慢性骨性疼痛患者焦虑与抑郁情况及影响因素
|
摘要
目的探讨慢性骨性疼痛人群焦虑和抑郁情绪的发生率及其影响因素,为治疗过程中提高慢性疼痛患者心理治疗服务提供参考依据。方法利用随机抽样法选取2016—2017年西北地区4所三甲医院751名慢性骨性疼痛患者,采用问卷调查方法进行调查并使用逐步回归方法进行影响因素分析。结果在751例慢性骨性疼痛患者中,焦虑不良反应的发生率为37.68%,抑郁不良反应的发生率为31.42%。慢性骨性疼痛患者焦虑状况与抑郁水平、病程时长、体重指数(BMI)、家庭关系和工具性日常生活能力(IADL)有关(均P<0.05);患者抑郁情况与焦虑水平、社交能力、疼痛强度、情绪控制能力有关(均P<0.05)。结论慢性骨性疼痛人群的焦虑和抑郁状况较为常见,且与多种因素有关,应引起疼痛临床的广泛关注,并根据影响因素提供针对性的心理治疗服务。
[Objective] To explore the morbidity and influencing factors of anxiety and depression in patients with chronic ostealgia,provide reference for improving the psychological care services of patients with chronic pain during treatment.[Methods]A random sampling method was used to select 751 patients with chronic ostealgia from four grade-A tertiary hospitals in Northwest China from 2016-2017. The questionnaire survey method was applied,and stepwise regression was used to analyze the influencing factors.[Results]In 751 patients with chronic ostealgia,the incidence of anxiety and depression was 37.68% and31.43%,respectively. The anxiety status in patients with chronic ostealgia was related to the depression level,duration of disease,body mass index(BMI),family relationship and instrumental daily living ability(IADL)(all P<0.05). The depression status was related to the anxiety level,ability of social contact,pain intensity and ability of emotional control(all P<0.05).[Conclusion]Anxiety and depression are common in people with chronic ostealgia,and related to many factors. It is necessary to pay close attention to this situation in pain clinic,and provide targeted psychotherapy services according to the influencing factors.
[Objective] To explore the morbidity and influencing factors of anxiety and depression in patients with chronic ostealgia,provide reference for improving the psychological care services of patients with chronic pain during treatment.[Methods]A random sampling method was used to select 751 patients with chronic ostealgia from four grade-A tertiary hospitals in Northwest China from 2016-2017. The questionnaire survey method was applied,and stepwise regression was used to analyze the influencing factors.[Results]In 751 patients with chronic ostealgia,the incidence of anxiety and depression was 37.68% and31.43%,respectively. The anxiety status in patients with chronic ostealgia was related to the depression level,duration of disease,body mass index(BMI),family relationship and instrumental daily living ability(IADL)(all P<0.05). The depression status was related to the anxiety level,ability of social contact,pain intensity and ability of emotional control(all P<0.05).[Conclusion]Anxiety and depression are common in people with chronic ostealgia,and related to many factors. It is necessary to pay close attention to this situation in pain clinic,and provide targeted psychotherapy services according to the influencing factors.
引文
[1]刘涵.医患关系紧张的心理成因探究---以急诊患者家属为例[J].医学与哲学(B),2013(1):65-66.
[2]欧红霞,舒京平,张莉丽.抑郁症与慢性疼痛共病情况及经济负担[J].中国心理卫生杂志,2009,23(10):706-709
[3]GALLAGHER RM,VERMA S,MOSSEY J.Chronic pain.Sources of late-life pain and risk factors for disability[J].Geriatrics,2000,55(9):40-44.
[4]张艳峰.日常生活能力量表在骨科住院患者中的应用[J].齐鲁护理杂志,2011,17(3):66-67.
[5]段泉泉,胜利.焦虑及抑郁自评量表的临床效度[J].中国心理卫生杂志,2012,26(9):676-679.
[6]LANGLEY GB,SHEPPEARD H.The visual analogue scale:Its use in pain measurement[J].Rheumatol Int,1985,5(4):145-8.
[7]胡强,万玉美,苏亮,等.中国普通人群焦虑障碍患病率的荟萃分析[J].中华精神科杂志,2013,46(4):204-211.
[8]CHEN R,COPELAND JR,WEI L.A meta-analysis of epidemiological studies in depression of older people in the People's Republic of China.[J].Int J Geriatr Psychiatry,1999,14(10):821-830.
