太原市养老机构老年人述情障碍现状及影响因素分析
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摘要
目的探讨太原市养老机构老年人的述情障碍状况并分析其影响因素。方法采用便利抽样法,选取216名居住于太原市6所养老机构的老年人为研究对象,应用一般资料调查表、多伦多述情障碍量表和Barthel指数评定量表进行调查。结果调查对象述情障碍的发生率为31.01%,总分为(57.03±5.51)分,主要表现为外向型思维和识别情感障碍。多元线性回归结果显示,养老机构老年人的年龄、文化程度、患病种类、日常活动能力、参加集体活动频率和亲友探望频率是影响其发生述情障碍的主要因素(P<0.05)。结论养老机构老年人述情障碍的发生率较高且程度较为严重,护理人员应基于对患者的综合评估,从患者、疾病和社会支持角度,以提高患者的情感认知能力、疾病管理能力和社会适应能力为目的,实施述情障碍的干预措施。
Objective To investigate the level and influencing factors of alexithymia among institutionalized older people in Taiyuan. Methods Using convenience sampling method,totally 216 elderly residents from 6 nursing homes in Taiyuan were investigated with general information questionnaire,Toronto Alexithymia Scale(TAS-20) and Barthel Index Scale(BI). Results The score of TAS-20 was 57.03±5.51,and 31.01% of institutionalized older people reported alexithymia. Multiple logistic regression showed that age,educational level,multi-morbidity,ADL,frequency of participation in group activities and number of friends and relatives visits were major influencing factors(P<0.05). Conclusion The prevalence of alexithymia is high among institutionalized older people and the situation is severe. Nurses should conduct interventions for alexithymia according to results of comprehensive assessment,focusing on patients,disease and social support,with the goals of improving patients' emotional cognitive ability,disease management ability and social adaptability.
Objective To investigate the level and influencing factors of alexithymia among institutionalized older people in Taiyuan. Methods Using convenience sampling method,totally 216 elderly residents from 6 nursing homes in Taiyuan were investigated with general information questionnaire,Toronto Alexithymia Scale(TAS-20) and Barthel Index Scale(BI). Results The score of TAS-20 was 57.03±5.51,and 31.01% of institutionalized older people reported alexithymia. Multiple logistic regression showed that age,educational level,multi-morbidity,ADL,frequency of participation in group activities and number of friends and relatives visits were major influencing factors(P<0.05). Conclusion The prevalence of alexithymia is high among institutionalized older people and the situation is severe. Nurses should conduct interventions for alexithymia according to results of comprehensive assessment,focusing on patients,disease and social support,with the goals of improving patients' emotional cognitive ability,disease management ability and social adaptability.
引文
[1]王静,王君俏,曹育玲,等.上海市养老机构老年人生活体验的质性研究[J].中华护理杂志,2014,49(1):11-15.
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[3]Santorelli GD,Ready RE.Alexithymia and executive function in younger and older adults[J].Clin Neuropsychol,2015,29(7):938-955.
[4]Mattila AK,Salminen JK,Nummi T,et al.Age is strongly associated with alexithymia in the general population[J].J Psychosom Res,2006,61(5):629-635.
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[7]徐凤麟,吴红霞,孙建萍,等.中国述情障碍护理研究的文献计量学分析[J].中华现代护理杂志,2017,23(14):1903-1907.
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[12]Luca A,Luca M,Di Mauro M,et al.Alexithymia,more than depression,influences glycaemic control of type 2 diabetic patients[J].J Endocrinol Invest,2015,38(6):653-660.
[13]Dressaire D,Stone CB,Nielson KA,et al.Alexithymia impairs the cognitive control of negative material while facilitating the recall of neutral material in both younger and older adults[J].Cogn Emot,2015,29(3):442-459.
[14]Dere J,Tang Q,Zhu X,et al.The cultural shaping of alexithymia:Values and externally oriented thinking in a Chinese clinical sample[J].Compr Psychiatry,2013,54(4):362-368.
[15]Hiirola A,Pirkola S,Karukivi M,et al.An evaluation of the absolute and relative stability of alexithymia over 11 years in a Finnish general population[J].J Psychosom Res,2017,95:81-87.
[16]Mier D,Lis S,Zygrodnik K,et al.Evidence for altered amygdala activation in schizophrenia in an adaptive emotion recognition task[J].Psychiatry Res,2014,221(3):195-203.
[17]Kojima M,Kojima T,Suzuki S,et al.Alexithymia,depression,inflammation,and pain in patients with rheumatoid arthritis[J].Arthritis Care Res(Hoboken),2014,66(5):679-686.
[18]肖慧欣,林诗竹,林祺,等.不同养老形式的老年人日常生活能力比较[J].中国老年学杂志,2017,37(4):999-1000.
[19]侯红,范亚蓓,吴玉霞,等.康复机器人辅助训练对偏瘫患者上肢功能及日常生活活动能力的影响[J].中国康复医学杂志,2015,30(10):1013-1016.
[20]朱美红,王晶,顾旭东,等.视觉反馈训练对脑卒中患者日常生活活动能力的影响[J].中华护理杂志,2015,50(5):577-581.
[21]Rebok GW,Ball K,Guey LT,et al.Ten-year effects of the advanced cognitive training for independent and vital elderly cognitive training trial on cognition and everyday functioning in older adults[J].J Am Geriatr Soc,2014,62(1):16-24.
