综合医院住院患者对自身常见心理问题的评价及其影响因素
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摘要
本研究主要针对综合医院非精神科住院患者对自身常见心理问题的评价及其影响因素进行调查分析。本研究选取1 329名非精神科住院患者作为调查对象,使其在规定指导语下完成患者健康抑郁症状群量表(depression scale of the patient health questionnaire, PHQ-9)、躯体症状群量表(somatic symptom scale of thepatient health questionnaire, PHQ-15)、广泛性焦虑量表(generalized anxiety disorder 7-item scale, GAD-7)、健康焦虑量表(whiteley-7 scale, WI-7)等自评量表,并回答封闭式问题"您认为自己目前存在心理或者情绪问题吗?"。根据上述两种对自身心理问题评价方式的结果是否一致将患者分为心理问题评价一致组和心理问题评价不一致组。调查得到如下结果:心理问题评价一致组人数占研究总人数的48.3%。通过单因素方差分析和二元Logistic回归分析结果得出,该综合医院非精神科男性住院患者及少数民族患者较女性患者及汉族患者更难意识到自身心理问题(B=-0.227, p=0.044; B=0.643, p=0.022)。本研究说明,加强普及大众心理健康教育,尤其是对非精神科住院患者(特别是男性和少数民族患者)的心理健康教育,使之能正确评价自身心理问题并寻求治疗,是非常有必要的。而非精神科医生则需要更多关注到男性患者和少数民族患者,早期识别并正确处理其心理问题,促进疾病恢复,提高患者满意度。
In this research, the ev aluation of common psychological problems and their influencing factors of non-psychiatric inpatients in general hospital were investigated and analyzed. 1 329 non-psychiatric inpatients were selected as subjects, make them complete depression scale of the Patient Health Questionnaire(PHQ-9), somatic symptom scale of the Patient Health Questionnaire(PHQ-15), Generalized Anxiety Disorder 7-item scale(GAD-7),Whiteley-7 scale(WI-7) and some other self-rating depression scales under the prescribed instructions, and answer the closed question"Do you think you have any psychological or emotional problems at the moment ?". The patients were divided into psychological problem evaluation consistency group and psychological problem evaluation inconsistency group according to whether the results of the above two evaluation methods on their own psychological problems were consistent or not. The following results were obtained: 48.3% of the total study participants were in the psychological problem evaluation consistency group. The results of single factor analysis of variance and binary Logistic regression analysis indicated that the non-psychiatric male inpatients and minority patients in the general hospital were more difficult to realize their psychological problems than female patients and Han patients(B=-0.227, p=0.044; B=0.643, p=0.022). The study suggested that strengthening and popularizing popular mental health education, particularly mental health education for non-psychiatric inpatients(especially male and minority patients) was very necessary for them to evaluate their psychological problems correctly and seek treatment. And non-psychiatric doctors need to pay more attention to male and minority patients, identify and deal with psychological problems early, promote disease recovery, and improve patient satisfaction.
In this research, the ev aluation of common psychological problems and their influencing factors of non-psychiatric inpatients in general hospital were investigated and analyzed. 1 329 non-psychiatric inpatients were selected as subjects, make them complete depression scale of the Patient Health Questionnaire(PHQ-9), somatic symptom scale of the Patient Health Questionnaire(PHQ-15), Generalized Anxiety Disorder 7-item scale(GAD-7),Whiteley-7 scale(WI-7) and some other self-rating depression scales under the prescribed instructions, and answer the closed question"Do you think you have any psychological or emotional problems at the moment ?". The patients were divided into psychological problem evaluation consistency group and psychological problem evaluation inconsistency group according to whether the results of the above two evaluation methods on their own psychological problems were consistent or not. The following results were obtained: 48.3% of the total study participants were in the psychological problem evaluation consistency group. The results of single factor analysis of variance and binary Logistic regression analysis indicated that the non-psychiatric male inpatients and minority patients in the general hospital were more difficult to realize their psychological problems than female patients and Han patients(B=-0.227, p=0.044; B=0.643, p=0.022). The study suggested that strengthening and popularizing popular mental health education, particularly mental health education for non-psychiatric inpatients(especially male and minority patients) was very necessary for them to evaluate their psychological problems correctly and seek treatment. And non-psychiatric doctors need to pay more attention to male and minority patients, identify and deal with psychological problems early, promote disease recovery, and improve patient satisfaction.
