哈尔滨地区抑郁症患者就诊行为的社会心理因素分析
发布时间：2018-09-15 05:52
【摘要】：目的：本文通过对首诊于哈尔滨市第一专科医院的抑郁症患者与首诊于哈尔滨医科大学附属第一医院、附属第二医院、哈尔滨市第一医院、哈尔滨市第二医院综合性医院神经内科的抑郁症患者自然状况(如性别、年龄、学历、性格、收入水平等)、症状特点及其家属对抑郁症的认识水平等因素的比较,分析导致抑郁症患者就诊行为差异的影响因素,以指导他们正确的就医行为。 方法：2009年7月—2010年7月,首诊到哈尔滨市第一专科医院(以下简称专科医院)的抑郁症患者及其陪同家属,编为A组；2009年7月—2009年9月首诊到哈尔滨医科大学第一附属医院、哈尔滨医科大学第二附属医院、哈尔滨市第一医院、哈尔滨市第二医院等综合性医院(以下简称综合性医院)神经内科的抑郁症患者及其陪同家属,编为B组。对A、 B两组抑郁症患者及其陪同家属进行一般状况问卷测查,并对抑郁症患者进行汉密尔顿抑郁量表(HAMD)、症状自评量表(SCL-90)测查,其中A组共收集问卷309份,B组共收集问卷303份 结果：(1)一般状况问卷调查：两组在有无宗教信仰方面有显著差异(χ2=6.329,p0.05),两组抑郁症患者的就诊年龄有显著差异(χ2=11.105,p0.05),具体表现在19岁-30岁、46-55岁年龄段患者与年龄在31岁-45岁、56岁-65岁、66岁及以上者之间的差异.两组抑郁症患者在可接受治疗费方面差异显著(χ2=13.705,p0.01),这种差异主要是在可接受的费用在1000以下与1000-2000、1万以上；1000-2000元与2000-5000元；2000-5000元与1万以上的家庭间的差异。两组抑郁症患者的费用来源有显著差异(χ2=19.667,p0.01),自费患者与享受医疗保险(包括城镇医保与居民医保)患者间有显著的差异性。两组患者家属对抑郁症的认识水平有差异有显著意义(t=2.675,p0.01)使用logistic回归分析得到三个变量即患者的宗教信仰、可接受的医疗费用及治疗费用来源影响患者的就诊行为(2)A、 B两组患者的客观抑郁程度无显著差异(χ2=1.863,p0.05).(3)HAMD因子分：在汉密尔顿抑郁量表中的7个因子中,两组的白夜变化(t=-2.130,p0.01)、绝望感(t=2.664,p0.01)两项有显著差异.(4)SCL-90：两组SCL-90测出的阳性症状均分(t=3.319,p0.01)、强迫症状(t=1.916,p0.01)、抑郁(t=0.136,p0.01)、精神病性(t=0.838,p0.01)四项具有显著差异。使用回归分析,得到HAMD中三个因子即焦虑躯体化、日夜变化及绝望感对抑郁症患者的就诊行为有影响,而SCL-90中的阳性症状均分影响患者的就诊行为。 结论： 1.抑郁症患者的就诊年龄、可接受治疗费用及治疗费用的来源、有无宗教信仰影响其就诊行为。19-30岁与46-55岁年龄段倾向综合医院就诊,31-45岁,56-66岁及66岁以上者倾向专科医院；有宗教信仰、可接受治疗费低及自费的抑郁症患者易选择综合医院就诊。 2.抑郁症家属对抑郁症的认识水平影响其就诊行为。家属对抑郁症的认识水平较全面者,易倾向选择专科医院。 3.抑郁症患者的主观症状特点影响其就诊行为。白夜变化明显者倾向选择综合医院就诊,而绝望感、强迫症状、抑郁、精神病性表现明显者则倾向专科医院就诊。 4.患者的客观抑郁症程度对其就诊行为无影响。
[Abstract]:OBJECTIVE: To study the natural conditions (such as sex, age, education background, personality, income water) of depressive patients who were first diagnosed in Harbin First Specialized Hospital, the First Affiliated Hospital of Harbin Medical University, the Second Affiliated Hospital, the First Harbin Hospital and the Second Harbin General Hospital. To analyze the influencing factors of the difference in the behavior of patients with depression, and to guide their correct behavior.
Methods: From July 2009 to July 2010, the patients with depression and their accompanying family members who were first diagnosed in Harbin First Specialist Hospital (hereinafter referred to as the Specialist Hospital) were divided into group A; from July 2009 to September 2009, they were first diagnosed in the First Affiliated Hospital of Harbin Medical University, the Second Affiliated Hospital of Harbin Medical University, the First Hospital of Harbin, and Harbin Medical University. Depressive patients and their accompanying family members in the Department of Neurology of General Hospital (hereinafter referred to as General Hospital) were divided into group B. The general status of depressive patients and their accompanying family members in groups A and B were investigated by questionnaire, and the depressive patients were tested by Hamilton Depression Scale (HAMD) and Symptom Checklist 90 (SCL-90). A total of 309 questionnaires were collected and 303 questionnaires were collected in group B.