[9]闻洁曦,邢国刚.慢性疼痛与抑郁关系的研究进展[J].中国疼痛医学杂志,2012,18(7):436-440.
[10]ASMUNDSON GJ.Anxiety and related factors in chronic pain[J].Pain Res Manag,2016,7(1):7-8.
[11]SHENGJ,LIUS,WANGY,etal.The Linkbetween Depression and Chronic Pain:Neural Mechanisms in the Brain[J].Neural Plast,2017,2017(4):1-10.[2018-08-30]https://www.ncbi.nlm.nih.gov/pubmed/DOI:10.1155/2017/9724371.
[12]ASMUNDSON GJ,KATZ J.Understanding the co-occurrence of anxiety disorders and chronic pain:state-of-the-art[J].Depress Anxiety,2009,26(10):888-901.
[13]赵学军,傅志俭,宋文阁,等.躯体疾病所致慢性疼痛患者焦虑和抑郁状况及其相关因素的研究[J].山东大学学报(医学版),2005,43(4):350-352.
[14]刘红兵,梁立双,汪蕾,等.慢性疼痛患者抑郁障碍及焦虑障碍的临床调查[J].山东大学学报(医学版),2003,41(5):587.
[15]蔡宏澜,段宝霖,王雅,等.慢性疼痛病人伴发焦虑、抑郁和躯体化症状的现况分析[J].中国疼痛医学杂志,2017,23(10):788-790.
[16]董文芳,陆建华.术后急性疼痛与慢性疼痛关系的研究进展[J].国际麻醉学与复苏杂志,2015,36(1):78-81.
[2]欧红霞,舒京平,张莉丽.抑郁症与慢性疼痛共病情况及经济负担[J].中国心理卫生杂志,2009,23(10):706-709
[3]GALLAGHER RM,VERMA S,MOSSEY J.Chronic pain.Sources of late-life pain and risk factors for disability[J].Geriatrics,2000,55(9):40-44.
[4]张艳峰.日常生活能力量表在骨科住院患者中的应用[J].齐鲁护理杂志,2011,17(3):66-67.
[5]段泉泉,胜利.焦虑及抑郁自评量表的临床效度[J].中国心理卫生杂志,2012,26(9):676-679.
[6]LANGLEY GB,SHEPPEARD H.The visual analogue scale:Its use in pain measurement[J].Rheumatol Int,1985,5(4):145-8.
[7]胡强,万玉美,苏亮,等.中国普通人群焦虑障碍患病率的荟萃分析[J].中华精神科杂志,2013,46(4):204-211.
[8]CHEN R,COPELAND JR,WEI L.A meta-analysis of epidemiological studies in depression of older people in the People's Republic of China.[J].Int J Geriatr Psychiatry,1999,14(10):821-830.
[9]闻洁曦,邢国刚.慢性疼痛与抑郁关系的研究进展[J].中国疼痛医学杂志,2012,18(7):436-440.
[10]ASMUNDSON GJ.Anxiety and related factors in chronic pain[J].Pain Res Manag,2016,7(1):7-8.
[11]SHENGJ,LIUS,WANGY,etal.The Linkbetween Depression and Chronic Pain:Neural Mechanisms in the Brain[J].Neural Plast,2017,2017(4):1-10.[2018-08-30]https://www.ncbi.nlm.nih.gov/pubmed/DOI:10.1155/2017/9724371.
[12]ASMUNDSON GJ,KATZ J.Understanding the co-occurrence of anxiety disorders and chronic pain:state-of-the-art[J].Depress Anxiety,2009,26(10):888-901.
[13]赵学军,傅志俭,宋文阁,等.躯体疾病所致慢性疼痛患者焦虑和抑郁状况及其相关因素的研究[J].山东大学学报(医学版),2005,43(4):350-352.
[14]刘红兵,梁立双,汪蕾,等.慢性疼痛患者抑郁障碍及焦虑障碍的临床调查[J].山东大学学报(医学版),2003,41(5):587.
[15]蔡宏澜,段宝霖,王雅,等.慢性疼痛病人伴发焦虑、抑郁和躯体化症状的现况分析[J].中国疼痛医学杂志,2017,23(10):788-790.
[16]董文芳,陆建华.术后急性疼痛与慢性疼痛关系的研究进展[J].国际麻醉学与复苏杂志,2015,36(1):78-81.