2型糖尿病患者心理社会因素特征

Characteristics of psychological and social factors in type 2 diabetes patients

目的:分析糖尿病患者在症状感受、人格特征和社会支持等方面的特点。方法:选择2003-03/2004-12南京医科大学附属第一医院内分泌科门诊的糖尿病患者96例为糖尿病组观察对象,正常对照组为同期南京医科大学第一附属医院体检的正常健康人68名。运用心理社会量表对两组人群进行社会支持、人格特征和症状感受等方面评估。心理健康状态采用症状自评量表评估,该量表包含躯体化、强迫症状、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性和附加项目等10个因子,采用5级评分制。人格特征采用艾森克人格问卷测验,包含88个项目,分为神经质量表、外向-内向量表、精神质量表、效度量表4个分量表。社会支持情况采用社会支持评定量表评定,该量表有10个项目,结果包括客观支持分、主观支持分、对支持的利用度3个因子分及总分。测试是在统一指导下,患者独自笔试完成,问卷当场收回。组间显著性检测采用t检验。结果:发放问卷164份,收回合格问卷164份,有效率100%。①糖尿病组患者抑郁均分、焦虑均分、强迫均分以及敌对性均分均高于正常对照组[(1.99±0.75),(1.61±0.61),P<0.05];[(2.33±0.77),(1.79±0.75),P<0.05];[(1.92±0.74),(1.49±0.42),P<0.05];[(2.08±1.04),(1.63±0.66),P<0.05]。②糖尿病组患者社会支持量表客观支持分高于正常对照组,主观支持分低于对照组,差异有显著性[(9.75±4.75),(6.44±3.36),P<0.05];[(17.15±4.59),(20.05±5.45),P<0.05]。而糖尿病组患者抑郁精神质、内-外向、神经质、社会支持总分和对支持的利用度与正常对照组的差异无显著性。结论:糖尿病患者躯体及情绪症状感受(抑郁,焦虑,强迫,敌对)较多,获得社会支持较多,但主观认为支持少,需要加强有针对性的心理康复教育。

AIM： To analyze the characteristics of symptoms perception, personality characteristics and social supports, etc. in diabetic patients. METHODS： Ninety-six diabetic patients, who were treated at the out- patient clinic, Department of Endocrinology, First Affiliated Hospital of Nanjing Medical University between March 2003 and December 2004, were selected as observational objects in diabetes group. Sixty-elght normal healthy people, who were made body examination in the First Affiliated Hospital of Nanjing Medical University in the same period, were considered as the normal control group. The social supports, personality characteristics and symptoms perception, etc. were evaluated with psychological social scale in persons of the two groups. Psychological healthy status was assessed with symptom checklist （SCL）, which included somatizatiom, obsessive-compulsive, interpersonal sensitivity, depression, anxiety, hostility, photic anxiety, paranoid ideation, psychoticism and additional items, etc. 10 factors, using 5-grade score. The personality characteristics was tested with Eysenck Personality Questionnaire （EPQ）, including 88 items and ：4 sub-scales： neuroticism （N）, extraversion （E）, psychoticism （P）, and social desirability （L）. The social support was dected with Social Support Rating Scale （SSRS）, which included 10 items, and the results included objective support score, subjective support score and the usage of support and total score. The written examination was conducted under unitive instruction by patients. The questionnaire was taken back on the spot. T-test was used to detect the significance among groups. RESULTS： 164 questionnaires were sent out and I64 qualified questionnaires were received with the 100% effective rate. ①Mean scores on depression, anxiety, obsession and hostility in the diabetes group were higher than those in the normal control group [ （1.99±0.75）, （1.61±0.61 ）,P 〈 0.05]; [（2.33±0.77）, （1.79±0.75）,P 〈 0.05]; [（1.92±0.74）, （1.49±0.42）,P 〈 0.05]; [（2.08±1.04）, （1.63±0.66）,P 〈 0.05]. ②Scores on objective support of SSRS in the diabetes group were higher than those in the normal control group, and the scores on subjective support were lower than those in the control group, and the difference had significance [（9.75±4.75）, （6.44±3.36）,P 〈 0.05]; [（ 17.15±4.59）, （20.05±5.45 ）,P 〈 0.05]. While scores on P, E, N, total score of social support and usage of support in the diabetes group had insignificant difference as compared with the normal control group. CONCLUSION： The diabetic patients have many symptom perceptions of body and mind, such as depression, anxiety, obsessive-compulsive and hostility, and gain more social supports, but subjective support is few. It is aim to strengthen education of psychological rehabilitation.