全科医生对心力衰竭患者抑郁状况认知情况的影响因素:一项社区观察性RECODE-心力衰竭研究
发布时间：2019-06-10 23:35
【摘要】：背景相对于其他患者来说,心力衰竭患者更容易患抑郁。但是由于抑郁和心力衰竭这两种疾病有些症状相似,诊断心力衰竭患者是否患抑郁比较困难。本研究旨在调查作为心力衰竭患者的首诊医生,全科医生对心力衰竭患者抑郁状况认知情况及其影响因素。方法此项横断面观察性研究的研究对象为3 224例社区心力衰竭患者。使用医院焦虑抑郁量表、PHQ-9抑郁症筛查量表及PROMIS焦虑抑郁量表中的部分条目调查心力衰竭患者的抑郁状况并对结果进行评估计算。对为这些患者接诊的272例全科医生就患者的躯体和心理共病情况进行了电话采访。使用描述性统计方法分析全科医生对患者的抑郁状况认知情况。使用Logistic回归分析影响全科医生对患者抑郁状况认知情况的因素。结果全科医生仅能诊断出35%的患者患有抑郁。影响其对心力衰竭患者抑郁状况认知情况的因素有:患者文化水平较高,全科医生了解到患者曾患有抑郁,调查前6个月内患者因为情感压力就诊,调查前6个月内患者多次联系全科医生,经纽约心脏病协会(NYHA)分级标准评估的重度心力衰竭,以及较为严重的抑郁症状。全科医生是否学过心理学或精神病学与其对心力衰竭患者抑郁状况的认知情况无关。结论研究表明,全科医生对心力衰竭患者的抑郁状况的认知水平较低。其受到多种因素的影响,包括对认知的定义以及社区临床实践情况。鼓励患者谈其情感压力,花足够的时间去诊疗患者,包括了解其抑郁病史,以及特别用心诊疗文化水平低的患者均可以提升全科医生对心力衰竭患者抑郁状况的认知水平。然而,相对于精神病学诊断标准,全科医生诊断出心力衰竭患者患有抑郁对患者预后及其生活质量的影响有待于进一步调查。
[Abstract]:Background patients with heart failure are more likely to suffer from depression than other patients. However, because depression and heart failure have similar symptoms, it is difficult to diagnose depression in patients with heart failure. The purpose of this study was to investigate the cognition and influencing factors of depression in patients with heart failure. Methods A total of 3 224 patients with community heart failure were enrolled in this cross-section observational study. The depression status of patients with heart failure was investigated by using some items of hospital anxiety and depression scale, PHQ-9 depression screening scale and PROMIS anxiety and depression scale, and the results were evaluated and calculated. 272 general practitioners receiving these patients were interviewed by telephone about the physical and psychological co-illness of the patients. Descriptive statistical methods were used to analyze the cognition of general practitioners on depression. Logistic regression analysis was used to analyze the factors influencing the cognition of general practitioners on depression. Results only 35% of the patients were diagnosed as depression by general practitioners. The factors affecting their cognition of depression in patients with heart failure were as follows: the patients had a high level of education, the general practitioner learned that the patients had suffered from depression, and the patients were treated due to emotional stress within six months of the survey. During the first six months of the survey, the patients contacted the general practitioner several times and were assessed by the New York Heart Association (NYHA) rating criteria for severe heart failure, as well as more severe depressive symptoms. Whether a general practitioner has studied psychology or psychiatry has nothing to do with his cognition of depression in patients with heart failure. Conclusion General practitioners' cognition of depression in patients with heart failure is low. It is affected by many factors, including the definition of cognition and community clinical practice. Encouraging patients to talk about their emotional stress and spending enough time to treat and treat patients, including understanding their history of depression, as well as paying special attention to the diagnosis and treatment of patients with low educational level, can improve the general practitioners' awareness of depression in patients with heart failure. However, compared with the diagnostic criteria of psychiatry, the effect of depression on the prognosis and quality of life of patients with heart failure diagnosed by general practitioners needs to be further investigated.
【分类号】：R541.6
，
本文编号：2496816
[Abstract]:Background patients with heart failure are more likely to suffer from depression than other patients. However, because depression and heart failure have similar symptoms, it is difficult to diagnose depression in patients with heart failure. The purpose of this study was to investigate the cognition and influencing factors of depression in patients with heart failure. Methods A total of 3 224 patients with community heart failure were enrolled in this cross-section observational study. The depression status of patients with heart failure was investigated by using some items of hospital anxiety and depression scale, PHQ-9 depression screening scale and PROMIS anxiety and depression scale, and the results were evaluated and calculated. 272 general practitioners receiving these patients were interviewed by telephone about the physical and psychological co-illness of the patients. Descriptive statistical methods were used to analyze the cognition of general practitioners on depression. Logistic regression analysis was used to analyze the factors influencing the cognition of general practitioners on depression. Results only 35% of the patients were diagnosed as depression by general practitioners. The factors affecting their cognition of depression in patients with heart failure were as follows: the patients had a high level of education, the general practitioner learned that the patients had suffered from depression, and the patients were treated due to emotional stress within six months of the survey. During the first six months of the survey, the patients contacted the general practitioner several times and were assessed by the New York Heart Association (NYHA) rating criteria for severe heart failure, as well as more severe depressive symptoms. Whether a general practitioner has studied psychology or psychiatry has nothing to do with his cognition of depression in patients with heart failure. Conclusion General practitioners' cognition of depression in patients with heart failure is low. It is affected by many factors, including the definition of cognition and community clinical practice. Encouraging patients to talk about their emotional stress and spending enough time to treat and treat patients, including understanding their history of depression, as well as paying special attention to the diagnosis and treatment of patients with low educational level, can improve the general practitioners' awareness of depression in patients with heart failure. However, compared with the diagnostic criteria of psychiatry, the effect of depression on the prognosis and quality of life of patients with heart failure diagnosed by general practitioners needs to be further investigated.
【分类号】：R541.6
，
本文编号：2496816
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