心境障碍患者家属的焦虑情绪状况及影响因素研究
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摘要
背景心境障碍的患病人数不断增加,与其有着紧密联系的家属承受着物质和精神的双重压力,极易产生焦虑、压抑等负面情绪。目的调查心境障碍患者家属的焦虑情绪状况,并分析影响因素。方法以南昌大学第一附属医院心身医学科就诊的患者家属作为调查对象,调查时间为2016年11月—2017年10月,采用方便抽样法抽取研究对象128例。采用焦虑自评量表(SAS)、简易应对方式量表(SCSQ)、家庭关怀度指数量表(APGAR)及自编一般情况问卷对家属进行调查。结果心境障碍患者家属中有56.2%(72/128)存在不同程度的焦虑情绪,家属的焦虑自评量表均分为(56.00±11.47)分。不同性别、治疗地点、居住地、受教育程度、医疗费用支付方式、家庭关怀度、应对方式的患者家属焦虑情绪发生率比较,差异有统计学意义(P<0.05);疾病类型、与患者的关系不同的患者家属焦虑情绪发生率比较,差异无统计学意义(P>0.05)。多因素Logistic回归分析结果显示,男性、采取积极应对方式是心境障碍患者家属焦虑情绪的保护因素,受教育程度低、医疗费用完全自费、家庭功能严重障碍是心境障碍患者家属出现焦虑情绪的危险因素(P<0.05)。结论超过一半的心境障碍患者家属存在焦虑情绪,男性、采取积极应对方式是其发生的保护因素,受教育程度低、医疗费用完全自费、家庭功能严重障碍是其发生的危险因素。
Background The number of people with mood disorders is increasing.Family member who are closely related to them are subject to both material and mental pressures and are prone to negative emotions such as anxiety,depression and so on.Objective To investigate the anxiety status of family members of patients with mood disorders and analyze its influencing factors.Methods We conducted a questionnaire survey from November 2016 to October 2017.Participants were 128 cases selected from the family members of the mood disorders patients from Department of Psychosomatic Medicine,the First Affiliated Hospital of Nanchang University by convenience sampling.We used the Zung Self-Rating Anxiety Scale(SAS),Simplified Coping Style Scale(SCSQ),family APGAR index,and self-made General Information Questionnaire to collect the corresponding data.Results 56.2%(72/128) of the family members of patients had different degrees of anxiety,with an average score of SAS of(56.00±11.47).The level of anxiety differed significantly in them by sex,place of residence,education level,medical treatment form and expense payment form of the patient,family APGAR index,family care and coping style(P<0.05),but not by the type of mood disorder suffered by the patient,and their relationship with the patient(P>0.05).Multivariate Logistic regression analysis showed that male and positive coping styles were associated with decreased risk of anxiety in family members of the patients,while low education level,paying out-of-pocket for medical care, and very low family APGAR index were associated with increased risk of anxiety in them(P<0.05).Conclusion More than half of thefamily members of patients with mood disorders have anxiety.Male and positive coping style are protective factors of anxiety,low education level,whereas paying out-of-pocket for medical care, and very low family APGAR index are its risk factors.
Background The number of people with mood disorders is increasing.Family member who are closely related to them are subject to both material and mental pressures and are prone to negative emotions such as anxiety,depression and so on.Objective To investigate the anxiety status of family members of patients with mood disorders and analyze its influencing factors.Methods We conducted a questionnaire survey from November 2016 to October 2017.Participants were 128 cases selected from the family members of the mood disorders patients from Department of Psychosomatic Medicine,the First Affiliated Hospital of Nanchang University by convenience sampling.We used the Zung Self-Rating Anxiety Scale(SAS),Simplified Coping Style Scale(SCSQ),family APGAR index,and self-made General Information Questionnaire to collect the corresponding data.Results 56.2%(72/128) of the family members of patients had different degrees of anxiety,with an average score of SAS of(56.00±11.47).The level of anxiety differed significantly in them by sex,place of residence,education level,medical treatment form and expense payment form of the patient,family APGAR index,family care and coping style(P<0.05),but not by the type of mood disorder suffered by the patient,and their relationship with the patient(P>0.05).Multivariate Logistic regression analysis showed that male and positive coping styles were associated with decreased risk of anxiety in family members of the patients,while low education level,paying out-of-pocket for medical care, and very low family APGAR index were associated with increased risk of anxiety in them(P<0.05).Conclusion More than half of thefamily members of patients with mood disorders have anxiety.Male and positive coping style are protective factors of anxiety,low education level,whereas paying out-of-pocket for medical care, and very low family APGAR index are its risk factors.