Results: (1) General Status Questionnaire: There were significant differences in religious beliefs between the two groups (2 = 6.329, p0.05). There were significant differences in the age of patients with depression between the two groups (2 = 11.105, p0.05). The differences between the patients aged 19-30, 46-55 and those aged 31-45, 56-65, 66 and over. There was a significant difference in the acceptable treatment fee between the two groups (_2 = 13.705, p0.01). The difference was mainly between the acceptable treatment fee below 1000 and over 1000-2000, between 1000-2000 and 2000-5000 yuan, and between 2000-5000 and over 10000 families. There was a significant difference between self-financed patients and those who enjoyed medical insurance (including urban medical insurance and residents'medical insurance). There was a significant difference between the two groups of patients' family members'understanding of depression (t = 2.675, p0.01). Three variables were obtained by logistic regression analysis, namely, patients' religious beliefs, acceptable medical expenses and treatment costs. There was no significant difference in the degree of objective depression between the two groups (_2 = 1.863, p0.05). (3) HAMD factor score: In the seven factors of Hamilton Depression Scale, the day-night changes (t = - 2.130, p0.01) and the sense of despair (t = 2.664, p0.01) were significantly different between the two groups. Average score (t = 3.319, p0.01), obsessive-compulsive symptoms (t = 1.916, p0.01), depression (t = 0.136, p0.01), psychoticism (t = 0.838, p0.01) were significantly different. Regression analysis showed that the three factors in HAMD, namely anxiety somatization, day-night changes and despair, had an impact on the behavior of depressive patients, while the positive symptoms in SCL-90 affected patients. Visiting behavior.
Conclusion:
1. The age of patients with depression, the source of acceptable treatment costs and treatment costs, whether religious beliefs affect their treatment behavior. People aged 19-30 and 46-55 tend to visit general hospitals, those aged 31-45, 56-66 and over tend to specialist hospitals; those with religious beliefs, low and self-supporting treatment fees are easy to choose. Choose a general hospital.
2. Depression family members'understanding of depression affects their hospitalization behavior.
3. Subjective symptoms of depressive patients affect their treatment behavior. Those with obvious changes in daytime and night tend to choose general hospitals, while those with despair, obsessive-compulsive symptoms, depression and psychotic manifestations tend to go to specialized hospitals.
4. the degree of objective depression has no effect on the patient's behavior.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.4
本文编号：2243968
[Abstract]:OBJECTIVE: To study the natural conditions (such as sex, age, education background, personality, income water) of depressive patients who were first diagnosed in Harbin First Specialized Hospital, the First Affiliated Hospital of Harbin Medical University, the Second Affiliated Hospital, the First Harbin Hospital and the Second Harbin General Hospital. To analyze the influencing factors of the difference in the behavior of patients with depression, and to guide their correct behavior.
Methods: From July 2009 to July 2010, the patients with depression and their accompanying family members who were first diagnosed in Harbin First Specialist Hospital (hereinafter referred to as the Specialist Hospital) were divided into group A; from July 2009 to September 2009, they were first diagnosed in the First Affiliated Hospital of Harbin Medical University, the Second Affiliated Hospital of Harbin Medical University, the First Hospital of Harbin, and Harbin Medical University. Depressive patients and their accompanying family members in the Department of Neurology of General Hospital (hereinafter referred to as General Hospital) were divided into group B. The general status of depressive patients and their accompanying family members in groups A and B were investigated by questionnaire, and the depressive patients were tested by Hamilton Depression Scale (HAMD) and Symptom Checklist 90 (SCL-90). A total of 309 questionnaires were collected and 303 questionnaires were collected in group B.
Results: (1) General Status Questionnaire: There were significant differences in religious beliefs between the two groups (2 = 6.329, p0.05). There were significant differences in the age of patients with depression between the two groups (2 = 11.105, p0.05). The differences between the patients aged 19-30, 46-55 and those aged 31-45, 56-65, 66 and over. There was a significant difference in the acceptable treatment fee between the two groups (_2 = 13.705, p0.01). The difference was mainly between the acceptable treatment fee below 1000 and over 1000-2000, between 1000-2000 and 2000-5000 yuan, and between 2000-5000 and over 10000 families. There was a significant difference between self-financed patients and those who enjoyed medical insurance (including urban medical insurance and residents'medical insurance). There was a significant difference between the two groups of patients' family members'understanding of depression (t = 2.675, p0.01). Three variables were obtained by logistic regression analysis, namely, patients' religious beliefs, acceptable medical expenses and treatment costs. There was no significant difference in the degree of objective depression between the two groups (_2 = 1.863, p0.05). (3) HAMD factor score: In the seven factors of Hamilton Depression Scale, the day-night changes (t = - 2.130, p0.01) and the sense of despair (t = 2.664, p0.01) were significantly different between the two groups. Average score (t = 3.319, p0.01), obsessive-compulsive symptoms (t = 1.916, p0.01), depression (t = 0.136, p0.01), psychoticism (t = 0.838, p0.01) were significantly different. Regression analysis showed that the three factors in HAMD, namely anxiety somatization, day-night changes and despair, had an impact on the behavior of depressive patients, while the positive symptoms in SCL-90 affected patients. Visiting behavior.
Conclusion:
1. The age of patients with depression, the source of acceptable treatment costs and treatment costs, whether religious beliefs affect their treatment behavior. People aged 19-30 and 46-55 tend to visit general hospitals, those aged 31-45, 56-66 and over tend to specialist hospitals; those with religious beliefs, low and self-supporting treatment fees are easy to choose. Choose a general hospital.
2. Depression family members'understanding of depression affects their hospitalization behavior.
3. Subjective symptoms of depressive patients affect their treatment behavior. Those with obvious changes in daytime and night tend to choose general hospitals, while those with despair, obsessive-compulsive symptoms, depression and psychotic manifestations tend to go to specialized hospitals.
4. the degree of objective depression has no effect on the patient's behavior.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2012
【分类号】：R749.4
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