毒性弥漫性甲状腺肿患者人际关系困扰现状及其影响因素研究

发布时间：2018-04-22 10:26

本文选题：弥漫性甲状腺肿伴甲亢症 + 甲状腺激素　；参考：《郑州大学》2016年硕士论文

【摘要】：目的通过对毒性弥漫性甲状腺肿(Graves’disease,GD)患者的人际关系困扰进行病例对照研究:(1)调查分析毒性弥漫性甲状腺肿患者中人际关系困扰的现状及影响因素;(2)研究人际关系困扰与人口学变量、疾病相关变量和心理变量之间的关系;(3)探讨毒性弥漫性甲状腺肿患者人际关系困扰的预测因素。为针对性给予干预措施提供临床参考和科学依据。方法本研究收集郑州大学第一附属医院内分泌科门诊2015年5月~11月已确诊的322例毒性弥漫性甲状腺肿患者,以及同时期该院体检中心的323名健康者作为研究对象,进行问卷调查和病例对照研究。研究工具采用一般资料问卷、人际关系综合诊断量表、社会支持评定量表和简易应对方式量表;生物学指标包括促甲状腺激素(TSH,Thyroid Stimulating Hormone),血清游离甲状腺素(FT4,Free Thyroxine),血清游离三碘甲腺原氨酸(FT3,Free Triiodothyronine)。使用SPSS 21.0统计软件,运用两独立样本t检验、单因素方差分析、Pearson积矩相关分析和多重逐步回归等方法进行统计分析,描述毒性弥漫性甲状腺肿患者的人际关系困扰状况并分析其影响因素。结果1.对符合纳入标准的330名毒性弥漫性甲状腺肿患者和体检中心健康者进行问卷调查,毒性弥漫性甲状腺肿患者组回收有效问卷322份,有效回收率为97.6%;健康组回收有效问卷323份,有效回收率为97.9%。2.毒性弥漫性甲状腺肿患者人际关系困扰总分为(11.06±7.00)及各维度得分均高于健康组人际关系困扰总分(5.98±4.92)及各维度评分,差异具有统计学意义(P0.05)。毒性弥漫性甲状腺肿患者人际关系困扰的检出率为52.5%,高于健康组(23.8%),差异具有统计学意义(P0.05)。3.毒性弥漫性甲状腺肿患者社会支持总分(36.91±6.59)及各维度低于健康组社会支持总分(40.36±6.12)及各维度;患者组积极应对(1.63±0.49)和消极应对评分(1.40±0.49)均低于健康组(1.88±0.44,1.54±0.54),差异具有统计学意义(P0.05)。4在毒性弥漫性甲状腺肿患者组中,伴有人际关系困扰患者年龄低于无人际关系困扰患者;女性患者、未婚或离异患者人际困扰检出率高于男性患者和已婚患者,差异有统计学意义(P0.05)。5.在毒性弥漫性甲状腺肿患者中,伴有人际关系困扰者的积极应对平均分(1.57±0.44)、社会支持总分(35.66±6.42)、主观支持(21.52±4.88)和对支持的利用(7.06±1.59)均低于无人际关系困扰患者(1.71±0.54、38.42±6.50、23.56±4.88、7.71±1.62),差异具有统计学意义(P0.05)。6.多重逐步回归分析结果显示,毒性弥漫性甲状腺肿患者人际关系困扰的影响因素有社会支持、性别、受教育程度和应对方式;交谈困扰的影响因素有应对方式、性别和社会支持;交际困扰的影响因素有社会支持、性别和是否核心家庭;待人接物困扰的影响因素有应对方式、性别、FT3和对支持的利用;异性交往困扰的影响因素有社会支持、受教育程度、年龄和是否核心家庭。7.分层回归的结果显示,毒性弥漫性甲状腺肿患者人际关系困扰受社会、生理、心理状态的影响,解释程度为21.5%。结论1.毒性弥漫性甲状腺肿患者人际关系困扰检出率及评分均高于健康人群,严重影响生活和工作的人际交流,有必要在毒性弥漫性甲状腺肿患者中广泛评估和干预人际交往障碍;该群体的社会支持处于中等偏下水平;积极应对能力不足,而消极应对方式居多。2毒性弥漫性甲状腺肿患者中,年龄小、女性、未婚或离异、受教育程度低、核心家庭者易产生人际关系困扰;并且其积极应对、社会支持、主观支持以及对支持的利用等能力也低于无人际关系困扰者。3人际关系困扰受社会、生理及心理因素共同作用,其中心理因素起关键作用。人际困扰的预测因素主要包括性别、受教育程度、社会支持、对支持的利用及应对方式等;首次发现待人接物困扰不仅受以上因素影响,还受FT3水平的影响
[Abstract]:Objective to carry out a case-control study on the interpersonal relationship in patients with Graves' disease (GD): (1) to investigate and analyze the status and influencing factors of interpersonal relationship in patients with toxic diffuse goiter; (2) to study the relationship between human relationship and demographic variables, disease related variables and psychological variables. (3) to explore the predictors of interpersonal relationship in patients with toxic diffuse goiter. To provide clinical reference and scientific basis for the targeted intervention measures. Methods this study collected 322 cases of toxic diffuse goiter diagnosed in the Department of endocrinology of the First Affiliated Hospital of Zhengzhou University in May 2015 ~11 months, and at the same time A questionnaire survey and a case control study were conducted in 323 healthy people in the medical center of the hospital. The research tools used the general data questionnaire, the interpersonal relationship comprehensive diagnosis scale, the social support assessment scale and the simple coping style scale; the biological indicators included the TSH, Thyroid Stimulating Hormone, and the serum. Free thyroxine (FT4, Free Thyroxine), serum free three iodide adenosine (FT3, Free Triiodothyronine). Using SPSS 21 statistical software, two independent sample t test, single factor variance analysis, Pearson product moment correlation analysis and multiple stepwise regression were used to analyze the patients with toxic diffuse goiter. 1. of the 330 patients with toxic diffuse goiter and healthy people who were in the medical center were investigated. 