小榄镇肺结核患者心理健康状况调查及影响因素分析
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摘要
目的调查肺结核患者心理健康状况,并分析其影响因素,为肺结核患者心理治疗和健康宣教提供理论依据。方法以2016年6月至2017年6月收治的86例肺结核患者(肺结核组)和同期体检的30例健康志愿者(对照组)为研究对象,采用症状自评量表(SCL-90)对2组心理健康状况进行调查,采用单因素和多元回归Logistic分析法分析小榄镇肺结核患者心理健康状况的独立影响因素。结果肺结核组SCL-90评分中的人际敏感、抑郁、焦虑、偏执、精神病性症状、阳性项目数得分明显高于对照组(P<0.05),但2组躯体化、强迫、敌对性、恐怖得分差异无统计学意义(P>0.05);单因素和多元Logistic回归分析:经济收入低(OR=2.358,P=0.004,95%CI 1.012～3.462)、文化程度高(OR=2.410,P=0.004,95%CI 1.011～3.568)和痰菌阳性(OR=2.586,P=0.002,95%CI 1.021～4.120)是影响肺结核患者心理健康状况的独立危险因素(P<0.05)。结论小榄镇肺结核患者心理健康状况不容乐观,经济收入、文化程度和痰菌检查结果是其独立影响因素,临床应据此为肺结核患者实施合理干预措施。
Objective To investigate the mental health status of patients with pulmonary tuberculosis and analyze its influencing factors in order to provide theoretical basis for psychological treatment and health education for patients with pulmonary tuberculosis.Methods Eighty-six patients with pulmonary tuberculosis(PTB group) treated in Xiaolan Hospital from June 2016 to June 2017 and thirty healthy volunteers(control group) who underwent physical examination in the hospital during the same period were enrolled in the study. SCL90 was used to investigate the mental health status of both groups. Univariate and multivariate regression logistic analysis were used to analyze the independent influencing factors of the mental health status of the patients.Results The scores of interpersonal sensitivity, depression, anxiety, paranoid, psychotic symptoms and number of positive items in SCL-90 of the patients in PTB group were significantly higher than those of the control group(P<0.05), but there was no significant difference between the two groups in scores of somatization, compulsion, hostility and terror(P>0.05). Univariate and multivariate logistic regression analyses showed that low income(OR=2.358,P=0.004, 95%CI 1.012～3.462), high education level(OR=2.410,P<0.01, CI 1.011～3.568) and positive sputum smear(OR=2.586,P<0.01, CI 1.021～4.120) were independent risk factors affecting the mental health status of patients with PTB.Conclusion The mental health status of patients with PTB in Xiaolan Town is not optimistic, with income, education level and examination results of sputum smear as the independent influencing factors. Therefore, reasonable intervention measures should be taken accordingly.
Objective To investigate the mental health status of patients with pulmonary tuberculosis and analyze its influencing factors in order to provide theoretical basis for psychological treatment and health education for patients with pulmonary tuberculosis.Methods Eighty-six patients with pulmonary tuberculosis(PTB group) treated in Xiaolan Hospital from June 2016 to June 2017 and thirty healthy volunteers(control group) who underwent physical examination in the hospital during the same period were enrolled in the study. SCL90 was used to investigate the mental health status of both groups. Univariate and multivariate regression logistic analysis were used to analyze the independent influencing factors of the mental health status of the patients.Results The scores of interpersonal sensitivity, depression, anxiety, paranoid, psychotic symptoms and number of positive items in SCL-90 of the patients in PTB group were significantly higher than those of the control group(P<0.05), but there was no significant difference between the two groups in scores of somatization, compulsion, hostility and terror(P>0.05). Univariate and multivariate logistic regression analyses showed that low income(OR=2.358,P=0.004, 95%CI 1.012～3.462), high education level(OR=2.410,P<0.01, CI 1.011～3.568) and positive sputum smear(OR=2.586,P<0.01, CI 1.021～4.120) were independent risk factors affecting the mental health status of patients with PTB.Conclusion The mental health status of patients with PTB in Xiaolan Town is not optimistic, with income, education level and examination results of sputum smear as the independent influencing factors. Therefore, reasonable intervention measures should be taken accordingly.
引文
1 丁小芳.50例耐多药肺结核患者的护理干预.实用临床医药杂志,2015,19:147-148.
2 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.中国卫生统计,2015,32:301-303.
3 张琦,白亚文,刘钊,等.抗结核药物肝损害对老年肺结核患者血清TNF-α、CG及CA-199水平影响.实用临床医药杂志,2016,20:45-47.
4 闻天舒.健康教育对肺结核患者心理状态的影响.中国地方病防治杂志,2016,26:119.
5 马爱群主编.内科学.第1版.北京:人民卫生出版社,2001.57-70.
6 Louw J,Peltzer K,Naidoo P,et al.Quality of life among tuberculosis (TB),TB retreatment and/or TB-HIV co-infected primary public health care patients in three districts in South Africa.Health & Quality of Life Outcomes,2012,10:1-8.
