心理社会因素对老年高血压病患者降压治疗疗效的影响

Impact of Psycho-social Factors on Anti-hyperfersion Treatment in the Elderly Patients

目的:探讨心理社会因素对老年高血压病疗效的影响。方法:用抑郁自评量表(SDS)、焦虑自评量表(SAS)、生活事件评定量表、社会支持评定量表分别对老年高血压病患者治疗达标组(A组)108例、治疗未达标组(B组)95例作有关心理社会因素评估。结果:(1)A组的抑郁症和焦虑症的发生率(7．4％和5．5％)明显低于B组(29．8％和25．3％,P<0．05);抑郁自评分和焦虑自评分A组 (35．4±6．5和32．8±7．6)也显著低于B组(56．5±10．6和48．3±9．5)(P<0．001)。(2)A组负性生活事件(4．6±3．8)、负性生活刺激量(11.4±5．4)、生活事件总刺激量(20．6±7．1)分别显著低于B组[(6．9±3．9)、(21．0±7．7)、(28．7±8．5),P均<0．001];A组社会支持总分(37．3±8．6)、客观支持分(12．5±4．3)、主观支持分(22．2±7．3)、支持利用度(9．6±3．2)均明显高于B组[(26．2±7．8)、(7．6± 3．8)、(12．5±6．3)、(4．8±2．1),均P<0．05]。(3)多因素Logistic分析证实SDS评分、SAS评分、负性生活事件刺激量、生活事件总刺激量、社会支持总分、主观支持分及支持利用度7因素对降压是否达标有显著影响(P<0．05)。结论:心理社会因素是影响老年高血压病治疗效果的重要因素之一。

Objective.. To study the impact of psycho-social factors on the treatment of the elderly patients with hypertension. Methods： 203 cases （aged 69.8 ± 6.2 yr） with hypertension were divided into two groups according to treatment responses： group A that reached target blood pressure （n= 108） and group B that unreached （n=95）. Their psycho-social factors were assessed by self-rating depression scale （SDS）, self-rating anxiety scale （SAS）, Life events scale and social support scale. Resdts： （1） The percentages of depression （7. 4% vs 29.8%,P〈0.05）, anxiety （5.5% vs 25. 3%,P〈0. 05）, SDS （35.4±6.5 vs 230.56.5± 10.6） and SAS （32.8±7.6 vs 48.3±9.5） scores were significantly lower in group A than those in group B （P〈0. 001 ）, respectively. （2） The negative life events （4. 6 ± 3.8 vs 6. 9 ±3.9）, the negative life stimulus extent （11.4 ± 5.4 vs 21.0 ± 7. 7） and total life event stimulus extent （20. 6± 7. 1 vs 28. 7 ± 8. 5） were markedly lower in group A than those in group B （P〈0. 001 ）, respectively. The scores of social support （37. 3 ± 8. 6 vs 26. 2 ± 7. 8）, obective （12.8± 4. 3 vs 7.6 ± 3.8） and subjective （22.2± 7. 3 vs 12.5 ± 6. 3） supports and support utilization ratio （9. 6 ± 3.2 vs 4. 8 ± 2. 1） were more higher in group A than those in group B （P〈0. 05）. （3） By multiple logictic analysis, it was found that SDS score, SAS score, negative events and total life events stimulus extent, social supports score and support utilization ratio showed marked effects on the treatment for the elderly patients with hypertension （P〈0. 05）. Conclusion：The psycho-social factors may remarkably impact therapeutic effect on hypertension in the elderly patients with hypertension.