引文
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[11]董香丽,孙伟铭,袁也丰.躯体化障碍患者家属焦虑情绪及影响因素分析[J].现代预防医学,2016,43(7):1253-1256.DONG X L,SUN W M,YUAN Y F.Anxious condition and influential factors of the family members of patient with somatoform disorde[J].Modern Preventive Medicine,2016,43(7):1253-1256.
[12]冯辉,陈玉明,庄晓伟,等.精神分裂症患者家属心理健康状况与应对方式的相关性[J].中国康复理论与实践,2016,22(8):968-972.DOI:10.3969/j.issn.1006-9771.2016.08.018.FENG H,CHEN Y M,ZHUANG X W,et al.Correlation between mental health and coping style of family members of patients with schizophrenia[J].Chinese Journal of Rehabilitation Theory and Practice,2016,22(8):968-972.DOI:10.3969/j.issn.1006-9771.2016.08.018.
[2]杨海晨.心境障碍患者轻躁狂症状的临床与静息态脑功能磁共振研究[D].长沙:中南大学,2013.YANG H C.The clinical and resting-state brain fMRI study about the hypomanic symptoms of the patients with mood disorders[D].Changsha:Central South University,2013.
[3]David H. Barlow.心理障碍临床手册[M].3版.刘兴华,译.北京:中国轻工业出版社,2004:287-354.BRALOW D H.Clinical handbook of psychological disorders[M].3rd ed.LIU X H,translator.Beijing:China Light Industry Press,2004:287-354.
[4]WEISSMAN M M,BLAND R C,CANINO G J,et al.Crossnational epidemiology of major depression and bipolar disorder[J].Journal of the American Medical Association,2015,276(4):293-299.
[5]ZAHRA G,FATEME D,MOHSEN Y.The effect of group psychoeducational program on quality of life in families of patients with mood disorders[J].Iranian Journal of Nursing&Midwifery Research,2014,19(1):50-55.
[6]张明园.精神科评定量表手册[M].长沙:湖南科学技术出版社,1993:73.ZHANG M Y.Handbook of psychiatric assessment scale[M].Changsha:Hunan Science and Technology Press,1993:73.
[7]汪向东.心理卫生评定量表手册(增订版)[M].北京:中国心理卫生杂志出版社,1992:122.WANG X D.Manual of mental health assessment scale(enlarged edition)[M].Beijing:Chinese Mental Health Journal Press,1992:122.
[8]张作记.行为医学量表手册[M].北京:中华医学电子音像出版社,2005:156.ZHANG Z J.Manual of behavioral medicine scale[M].Beijing:China Medical Electronics Audiovisual Publishing House,2005:156.
[9]徐飒,张奕琳,单岩,等.血液透析患者家庭关怀度与自我管理行为的关系[J].广东医学,2016,37(17):2642-2645.DOI:10.13820/j.cnki.gdyx.2016.17.025.XU S,ZHANG Y L,SHAN Y,et al.Relationship between family care and self-management behaviors in hemodialysis patients[J].Guangdong Medical Journal,2016,37(17):2642-2645.DOI:10.13820/j.cnki.gdyx.2016.17.025.
[10]文莎丽,张静平.直肠癌结肠造口患者家属焦虑、抑郁状况及其影响因素研究[J].中国全科医学,2013,16(19):2290-2292.DOI:10.3969/j.issn.1007-9572.2013.07.030.WEN S L,ZHANG J P.Anxiety and depression and the related influential factors in family members of colorectal cancer patients with stoma[J].Chinese General Practice,2013,16(19):2290-2292.DOI:10.3969/j.issn.1007-9572.2013.07.030.
[11]董香丽,孙伟铭,袁也丰.躯体化障碍患者家属焦虑情绪及影响因素分析[J].现代预防医学,2016,43(7):1253-1256.DONG X L,SUN W M,YUAN Y F.Anxious condition and influential factors of the family members of patient with somatoform disorde[J].Modern Preventive Medicine,2016,43(7):1253-1256.
[12]冯辉,陈玉明,庄晓伟,等.精神分裂症患者家属心理健康状况与应对方式的相关性[J].中国康复理论与实践,2016,22(8):968-972.DOI:10.3969/j.issn.1006-9771.2016.08.018.FENG H,CHEN Y M,ZHUANG X W,et al.Correlation between mental health and coping style of family members of patients with schizophrenia[J].Chinese Journal of Rehabilitation Theory and Practice,2016,22(8):968-972.DOI:10.3969/j.issn.1006-9771.2016.08.018.