7 陈曦,赵瑶,许琰,等.北京市肺结核患者抑郁和焦虑现况及其影响因素.中华医学杂志,2016,96:2749-2753.
8 石中全.黄芪注射液对耐药肺结核患者免疫功能的影响.辽宁中医杂志,2017,23:511-513.
9 魏萱,杨平,徐凌忠,等.初治肺结核患者心理健康状况及其影响因素分析.中国卫生统计,2015,32:194-196.
10 张克迅,李佩竹,彭凤玲,等.广州市海珠区流动人口肺结核患者心理健康状况分析.结核病与肺部健康杂志,2013,2:185-188.
11 谢菲.护理干预对肺结核患者的心理状态及生理质量的影响.吉林医学,2015,20:136-137.
12 刘关鹏,王昱,蔡立莉,等.肺结核患者全身健康状态调查.中国全科医学,2016,19:1333-1337.
13 王淑平,田艳茹,耿藏缺,等.耐药肺结核患者的心理行为特征及应对方式分析.河北医药,2015,37:3667-3669.
14 伍小英,谭守勇,罗少霞,等.广州市越秀区肺结核患者心理健康状况及影响因素分析.广东医学,2015,36:1249-1251.
15 World Health Organization.WHO Report:The global plan to stop TB 2011-2015.Geneva:WHO,2011.1-24.
16 Russell S.The economic burden of illness for households in develo-ping countries:A review of studies focusing on malaria,tuberculosisand human immunodeficiency virus/acquired immunodeficiency syndrome.Am J Trop Med Hyg,2004,71:147-155.
17 World Health Organization.WHO Report:2011 Global Tuberculo sis Control.Geneva:WHO,2011.1-27.
18 李雪,刘小秋,张慧,等.2001-2010年全国肺结核患者发现情况分析.中国防痨杂志,2014,36:592-595.
19 黄飞,王黎霞,成诗明,等.医防合作对提高肺结核患者发现的影响.中国防痨杂志,2010,32:361-365.
20 吕承菲,孙强,王黎霞,等.中国四个项目地区耐多药肺结核患者筛查率、检出率与发现及时性的比较.中国防痨杂志,2013,35:955-959.
2 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.中国卫生统计,2015,32:301-303.
3 张琦,白亚文,刘钊,等.抗结核药物肝损害对老年肺结核患者血清TNF-α、CG及CA-199水平影响.实用临床医药杂志,2016,20:45-47.
4 闻天舒.健康教育对肺结核患者心理状态的影响.中国地方病防治杂志,2016,26:119.
5 马爱群主编.内科学.第1版.北京:人民卫生出版社,2001.57-70.
6 Louw J,Peltzer K,Naidoo P,et al.Quality of life among tuberculosis (TB),TB retreatment and/or TB-HIV co-infected primary public health care patients in three districts in South Africa.Health & Quality of Life Outcomes,2012,10:1-8.
7 陈曦,赵瑶,许琰,等.北京市肺结核患者抑郁和焦虑现况及其影响因素.中华医学杂志,2016,96:2749-2753.
8 石中全.黄芪注射液对耐药肺结核患者免疫功能的影响.辽宁中医杂志,2017,23:511-513.
9 魏萱,杨平,徐凌忠,等.初治肺结核患者心理健康状况及其影响因素分析.中国卫生统计,2015,32:194-196.
10 张克迅,李佩竹,彭凤玲,等.广州市海珠区流动人口肺结核患者心理健康状况分析.结核病与肺部健康杂志,2013,2:185-188.
11 谢菲.护理干预对肺结核患者的心理状态及生理质量的影响.吉林医学,2015,20:136-137.
12 刘关鹏,王昱,蔡立莉,等.肺结核患者全身健康状态调查.中国全科医学,2016,19:1333-1337.
13 王淑平,田艳茹,耿藏缺,等.耐药肺结核患者的心理行为特征及应对方式分析.河北医药,2015,37:3667-3669.
14 伍小英,谭守勇,罗少霞,等.广州市越秀区肺结核患者心理健康状况及影响因素分析.广东医学,2015,36:1249-1251.
15 World Health Organization.WHO Report:The global plan to stop TB 2011-2015.Geneva:WHO,2011.1-24.
16 Russell S.The economic burden of illness for households in develo-ping countries:A review of studies focusing on malaria,tuberculosisand human immunodeficiency virus/acquired immunodeficiency syndrome.Am J Trop Med Hyg,2004,71:147-155.
17 World Health Organization.WHO Report:2011 Global Tuberculo sis Control.Geneva:WHO,2011.1-27.
18 李雪,刘小秋,张慧,等.2001-2010年全国肺结核患者发现情况分析.中国防痨杂志,2014,36:592-595.
19 黄飞,王黎霞,成诗明,等.医防合作对提高肺结核患者发现的影响.中国防痨杂志,2010,32:361-365.
20 吕承菲,孙强,王黎霞,等.中国四个项目地区耐多药肺结核患者筛查率、检出率与发现及时性的比较.中国防痨杂志,2013,35:955-959.