322 of the effective questionnaires were recovered, the effective recovery rate was 97.6%, 323 of the effective questionnaires were recovered in the healthy group, and the effective recovery rate was 97. The total score of interpersonal relationship in patients with.9%.2. toxic diffuse goiter was (11.06 + 7) and the scores of all dimensions were higher than those of the healthy group (5.98 + 4.92) and the scores of each dimension. The difference was statistically significant (P0.05). The detection rate of interhuman relationship in patients with toxic diffuse goiter was 52.5%, higher than that of the healthy group (23.8%). The difference had statistical significance (P0.05) the total score of social support (36.91 + 6.59) and the dimensions of the social support (40.36 + 6.12) and all dimensions of the patients with.3. toxic diffuse goiter. The positive response (1.63 + 0.49) and negative coping score (1.40 + 0.49) in the patients were lower than that of the healthy group (1.88 + 0.44,1.54 + 0.54), and the difference was statistically significant. Learning significance (P0.05).4 in patients with toxic diffuse goiter, patients with interpersonal relationships were younger than those without interpersonal distress; women, unmarried or divorced patients had higher detection rates than men and married patients, and the difference was statistically significant (P0.05).5. in patients with toxic diffuse goiter. The average score of positive coping (1.57 + 0.44), social support total score (35.66 + 6.42), subjective support (21.52 + 4.88) and support use (7.06 + 1.59) were lower than those without interpersonal relationship (1.71 + 0.54,38.42 + 6.50,23.56 + 4.88,7.71 + 1.62), and the difference was statistically significant (P0.05).6. multiple stepwise regression analysis The results showed that the influencing factors of interpersonal relationship in patients with toxic diffuse goiter were social support, gender, education and coping style. The influencing factors of the conversation were coping style, gender and social support, social support, sex and core family, and the influencing factors of the plagued by people. There are coping styles, sex, FT3 and use of support; the influence factors of heterosexual communication are social support, education, age, and core family.7. stratified regression results show that the interpersonal relationship of the patients with toxic diffuse goiter is affected by social, physiological and psychological state, and the degree of interpretation is 21.5%. conclusion 1. toxicity mass. The detection rate and score of interpersonal relationship in the patients with diffuse goiter are higher than those of the healthy people, which seriously affect the interpersonal communication of life and work. It is necessary to assess and interfere with interpersonal communication disorders widely in patients with toxic diffuse goiter; the social support of this group is at the middle level, and the positive coping ability is insufficient, and the negative response should be negative. Among the patients with multiple.2 toxic diffuse goiter, the age, female, unmarried or divorced, low education, and the core family are prone to interpersonal relationship, and the ability to respond positively, social support, subjective support and support is lower than that of people without interpersonal relationship, and the social relationship is affected by society and physiology. The psychological factors play a key role. Psychological factors play a key role. The predictors of interpersonal distress include gender, education, social support, the use of support and the way of coping. The first discovery of the plagued by people is not only influenced by the above factors, but also influenced by the level of FT3.

【学位授予单位】：郑州大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R581.3

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