人心理健康状况研究[J].中国卫生统计,2015,32(2):301-303,306.
[21]马佳,李双飞,张燕.应用Kessler10量表对白领心理健康状况的调查研究[J].实用预防医学,2014,21(1):25-27.MA Jia,LI Shuangfei,ZHANG Yan. Survey on the mental health status of white collars based on scale of Kessler 10[J]. Practical Preventive Medicine,2014,21(1):25-27.
[22]丁燕,徐凌忠,王兴洲,等. Kessler10量表在农村居民心理健康状况中的评价研究[J].中国卫生事业管理,2009,26(9):632-633,641.DING Yan,XU Lingzhong,WANG Xingzhou,et al.Evaluating the mental health status of rural residents based on scale of Kessler 10[J]. Chinese Health Service Management,2009,26(9):632-633,641.
[23]黄伟,葛晓娇,侯赛,等.大别山区老年人日常生活活动能力及影响因素[J].中国公共卫生,2012,28(7):884-886.HUANG Wei,GE Xiaojiao,HOU Sai,et al. Ability of daily living and its influencing factors among rural elderly in Dabieshan mountain area[J]. China Journal Public Health,2012,28(7):884-886.
[24]王岩,魏薇,任玉茹,等.心理健康对高血压患病率的影响[J].医学信息,2016,29(1):343.
[25]刘靖.心理护理对首发高血压患者心理健康状况的影响[J].中华全科医学,2014,12(8):1335-1337.LIU Jing. Effects of psychological nursing on mental health of patients with first-episode hypertension[J].Chinese Journal of General Practice,2014,12(8):1335-1337.
[26]奉燕,薛志强,吴恒,等.社区老年高血压患者心理健康状况调查[J].中华全科医学,2009,7(3):289-291.FENG Yan,XUE Zhiqiang,WU Heng,et al. A survey of psychological health condition of aged hypertension patients in community[J]. Chinese Journal of General Practice,2009,7(3):289-291.
[27]周成超,楚洁,徐凌忠,等.农村空巢老年人健康自评状况及影响因素分析[J].中国公共卫生,2009,25(5):559-561.ZHOU Chengchao,CHU Jie,XU Lingzhong, et al.Self-perceived health status of empty-nest elderly people in rural Anhui[J]. Chinese Journal of Public Health,2009,25(5):559-561.
[28]赵秀秀,隋艾汝,廖唐洪,等.东营市农村居民健康状况综合评价[J].中国卫生统计,2013,30(1):40-41,45.
[29]徐子淇,王崇,刘日辉,等.吉林省成年人一般心理健康状况及其相关影响因素的调查分析[J].吉林大学学报(医学版),2013,39(6):1282-1287.XU Ziqi,WANG Chong,LIU Rihui,et al. Investigation on general mental health status and its influencing factors among adults in Jilin province[J]. Journal of Jilin University(Medicine Edition),2013,39(6):1282-1287.
[30]马跃,苏莹莹,杨光,等.长春市成年居民一般心理健康状况及其影响因素分析[J].中华疾病控制杂志,2016,20(7):663-666.MA Yue,SU Yingying,YANG Guang,et al. The general mental health status and analysis on its related factors in adults of Changchun city[J]. Chinese Journal of Disease Control&Prevention,2016,20(7):663-666.
[31]赵玉娜,陈长香,李淑杏,等.社区老年人经济收入与心理健康状况的相关性[J].河北医药,2014,36(18):2829-2831.
[32]林爱清.包头市老年人心理健康状况及其影响因素的研究[D].济南:山东大学,2008.
[2]郭杰,余灿清,吕筠,等.中国10个地区人群高血压患病率、知晓率、治疗率和控制情况分析[J].中华高血压杂志,2016,37(4):469-474.GUO Jie,YU Canqing,LüJun,et al. Status of prevalence,awareness,treatment and control on hypertension among adults in 10 regions,China[J]. Chinese Journal of Hypertension,2016,37(4):469-474.
[3] Lu J,Lu Y,Wang X,et al. Prevalence,awareness,treatment,and control of hypertension in China:data from 1. 7 million adults in a population-based screening study(China PEACE Million Persons Project)[J]. Lancet,2017,390(10112):2549-2558.
