不同预后糖尿病足坏疽患者心理障碍及其相关因素

Psychological disorder and the related factors in patients with diabetic foot gangrene of different prognosis

目的:评价不同预后糖尿病坏疽患者的心理障碍,寻求有效的生物-心理-社会综合治疗及其评估模式。方法:对大连医科大学第二附属医院糖尿病足坏疽患者86例(愈合组32例、未愈组22例、截肢组32例)进行一般统计学资料、贝克抑郁自评问卷(BDI)、医学应对问卷(MCMQ)、领悟社会支持量表(PSSS)和艾森克个性问卷(EPQ)测查,进行单因素方差和多元logistic回归分析。结果:愈合组BDI评分(19.10±7.13)最低,与截肢组(24.00±4.87)比较,差异有显著性(t=2.946,P=0.003);各组PSSS和EPQ评分差异均无显著性(P均>0.05)。BDI总分与PSSS内支持间呈显著负相关(β=-0.273,P=0.02),BDI总分与屈服呈显著正相关(β=0.373,P=0.000)。结论:糖尿病足坏疽患者在抑郁、焦虑、医学应对方式方面与不同预后密切相关;糖尿病足坏疽患者不同预后与年龄、性别、收入、受教育程度、等多项自然状况及疾病特征因素有显著的相关性;期望心理干预支持,能改善糖尿病足坏疽患者的抑郁障碍及预后。

AIM:To assess the psychological disorders in patients with diabetic foot gangrene of different prognosis, so as to seek effective biological psychological social comprehensive treatment and its evaluating pattern. METHODS:Eighty six patients with diabetic foot gangrene [healing group(n=32),unhealing group(n=22),amputation group(n=32)] in the Second Affiliated Hospital of Dalian Medical University were investigated with general statistical data questionnaire,Beck depression inventory(BDI),medical coping modes questionnaire(MCMQ),perceived social support scale(PSSS) and Eysneck personality questionnaire(EPQ),and then one way analysis of variance and multi factor Logistic regression analysis were performed. RESULTS:The score of BDI was the lowest in the healing group(19.10±7.13),significantly different from that in the amputation group(24.00±4.87)(t=2.946,P=0.003).There were insignificant differences in the scores of PSSS and EPQ among the groups(P >0.05).The total score of BDI had significant negative correlation with the score of inner support of PSSS(β=-0.273,P=0.02),but significantly and positively correlated with the score of surrender (β=0.373,P=0.000). CONCLUSION:The depression,anxiety and medical coping style of patients with diabetic foot gangrene are closely correlated with different prognosis.The different prognosis of patients with diabetic foot gangrene had significant correlation with their age,gender,income,educational background and the characteristics of disease.It is expected that the support of psychological intervention can ameliorate the depressive disorder and prognosis of patients with diabetic foot gangrene.