非典型肺炎患者心理健康状况与社会支持的相关性

Association between mental health status and social support in patients with severe acute respiratory syndrome

目的:探讨非典型肺炎患者不同时期心理健康状况以及与社会支持的相互关系。方法:于2003-08随机调查山西省太原市出院3个月后返院复查的非典型性肺炎患者130例。采用自制调查表收集患者的个人资料和一般情况,内容包括:姓名、性别、年龄、文化程度、婚姻情况,入院时间、出院时间。采用症状自评量表评定非典型肺炎患者的心理健康状况,记录9个因子分。采用领悟社会支持量表以及关于社会支持的3个自编条目(①在你住院/隔离时,你最希望从哪些人/途径获得帮助和支持?②在你住院/隔离时,你还可以从哪些人/途径获得帮助和支持?③在你住院或隔离时,具体说明你可以从医护人员那里获得怎样的帮助和支持?)测查非典型肺炎患者不同时期的社会支持总分,由所有条目分累计。要求被试者自填入院时、出院时、出院3个月时的心理状况,当场完成问卷调查(文盲和年龄过大或过小者由他人代填)。结果:发放调查问卷130份,收回有效答卷117份,有效率90%。①非典型肺炎患者不同阶段的症状自评量表与国内常模比较:非典型肺炎患者入院时、出院时2个阶段症状自评量表的评分均偏高,与国内常模比较差异有显著性,特别是躯体化、焦虑2个因子的症状尤为突出。②非典型肺炎患者3个阶段的社会支持总分与同阶段症状自评量表各因子的相关分析:非典型肺炎患者入院时社会支持与症状自评量表的人际关系敏感因子呈负相关,相关系数为-0.209,差异有显著性。出院3个月时社会支持和抑郁、偏执因子呈负相关,相关系数为-0.294,-0.207,差异也有显著性。结论:①非典型肺炎患者入院时、出院时的心理健康状况欠佳,出院3个月后心理健康状况明显改善,社会支持与非典型性肺炎患者入院时的人际关系敏感呈负相关,与出院3个月时的抑郁、偏执呈负相关。②加强有效的社会支持有利于改善应激时的心理健康状态,消除康复期的抑郁情绪和偏执性思维。

AIM： To explore the mental health status of patients with severe acute respiratory syndrome （SARS） at different period, and study its correlation with social support. METHODS： In August 2003, 130 SARS patients, who were reexamined in Taiyuan Shanxi province at 3 months after discharge, were assessed with self-compiled questionnaires to collect the individual information and general state of health, which included name, gender, age, profession, marriage and date of admission and discharge. Their mental health status was evaluated with symptom checklist-90 （SCL-90）, 9 factor scores were recorded. Their total score of social support at different period of SARS was determined with the perceived social support scale （PSSS） and three self-compiled items about social support （During you were isolated, ① from who or what way did you hope to obtain help and support？② from what way did you hope to obtain help and support？ ③ what kinds of help and support did you obtain from the medical staff？）, all item scores were added up. The participants were requested to fill in the psychological status at admission, discharge and just at that time by themselves and finished the questionnaire on the spot （illiteracies and too elder or younger could fill them by others）. RESULTS： Totally 130 questionnaires were sent out, and 117 ones were valid, the effective rate was 90%.① Comparison of SCL-90 between SARS patients at different period and national norms： The SCL-90 scores at admission and discharge in the SARS patients were significantly higher than those of national norms, especially the symptoms of somatization and anxiety.②Correlated analysis between social support score of 3 stages of SARS patients and the SCL-90 scores of the same stage reveals： The social support of SARS patients at admission had significant negative correlation with the factor of interpersonal sensitivity in SCL-90 （r=-0.209）. The social support of SARS patients at 3 months after discharge was significantly and negatively correlated with the factors of depression and paranoid ideation （r=-0.294, -0.207）. CONCLUSION：①The mental health status of SARS patients is not very good at admission and discharge, and it is obviously improved at 3 months after discharge.Social support is positively correlated with the interpersonal sensitivity at admission and depression and paranoid ideation at 3 months after discharge in SARS patients.②Enbancement of effective social support is good for the improvement of psychological health state under stress and the elimination of depression and paranoid thoughts at rehabilitative period.