引文
Bener A.,Al-Kazaz M.,Ftouni D.,Al-Harthy M.,and Dafeeah E.E.,2013,Diag nostic overlap of depressive,anxiety,stress and somatoform disorders in primary care,Asia-Pac.Psychiatry,5(1):E29-E38
Clarke D.M.,Piterman L.,Byrne C.J.,and Austin D.W.,2008,Somatic symptoms,hypochondriasis and psychological distress:a study of somatisation in Australian general practice,Med.J.Aust.,189(10):560-564
Conradt M.,Cavanagh M.,Franklin J.,and Rief W.,2006,Dimensionality of the Whiteley Index:assessment of hypochondriasis in an Australian sample of primary care patients,J.Psychosom.Res.,60(2):137-143
Hansen M.S.,Fink P.,Frydenberg M.,de Jonge P.,and Huyse F.J.,2001,Complexity of care and mental illness in medical inpatients,Gen.Hosp.Psychiatry,23(6):319-325
He X.,Li C.,Qian J.,and Cui H.,2010,Reliability and validity of a generalized anxiety disorder scale in general hospital outpatients,Shanghai Arch.Psychiat.,22(4):200-203
Koh J.S.,Ko H.J.,Wang S.M.,Cho K.J.,Kim J.C.,Lee S.J.,and Pae C.U.,2014,Depression and somatic symptoms may influence on chronic prostatitis/chronic pelvic pain syndrome:a preliminary study,Psychiatry Investigation,11(4):495-498
Koh J.S.,Ko H.J.,Wang S.M.,Cho K.J.,Kim J.C.,Lee S.J.,and Pae C.U.,2014,The impact of depression and somatic symptoms on treatment outcomes in patients with chronic prostatitis/chronic pelvic pain syndrome:a preliminary study in a naturalistic treatment setting,Int.J.Clin.Pract.,68(4):478-485
Konnopka A.,Kaufmann C.,K觟nig H.H.,Heider D.,Wild B.,Szecsenyi J.,Herzog W.,Heinrich S.,and Schaefert R.,2013,Association of costs with somatic symptom severity in patients with medically unexplained symptoms,J.Psychosom.Res.,75(4):370-375
K觟rber S.,Frieser D.,Steinbrecher N.,and Hiller W.,2011,Classification characteristics of the Patient Health Questionnaire-15 for screening somatoform disorders in a primary care setting,J.Psychosom.Res.,71(3):142-147
Kroenke K.,Spitzer R.L.,and Williams J.B.,2002,The PHQ-15:validity of a new measure for evaluating the severity of somatic symptoms,Psychosom.Med.,64(2):258-266
Lee S.,Ma Y.L.,and Tsang A.,2011,Psychometric properties of the Chinese 15-item Patient Health Questionnaire in the general population of Hong Kong,J.Psychosom.Res.,71(2):69-73
Lee S.,Ng K.L.,Ma Y.L.,Tsang A.,and Kwok K.P.,2011,Ageneral population study of the Chinese Whiteley-7 Index in Hong Kong,J.Psychosom.Res.,71(6):387-391
Manea L.,Gilbody S.,and McMillan D.,2012,Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire(PHQ-9):a meta-analysis,Can.Med.Assoc.J.,184(3):E191-E196
Na Y.M.,Kim K.S.,Lee K.U.,Chae J.H.,Kim J.H.,Kim D.J.,Bahk W.M.,Jang Y.S.,Lee A.K.,Woo Y.S.,and Lee P.S.,2007,The relationship between depressive symptoms in outpatients with chronic illness and health care costs,Yonsei Med.J.,48(5):787-794
Phillips M.R.,Zhang J.,Shi Q.,Song Z.,Ding Z.,Pang S.,Li X.,Zhang Y.,and Wang Z.,2009,Prevalence,treatment,and associated disability of mental disorders in four provinces in China during 2001~2005:an epidemiological survey,Lancet.,373(9680):2041-2053
