医院慢性阻塞性肺疾病患者焦虑抑郁发生情况及影响因素

发布时间：2018-04-13 22:21

本文选题：慢性阻塞性肺疾病 + 知觉压力　；参考：《山东大学》2016年硕士论文

【摘要】：目的调查住院COPD患者焦虑、抑郁情绪的发生情况,探讨其影响因素,尤其是知觉压力、情绪调节策略(情绪调节、反刍思维各成分)对COPD患者焦虑、抑郁的影响,为焦虑、抑郁症状的发生机制提供依据,以便更有效地对焦虑、抑郁症状进行预防和干预。方法选取山东省某三级甲等综合医院诊断为COPD的患者94名,用一般资料调查表、知觉压力量表(PSS-10)、反刍思维量表(RRS)、情绪调节问卷(ERQ)医院焦虑抑郁量表(HADS)分别收集患者的一般资料、知觉压力、反刍思维各维度、情绪调节、焦虑、抑郁的信息。其中HADS焦虑、抑郁得分分别≥9分认为患者存在焦虑、抑郁情绪。采用分层线性回归对COPD患者焦虑、抑郁的影响因素进行分析。结果1. COPD患者焦虑维度得分6.82±3.75,抑郁维度得分6.51±4.64,焦虑的阳性峙为27.7%,抑郁的阳性率为27.7%,焦虑合并抑郁的患者占18.1%。2.焦虑症状的影响因素(1)单因素方差分析结果表明：不同人口学特征间HADS焦虑得分差异均无统计学意义(均P0.05)。(2)单因素方差分析结果表明：因本病住院次数大于2次/年者焦虑得分显著高于2次/年(P=0.045)、1次/年(P=0.005),其余疾病特征间HADS焦虑得分差异无统计学意义(均P0.05)(3)分层线性回归结果显示：知觉压力、症状反刍对焦虑总分的标准化偏回归系数为0.414(P0.001)、0.512(P=0.001),能解释焦虑症状61.5%的方差变异。其余几个情绪调节策略对焦虑症状的影响不显著。3.抑郁症状的影响因素(1)单因素方差分析结果表明：年龄在71.5岁以上的患者HADS抑郁得分显著高于71.5岁以下患者(P=0.037),其余人口学特征间HADS抑郁得分差异无统计学意义(均P0.05)。(2)单因素方差分析结果表明：合并慢性病种类间HADS抑郁得分的差异接近统计学显著水平(P=0.052),其余疾病特征间HADS抑郁得分差异均无统计学意义(均P0.05)。(3)分层线性回归结果显示：知觉压力、症状反刍对抑郁总分的标准化偏回归系数为0.315(P=0.004)、0.480(P=0.013),能解释抑郁症状35.1%的方差变异。其余几个情绪调节策略对焦虑症状的影响不显著。结论1.住院COPD患者中焦虑、抑郁的阳性率较高,应引起医务人员的重视并针对相关因素制定相应的措施进行干预,改善COPD住院患者的心理状况。2.因COPD住院次数越多,越容易发生焦虑症状。3.年龄较大、合并慢性病是COPD患者抑郁症状的影响因素。4. COPD患者的知觉压力水平越高、症状反刍越严重,其焦虑、抑郁症状越严重。
[Abstract]:Objective to investigate the occurrence of anxiety and depression in patients with COPD, and to explore the influence factors of anxiety and depression in COPD patients, especially the influence of perceptual pressure, emotion regulation strategies (emotion regulation, ruminant thinking) on anxiety and depression in COPD patients.The mechanism of depressive symptoms provides evidence for more effective prevention and intervention of anxiety and depressive symptoms.Methods 94 patients diagnosed as COPD in a general hospital of Grade 3A in Shandong Province were collected by general information questionnaire, perceptual stress scale (PSS-10), ruminant thinking scale (RRS), emotion regulation questionnaire (EQ) hospital anxiety and depression scale (HADSs).Perceptual stress, ruminant thinking dimensions, emotional regulation, anxiety, depression information.The scores of HADS anxiety and depression were more than 9.The factors influencing anxiety and depression in patients with COPD were analyzed by stratified linear regression.Result 1.The scores of anxiety dimension and depression dimension in COPD patients were 6.82 卤3.75, 6.51 卤4.64, 27.7and 27.7g, respectively.The univariate ANOVA results showed that there was no significant difference in HADS anxiety scores among different demographic characteristics (all P0.05. 2) the univariate ANOVA results showed that: the number of hospitalizations due to the disease was more than 2 times.The scores of anxiety were significantly higher than that of twice a year (P 0.045 / year). There was no significant difference in HADS anxiety scores among the other disease features (all P 0.05 / year). The results of stratified linear regression showed that: perceptual pressure;The standardized partial regression coefficient of symptom ruminant to total anxiety score was 0.414% P 0.001 0. 512 P 0. 001g, which could explain 61.5% variance variation of anxiety symptoms.The effect of other emotion regulation strategies on anxiety symptoms was not significant. 3. 3.The results of univariate ANOVA showed that the scores of HADS depression in patients over 71.5 years old were significantly higher than those in patients under 71.5 years old (P < 71.5). There was no significant difference in HADS depression scores among other demographic features (P < 0.05).Analysis of variance of univariate analysis of variance showed that the difference of HADS depression scores among the types of chronic diseases was close to the statistically significant level (P0.052%), but there was no significant difference in HADS depression scores among other disease characteristics (all P0.05%. 3) hierarchical linear regression analysis.The results showed that: perceptual pressure,The standardized partial regression coefficient of symptom ruminant to the total score of depression was 0.315 P0. 004 and 0. 480 P0. 013, which could explain the variance variation of depressive symptom 35. 1%.Other emotion regulation strategies had no significant effect on anxiety symptoms.Conclusion 1.The positive rate of anxiety and depression in hospitalized patients with COPD is higher. The medical staff should pay attention to it and make corresponding intervention to improve the psychological status of COPD inpatients. 2.Because of COPD, the more times of hospitalization, the more likely to develop anxiety symptoms. 3. 3.Age and chronic disease are the influencing factors of depression in COPD patients. 4. 4.The higher the level of perceived stress, the more serious the symptoms of regurgitation, anxiety and depression in patients with COPD.
【学位授予单位】：山东大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R473.5

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