[4]王增武,武阳丰,赵连成,等.中国中年人群高血压患病率及知晓率、治疗率、控制率的演变趋势[J].中华流行病学杂志,2004,25(5):407-411.WANG Zengwu,WU Yangfeng,ZHAO Liancheng,et al. Trends in prevalence,awareness,treatment and control of hypertension in middle-aged Chinese population[J].Chinese Journal of Epidemiology,2004,25(5):407-411.
[5]钱岳晟,张怡,张瑾,等.上海市普陀区社区人群原发性高血压患病率、知晓率、治疗率和控制率的抽样调查[J].中华高血压杂志,2010,18(11):1059-1062.QIAN Yuesheng,ZHANG Yi,ZHANG Jin,et al. Sampling survey of prevalence,awareness,treatment and control rate of hypertension in community in Putuo District Shanghai[J]. Chinese Journal of Hypertension,2010,18(11):1059-1062.
[6]杨娉婷,林玲,袁洪.心理、行为因素与原发性高血压的关系[J].医学综述,2007,13(19):1485-1488.YANG Pingting,LIN Ling,YUAN Hong. The relationship between psychological or behavior factor and essential hypertension[J]. Medical Recapitulate,2007,13(19):1485-1488.
[7] Wassertheil-Smoller S,Applegate WB,Berge K,et al.Change in depression as a precursor of cardiovascular events. shep cooperative research group(systolic hypertension in the elderly)[J]. Arch Intern Med,1996,156(5):553-561.
[8]谢秀梅,余国龙,何劲,等.心理社会因素对老年人高血压疗效的影响[J].中华老年医学杂志,2003,22(7):4-6.XIE Xiumei,YU Guolong,HE Jin,et al. Influences of psycho-social factors in the treatment of the elderly patients with hypertension[J]. Chinese Journal of Geriatrics,2003,22(7):4-6.
[9]李秀娜,周玉杰.北京通州台湖地区65岁以上高血压老人心理健康现况及影响因素研究[J].首都医科大学学报,2018,39(1):112-119.LI Xiuna,ZHOU Yujie. Mental health status and its impact factors among hypertension patients over 65 years old in Taihu,Tongzhou,Beijing area:a cross-sectional study[J]. Journal of Capital Medical University,2018,39(1):112-119.
[10]王慧,张蕾蕾,隗冬艳,等.北京市空巢老年高血压患者心理健康状况及其影响因素[J].职业与健康,2018,34(1):60-66.WANG Hui, ZHANG Leilei, KUI Dongyan, et al.Mental health status and its influencing factors of empty nesters with hypertension in Beijing[J]. Occupation and Health,2018,34(1):60-66.
[11]李亚楠,张静,徐淑秀. 190例农村老年高血压患者治疗依从性影响因素的分析[J].中国护理管理,2015,15(3):304-308.LI Yanan,ZHANG Jing,XU Shuxiu. Analysis of influencing factors of the treatment compliance of the elderly hypertensive patients in the countryside[J]. Chinese Nursing Management,2015,15(3):304-308.
[12]张惠峰,沈月秀.社区干预对农村老年高血压患者服药依从性的影响[J].解放军护理杂志,2008,23(1):727-728.
[13]高红霞,张慧,徐娟,等.农村老年高血压患者治疗依从性的影响因素[J].公共卫生与预防医学,2017,28(1):35-38.GAO Hongxia,ZHANG Hui,XU Juan,et al. Effect factors analysis on the treatment compliance of hypertension of rural aged[J]. Journal of Public Health and Preventive Medicine,2017,28(1):35-38.
[14]赵积存,雷秉海.贫困地区农村60岁以上老年高血压患者高危因素调查结果分析[J].中国老年学,2009,29(23):3133.
[15]Kessler RC,Andrews G,Colpe LJ,et al. Short screening scales to monitor population prevalences and trends in non-specific psychological distress[J]. Psychol Med,2002,32(6):959-976.
[16]Kessler RC,Barker PR,Colpe LJ,et al. Screening for serious mental illness in the general population[J]. Arch Gen Psychiatry,2003,60(2):184-189.
[17]Andrews G,Slade T. Interpreting scores on the Kessler psychological distress scale(K10)[J]. Aust N Z J Public Health,2001,25(6):494-497.
