帕金森病患者生活质量的调查与护理对策

Quality of life survey and nursing care of patients with Parkinson′s disease

目的帕金森病(PD)患者健康相关生活质量调查。方法选择2007年8月-2009年10月在上海交通大学医学院附属仁济医院帕金森病门诊和病房治疗的原发性PD患者161例,采用问卷调查法,应用17项汉密尔顿抑郁量表(HRSD)评价患者抑郁程度,根据评分结果将PD患者分为非抑郁症组和抑郁症组。运用PD生活质量调查表(PDQ-39)评价患者生活质量并比较抑郁组和非抑郁组的PDQ-39得分。合并抑郁,结果 PD合并抑郁的发病率为19.9%;生活质量总体水平为(34.62±26.36)分,其中得分最大的为运动类(11.18±12.54)分、情感状态类(6.61±5.63)分、日常生活类(6.55±6.30)分,其次为认知类(3.96±2.81)分、病耻感类(3.17±4.58)分。抑郁组的总体生活质量显著低于非抑郁组,其运动类、日常活动类、情感状态类、病耻感类、认知类、交流类和身体不适类评分显著高于非抑郁组,差异有显著统计学意义(P<0.01)。结论在临床护理中可实施心理护理、健康教育、康复锻炼以改善帕金森病患者的生活质量。

Objective To investigate the health-related life quality of patients with Parkinson′s disease（PD）.Methods A total of 161 PD patients in our hospital were enrolled from August,2007 to October 2009.The Questionnaire,Hamilton Rating Scale for Depression（HRSD） were used to evaluate the PD patients′ depression.According to depression status,the PD patients were divided into non-depression group and depression group.Then Parkinson′s Disease Questionnaire（PDQ-39） was used to evaluate the patients′ quality of life.Results The incidence rate of depression was 19.9% in PD patients.Their score of overall quality of life was（34.62±26.36）,with descending order as follows： exercise（11.18±12.54）,emotional well-being（6.61±5.63）,daily life（6.55±6.30）,cognition（3.96±2.81） and stigma（3.17±4.58）.The depression group got lower score of overall quality of life and higher scores in exercise,emotional well-being,daily life,cognition,stigma,communication and feeling ill than the non-depression group（P〈0.01）.Conclusion Psychological care,health education and rehabilitation exercises should be carried out to improve PD patients′ quality of life in clinical nursing.