Polidoro Lima M.,and Osório F.L.,2014,Indicators of psychiatric disorders in different oncology specialties:a prevalence study,J.Oncol.,2014:350262
Qin X.,Phillips M.R.,Wang W.,Li Y.,Jin Q.,Ai L.,Wei S.,Dong G.,and Liu L.,2010,Prevalence and rates of recognition of anxiety disorders in internal medicine outpatient department of 23 general hospitals in Shenyang,China,Gen.Hosp.Psychiat.,32(2):192-200
Qin X.,Wang W.,Jin Q.,Ai L.,Li Y.,Dong G.,Liu L.,and Phillips M.R.,2008,Prevalence and rates of recognition of depressive disorders in internal medicine outpatient department of 23 general hospitals in Shenyang,China,J.Affect.Disord.,110(1-2):46-54
Spitzer R.L.,Kroenke K.,Williams J.B.,and L觟we B.,2006,Abrief measure for assessing generalized anxiety disorder:the GAD-7,Arch.Intern.Med.,166(10):1092-1097
Toft T.,Fink P.,Oernboel E.,Christensen K.,Frostholm L.,and Olesen F.,2005,Mental disorders in primary care:prevalence and co-morbidity among disorders,results from the functional illness in primary care(FIP)study,Psychol.Med.,35(8):1175-1184
Zhong B.L.,Chen H.H.,Zhang J.F.,Xu H.M.,Zhou C.,Yang F.,Song J.,Tang J.,Xu Y.,Zhang S.,Zhang Y.,and Zhou L.,2010,Prevalence,correlates and recognition of depression among inpatients of general hospitals in Wuhan,China,Gen.Hosp.Psychiat.,32(3):268-275
Zhu C.,Ou L.,Geng Q.,Zhang M.,Ye R.,Chen J.,and Jiang W.,2012,Association of somatic symptoms with depression and anxiety in clinical patients of general hospital in Guangzhou,China,Gen.Hosp.Psychiatry,34(2):113-120
Clarke D.M.,Piterman L.,Byrne C.J.,and Austin D.W.,2008,Somatic symptoms,hypochondriasis and psychological distress:a study of somatisation in Australian general practice,Med.J.Aust.,189(10):560-564
Conradt M.,Cavanagh M.,Franklin J.,and Rief W.,2006,Dimensionality of the Whiteley Index:assessment of hypochondriasis in an Australian sample of primary care patients,J.Psychosom.Res.,60(2):137-143
Hansen M.S.,Fink P.,Frydenberg M.,de Jonge P.,and Huyse F.J.,2001,Complexity of care and mental illness in medical inpatients,Gen.Hosp.Psychiatry,23(6):319-325
He X.,Li C.,Qian J.,and Cui H.,2010,Reliability and validity of a generalized anxiety disorder scale in general hospital outpatients,Shanghai Arch.Psychiat.,22(4):200-203
Koh J.S.,Ko H.J.,Wang S.M.,Cho K.J.,Kim J.C.,Lee S.J.,and Pae C.U.,2014,Depression and somatic symptoms may influence on chronic prostatitis/chronic pelvic pain syndrome:a preliminary study,Psychiatry Investigation,11(4):495-498
Koh J.S.,Ko H.J.,Wang S.M.,Cho K.J.,Kim J.C.,Lee S.J.,and Pae C.U.,2014,The impact of depression and somatic symptoms on treatment outcomes in patients with chronic prostatitis/chronic pelvic pain syndrome:a preliminary study in a naturalistic treatment setting,Int.J.Clin.Pract.,68(4):478-485
Konnopka A.,Kaufmann C.,K觟nig H.H.,Heider D.,Wild B.,Szecsenyi J.,Herzog W.,Heinrich S.,and Schaefert R.,2013,Association of costs with somatic symptom severity in patients with medically unexplained symptoms,J.Psychosom.Res.,75(4):370-375