[18]徐凌忠,王建新,孙辉,等. Kessler10在我国的首次应用研究及其重要意义[J].卫生软科学,2005,19(6):410-412.
[19]周成超,何江江,徐凌忠,等. Kessler10量表在我国老年人心理健康测评中的初次应用[J].中国临床心理学杂志,2009,17(6):761-763.ZHOU Chengchao,HE Jiangjiang,XU Lingzhong,et al. First application of Kessler 10 scale to measuring mental health status of the aged in China[J]. Chinese Journal of Clinical Psychology,2009,17(6):761-763.
[20]程杨杨,徐凌忠,许敏兰,等.基于Kessler10量表的山东省农村肺结核病人心理健康状况研究[J].中国卫生统计,2015,32(2):301-303,306.
[21]马佳,李双飞,张燕.应用Kessler10量表对白领心理健康状况的调查研究[J].实用预防医学,2014,21(1):25-27.MA Jia,LI Shuangfei,ZHANG Yan. Survey on the mental health status of white collars based on scale of Kessler 10[J]. Practical Preventive Medicine,2014,21(1):25-27.
[22]丁燕,徐凌忠,王兴洲,等. Kessler10量表在农村居民心理健康状况中的评价研究[J].中国卫生事业管理,2009,26(9):632-633,641.DING Yan,XU Lingzhong,WANG Xingzhou,et al.Evaluating the mental health status of rural residents based on scale of Kessler 10[J]. Chinese Health Service Management,2009,26(9):632-633,641.
[23]黄伟,葛晓娇,侯赛,等.大别山区老年人日常生活活动能力及影响因素[J].中国公共卫生,2012,28(7):884-886.HUANG Wei,GE Xiaojiao,HOU Sai,et al. Ability of daily living and its influencing factors among rural elderly in Dabieshan mountain area[J]. China Journal Public Health,2012,28(7):884-886.
[24]王岩,魏薇,任玉茹,等.心理健康对高血压患病率的影响[J].医学信息,2016,29(1):343.
[25]刘靖.心理护理对首发高血压患者心理健康状况的影响[J].中华全科医学,2014,12(8):1335-1337.LIU Jing. Effects of psychological nursing on mental health of patients with first-episode hypertension[J].Chinese Journal of General Practice,2014,12(8):1335-1337.
[26]奉燕,薛志强,吴恒,等.社区老年高血压患者心理健康状况调查[J].中华全科医学,2009,7(3):289-291.FENG Yan,XUE Zhiqiang,WU Heng,et al. A survey of psychological health condition of aged hypertension patients in community[J]. Chinese Journal of General Practice,2009,7(3):289-291.
[27]周成超,楚洁,徐凌忠,等.农村空巢老年人健康自评状况及影响因素分析[J].中国公共卫生,2009,25(5):559-561.ZHOU Chengchao,CHU Jie,XU Lingzhong, et al.Self-perceived health status of empty-nest elderly people in rural Anhui[J]. Chinese Journal of Public Health,2009,25(5):559-561.
[28]赵秀秀,隋艾汝,廖唐洪,等.东营市农村居民健康状况综合评价[J].中国卫生统计,2013,30(1):40-41,45.
[29]徐子淇,王崇,刘日辉,等.吉林省成年人一般心理健康状况及其相关影响因素的调查分析[J].吉林大学学报(医学版),2013,39(6):1282-1287.XU Ziqi,WANG Chong,LIU Rihui,et al. Investigation on general mental health status and its influencing factors among adults in Jilin province[J]. Journal of Jilin University(Medicine Edition),2013,39(6):1282-1287.
[30]马跃,苏莹莹,杨光,等.长春市成年居民一般心理健康状况及其影响因素分析[J].中华疾病控制杂志,2016,20(7):663-666.MA Yue,SU Yingying,YANG Guang,et al. The general mental health status and analysis on its related factors in adults of Changchun city[J]. Chinese Journal of Disease Control&Prevention,2016,20(7):663-666.
[31]赵玉娜,陈长香,李淑杏,等.社区老年人经济收入与心理健康状况的相关性[J].河北医药,2014,36(18):2829-2831.
[32]林爱清.包头市老年人心理健康状况及其影响因素的研究[D].济南:山东大学,2008.