[22]Baiardini I,AbbàS,Ballauri M,et al.Alexithymia and chronic diseases:the state of the art[J].G Ital Med Lav Erg,2011,33(1):A47-A52.
[23]陈美婷.“慢”漫长路遇见人生的转折:罹患慢性疾病老年人参与志愿者服务经验之初探[D].花莲:慈济大学,2015.
[24]郝学敏.心理健康课程和绘画辅导对女性戒毒人员述情障碍干预效果的比较[D].太原:山西医科大学,2016.
[25]柳广.社会工作介入民办养老机构的服务的研究[D].武汉:华中科技大学,2015.
[26]陈瑞云,张希,戴付敏,等.郑州市养老机构老年人关怀需求现状及影响因素研究[J].中华护理杂志,2017,52(7):867-873.
[2]Sifneos PE.The prevalence of‘alexithymic’characteristics in psychosomatic patients[J].Psychother Psychosom,1973,22(2):255-262.
[3]Santorelli GD,Ready RE.Alexithymia and executive function in younger and older adults[J].Clin Neuropsychol,2015,29(7):938-955.
[4]Mattila AK,Salminen JK,Nummi T,et al.Age is strongly associated with alexithymia in the general population[J].J Psychosom Res,2006,61(5):629-635.
[5]Terock J,Janowitz D,Spitzer C,et al.Alexithymia and self-directedness as predictors of psychopathology and psychotherapeutic treatment outcome[J].Compr Psychiatry,2015,62:34-41.
[6]张瑞星,李国荣,史诺.老年躯体形式障碍患者述情障碍特征[J].中国老年学杂志,2015,35(16):4660-4661.
[7]徐凤麟,吴红霞,孙建萍,等.中国述情障碍护理研究的文献计量学分析[J].中华现代护理杂志,2017,23(14):1903-1907.
[8]李康,贺佳.医学统计学[M].6版.北京:人民卫生出版社,2013:120-121.
[9]Bagby RM,Taylor GJ,Parker JD.The twenty-item Toronto Alexithymia Scale—II.Convergent,discriminant,and concurrent validity[J].J Psychosom Res,1994,38(1):33-40.
[10]蚁金瑶,姚树桥,朱熊兆.TAS-20中文版的信度、效度分析[J].中国心理卫生杂志,2003(11):763-767.
[11]张明园.精神科评定量表手册[M].长沙:湖南科学技术出版社,1998:166-168.
[12]Luca A,Luca M,Di Mauro M,et al.Alexithymia,more than depression,influences glycaemic control of type 2 diabetic patients[J].J Endocrinol Invest,2015,38(6):653-660.
[13]Dressaire D,Stone CB,Nielson KA,et al.Alexithymia impairs the cognitive control of negative material while facilitating the recall of neutral material in both younger and older adults[J].Cogn Emot,2015,29(3):442-459.
[14]Dere J,Tang Q,Zhu X,et al.The cultural shaping of alexithymia:Values and externally oriented thinking in a Chinese clinical sample[J].Compr Psychiatry,2013,54(4):362-368.
[15]Hiirola A,Pirkola S,Karukivi M,et al.An evaluation of the absolute and relative stability of alexithymia over 11 years in a Finnish general population[J].J Psychosom Res,2017,95:81-87.
[16]Mier D,Lis S,Zygrodnik K,et al.Evidence for altered amygdala activation in schizophrenia in an adaptive emotion recognition task[J].Psychiatry Res,2014,221(3):195-203.
[17]Kojima M,Kojima T,Suzuki S,et al.Alexithymia,depression,inflammation,and pain in patients with rheumatoid arthritis[J].Arthritis Care Res(Hoboken),2014,66(5):679-686.
[18]肖慧欣,林诗竹,林祺,等.不同养老形式的老年人日常生活能力比较[J].中国老年学杂志,2017,37(4):999-1000.
[19]侯红,范亚蓓,吴玉霞,等.康复机器人辅助训练对偏瘫患者上肢功能及日常生活活动能力的影响[J].中国康复医学杂志,2015,30(10):1013-1016.
[20]朱美红,王晶,顾旭东,等.视觉反馈训练对脑卒中患者日常生活活动能力的影响[J].中华护理杂志,2015,50(5):577-581.
[21]Rebok GW,Ball K,Guey LT,et al.Ten-year effects of the advanced cognitive training for independent and vital elderly cognitive training trial on cognition and everyday functioning in older adults[J].J Am Geriatr Soc,2014,62(1):16-24.
[22]Baiardini I,AbbàS,Ballauri M,et al.Alexithymia and chronic diseases:the state of the art[J].G Ital Med Lav Erg,2011,33(1):A47-A52.
[23]陈美婷.“慢”漫长路遇见人生的转折:罹患慢性疾病老年人参与志愿者服务经验之初探[D].花莲:慈济大学,2015.
[24]郝学敏.心理健康课程和绘画辅导对女性戒毒人员述情障碍干预效果的比较[D].太原:山西医科大学,2016.
[25]柳广.社会工作介入民办养老机构的服务的研究[D].武汉:华中科技大学,2015.
[26]陈瑞云,张希,戴付敏,等.郑州市养老机构老年人关怀需求现状及影响因素研究[J].中华护理杂志,2017,52(7):867-873.