K觟rber S.,Frieser D.,Steinbrecher N.,and Hiller W.,2011,Classification characteristics of the Patient Health Questionnaire-15 for screening somatoform disorders in a primary care setting,J.Psychosom.Res.,71(3):142-147
Kroenke K.,Spitzer R.L.,and Williams J.B.,2002,The PHQ-15:validity of a new measure for evaluating the severity of somatic symptoms,Psychosom.Med.,64(2):258-266
Lee S.,Ma Y.L.,and Tsang A.,2011,Psychometric properties of the Chinese 15-item Patient Health Questionnaire in the general population of Hong Kong,J.Psychosom.Res.,71(2):69-73
Lee S.,Ng K.L.,Ma Y.L.,Tsang A.,and Kwok K.P.,2011,Ageneral population study of the Chinese Whiteley-7 Index in Hong Kong,J.Psychosom.Res.,71(6):387-391
Manea L.,Gilbody S.,and McMillan D.,2012,Optimal cut-off score for diagnosing depression with the Patient Health Questionnaire(PHQ-9):a meta-analysis,Can.Med.Assoc.J.,184(3):E191-E196
Na Y.M.,Kim K.S.,Lee K.U.,Chae J.H.,Kim J.H.,Kim D.J.,Bahk W.M.,Jang Y.S.,Lee A.K.,Woo Y.S.,and Lee P.S.,2007,The relationship between depressive symptoms in outpatients with chronic illness and health care costs,Yonsei Med.J.,48(5):787-794
Phillips M.R.,Zhang J.,Shi Q.,Song Z.,Ding Z.,Pang S.,Li X.,Zhang Y.,and Wang Z.,2009,Prevalence,treatment,and associated disability of mental disorders in four provinces in China during 2001~2005:an epidemiological survey,Lancet.,373(9680):2041-2053
Polidoro Lima M.,and Osório F.L.,2014,Indicators of psychiatric disorders in different oncology specialties:a prevalence study,J.Oncol.,2014:350262
Qin X.,Phillips M.R.,Wang W.,Li Y.,Jin Q.,Ai L.,Wei S.,Dong G.,and Liu L.,2010,Prevalence and rates of recognition of anxiety disorders in internal medicine outpatient department of 23 general hospitals in Shenyang,China,Gen.Hosp.Psychiat.,32(2):192-200
Qin X.,Wang W.,Jin Q.,Ai L.,Li Y.,Dong G.,Liu L.,and Phillips M.R.,2008,Prevalence and rates of recognition of depressive disorders in internal medicine outpatient department of 23 general hospitals in Shenyang,China,J.Affect.Disord.,110(1-2):46-54
Spitzer R.L.,Kroenke K.,Williams J.B.,and L觟we B.,2006,Abrief measure for assessing generalized anxiety disorder:the GAD-7,Arch.Intern.Med.,166(10):1092-1097
Toft T.,Fink P.,Oernboel E.,Christensen K.,Frostholm L.,and Olesen F.,2005,Mental disorders in primary care:prevalence and co-morbidity among disorders,results from the functional illness in primary care(FIP)study,Psychol.Med.,35(8):1175-1184
Zhong B.L.,Chen H.H.,Zhang J.F.,Xu H.M.,Zhou C.,Yang F.,Song J.,Tang J.,Xu Y.,Zhang S.,Zhang Y.,and Zhou L.,2010,Prevalence,correlates and recognition of depression among inpatients of general hospitals in Wuhan,China,Gen.Hosp.Psychiat.,32(3):268-275
Zhu C.,Ou L.,Geng Q.,Zhang M.,Ye R.,Chen J.,and Jiang W.,2012,Association of somatic symptoms with depression and anxiety in clinical patients of general hospital in Guangzhou,China,Gen.Hosp.Psychiatry,34(2):113-120