艾滋病自愿咨询检测（VCT）门诊求诊者心理健康状况调查

发布时间：2018-03-22 00:22

本文选题：艾滋病　切入点：VCT　出处：《中国疾病预防控制中心》2014年硕士论文　论文类型：学位论文

【摘要】：研究背景心理问题与HIV/AIDS存在相互关系,前者可导致高危行为,病毒和机会性感染会损害中枢神经系统,感染本身、抗病毒治疗负作用、社会歧视和侮辱又可引起心理问题。因此,为易感者和HIV感染者/患者(People Living with HIV/AIDS,PLWHA)提供心理干预是预防高危行为,防止HIV传播的重要措施之一。艾滋病自愿咨询检测(Voluntary Counselling and Testing, VCT)门诊是发现易感人群和PLWHA的有效途径,也是求诊者得到心理干预的重要场所,只有充分了解VCT门诊求诊者心理状况,才能制定相应政策和提供有针对性的心理干预服务。研究目的了解北京市某疾控中心VCT门诊求诊者心理状况,探讨求诊者心理健康的影响因素,为提高求诊者心理健康水平,降低感染传播HIV的风险提供科学依据。研究方法本研究为横断面调查,研究对象为2012年9月2013年6月前来北京市某疾控中心VCT门诊进行咨询检测的所有求诊者。采用症状自评量表SCL-90、艾森克人格问卷(EPQ)和社会支持评定量表对所有求诊者进行测评,测评采用匿名的方式,调查数据采用SPSS19.0和Excel软件计算合并均数、标准差,进行方差分析、t检验、Dunnett-t检验、相关分析及多元Logistic回归等统计学分析。研究结果 2012年9月——2013年6月共调查VCT门诊求诊者173人,收到有效问卷161份。161名求诊者中心理症状检出率为45.34%,排在前三位的心理症状依次为强迫、焦虑、抑郁。心理症状阳性者近期心理症状较PLWHA、感染HIV高危人群、躯体疾病、神经症患者严重。本研究以SCL-90总分、各因子分作为衡量心理健康的指标,以SCL-90总分筛选阳性和各因子分筛查阳性为因变量探讨影响心理健康的影响因素。心理症状主要的影响因素有神经质和客观支持,以SCL-90总分筛选阳性作多元Logistic回归分析显示,影响求诊者心理健康的因素是神经质(N)(OR=1.10,95%CI:1.06-1.13)和客观支持(OR=0.86,95%CI:0.76-0.98),回归方程的预测准确率达72.7%,未发现艾滋病相关因素对求诊者心理健康的影响。以SCL-90各因子筛查阳性为因变量作多元Logistic回归分析发现神经质(N)进入了除敌对因子以外所有心理因子,其他影响因素还有精神质(P)、内外向(E)、客观支持。各因子回归方程的预测准确率在70.2%-93.8%之间。研究结论 VCT门诊求诊者心理健康水平低于全国常模,存在不同程度的心理问题,强迫、焦虑、抑郁症状出现较多。尤其是心理症状筛选阳性的求诊者存在明显的不良情绪,其近期心理症状较PLWHA、HIV高危人群、神经症和其他躯体疾病严重。面临有可能感染HIV时,具有神经质倾向的求诊者容易出现心理问题,而社会支持有助于减少心理症状。急需提高VCT门诊工作人员对求诊者心理症状的认识和心理干预能力,开展良好的转介服务,使心理症状严重者能得到专业的咨询和治疗。
[Abstract]:Research background. Psychological problems are related to HIV/AIDS, the former can lead to high-risk behavior, viral and opportunistic infections can damage the central nervous system, infection itself, antiviral treatment negative effects, social discrimination and stigma can cause psychological problems. Providing psychological intervention for people Living with HIV / AIDS / HIV / AIDS PLWHA is one of the important measures to prevent high risk behaviors and prevent the spread of HIV. Voluntary Counselling and testing (VCT) clinic is an effective way to find the susceptible population and PLWHA. It is also an important place for patients to get psychological intervention. Only by fully understanding the psychological condition of VCT outpatients can we formulate corresponding policies and provide targeted psychological intervention services. Research purpose. To understand the psychological status of the patients in VCT outpatient clinic of a disease control center in Beijing, and to explore the influencing factors of their mental health, to provide scientific basis for improving the mental health level of the patients and reducing the risk of infection and transmission of HIV. Research method. This study is a cross-sectional survey. The subjects of the study were all the patients who came to the VCT clinic of a Beijing CDC for counseling and testing before September 2012. SCL-90, Eysenck Personality questionnaire (Eysenck Personality questionnaire) and Social support rating scale were used to evaluate all the patients. SPSS19.0 and Excel software were used to calculate the combined mean and standard deviation, and the analysis of variance (ANOVA) was performed by Dunnett-t test, correlation analysis and multivariate Logistic regression. Research results. From September 2012 to June 2013, a total of 173 VCT outpatients were investigated, and the positive rate of psychological symptoms was 45.34. The first three psychological symptoms were obsessive-compulsion and anxiety. Depression. Patients with positive psychological symptoms have more recent psychological symptoms than PLWHA. patients with high risk of HIV infection, somatic disease and neurosis are more serious. In this study, the total score of SCL-90 and the scores of each factor were taken as indicators of mental health. The influencing factors of mental health were investigated by using SCL-90 total score screening positive and factor score screening positive as dependent variables. The main influencing factors of psychological symptoms were neuroticism and objective support. Multiple Logistic regression analysis showed that SCL-90 total score screening positive was used as multivariate Logistic regression analysis. The factors affecting the mental health of the patients were neurotic 1.1095 CI: 1.06-1.13) and objective support: 0.866% CI: 0.76-0.98. The predictive accuracy of regression equation was 72.7. No influence of AIDS-related factors on the mental health of the patients was found. The positive screening of SCL-90 factors was taken as a dependent variable. Multiple Logistic regression analysis showed that neurotic N) entered all psychological factors except hostile factors. Other influencing factors were psychoticism, introversion and extroversion, objective support. The prediction accuracy of regression equation was 70.2% -93.8%. Research conclusion. The mental health level of VCT outpatients was lower than the national norm, and there were many psychological problems, compulsion, anxiety and depression. Its recent psychological symptoms are more serious than those of PLWHA high risk group, neurosis and other somatic diseases. When it is possible to be infected with HIV, patients with neuroticism tend to have psychological problems. The social support is helpful to reduce psychological symptoms. It is urgent to improve the cognition and psychological intervention ability of VCT outpatient staff to develop good referral service so that the patients with severe psychological symptoms can get professional counseling and treatment.
【学位授予单位】：中国疾病预防控制中心
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R512.91

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