生殖道感染——影响妇女精神状态的主要因素:有无生殖道感染的纳西族妇女的焦虑和抑郁症状的比较

Reproductive Tract Infections (RTIs)──A Main Factor Influencing Women's Mental Status:Comparison on Depression & Anxiety between Naxi Women Having and Not Having RTIs

目的 :探讨生殖道感染与心理卫生之间的关系、比较四川纳西族妇女中有无生殖道感染人群的精神状态及其影响因素、并从心理卫生角度提出改善纳西族妇女生殖健康状况的建议。方法 :本研究采用抑郁自评量表(CES -D)和焦虑自评量表 (SAS)于 2 0 0 1年 7- 8月对四川省泸沽湖地区的 2 80名 2 0岁以上的纳西族已婚育龄妇女进行了评定。结果 :四川纳西族地区妇女的精神卫生状况不容乐观。在本研究调查的 2 80名纳西族妇女中 ,只有 74人 (2 6 4 % )没有表现出自述抑郁症状、 116人 (41 4 % )没有表现出自述焦虑症状。该研究人群的抑郁症状总均分为 2 0 1、焦虑症状总标准分均值为 5 0 2 ,均超过被怀疑有症状的底线值。且在有、无生殖道感染两组间有显著性差异。分析表明 ,生殖道感染是抑郁和焦虑症状的主要危险因素 (OR值分别为 :16 0 4 3和 12 95 4 )。同时抑郁和焦虑症状还分别与生育孩子多 (≥ 2个 ,P =0 0 0 4 5 ,OR =3 14 9,95 %可信区间 :1 2 2 8,8 0 76 ) ,以及初次性生活时的年龄较小 (<17岁 ,P =0 0 2 13,OR =3 0 4 2 ,95 %可信区间 :1 895 ,4 884 ) ,多次妊娠 (≥ 3次 ,P =0 0 0 5 1,OR =2 72 8,95 %可信区间 :1 990 ,4 173)等因素有关。笔者认为 ,当务之急是要提高当地医务人员心理卫生知?

Objective： 1 ） to explore the relationship between RTIs and mental status of Naxi women; 2） to compare the differences of depression ＆ anxiety between Naxi women who have and not have RTIs; and 3） to put forward some suggestions for improving Naxi women＇ s reproductive health in psychological point of view. Methods ： A cross - sectional survey was adopted. 2 80 married Naxi female volunteers who aged above 20 were selected by cluster random sampling from the two selected villages of Luguhu Township of Yanyuan county in Sichuan where Naxi mainly reside. Two self- reporting scales, CES - D and SAS were used for assessment of depression and anxiety of the subjects. Results： The facts of mental status of Sichuan Naxi women brook no optimism. Among 280 Naxi reproductive age women who were investigated in current study, only 74 （26.4%） have no depres- sion symptoms, and 116 （41.4%） have no anxiety symptoms. For the study population, the average total scores （TS） of CES -D was 20.1, and the average total index scores （TIS） of SAS was 50.2, and both of them were above a minimum value doubted to have symptoms. There were big differences of beth average TS of CES - D and TIS of SAS between Naxi women who have and not have RTIs. Further analysis revealed that RTI is a main risk factor influencing women＇s mental status （OR = 16.043 for depression, and OR= 12.954 for anxiety）. In addition, Naxi women＇s depression and anxiety are related to order births （ ≤ 2, OR=3.149, 95% CI： 1.228, 8.076）, sex debut is younger （≤17, OR=3.043, 95% CI： 1.895, 4.884）, and multiple pregnancy （≥3, OR = 2.728, 95% CI： 1.990, 4. 173）, etc. It was suggested that for improving Naxi women＇ s mental status, a pressing matter of the moment is to obtain the knowledge about mental health and the diagnosis and treatment levels of psychological disorders for local medical persons. Meanwhile, psychological counselling may be an important evenet in reproductive health services.