心理干预对强直性脊柱炎患者生存质量及心理健康状况的影响

Study on living quality of ankylosing spondylitis patients and psychological intervention effect evaluation

目的探讨心理干预对强直性脊柱炎患者的生存质量及心理健康状况的影响。方法采用病例对照研究方法,测查一般资料、生理指标、健康状况调查问卷(SF-36)、社会支持量表(SSRS)、艾森克个性问卷(EPQ)、医学应对问卷(MCMQ)、抑郁自评量表(SDS)和焦虑自评量表(SAS)。对82例强直性脊柱炎患者进行为期1个月的追踪研究,42例常规治疗联合心理干预,40例常规治疗。结果1.SF-36生存质量影响因素逐步回归结果:影响有性别、受教育程度、家庭人均收入、社会支持、应对方式(回避和屈服)和人格特质。2.①SDS分值具有随治疗时间逐渐下降的趋势[心理干预组:(57.24±8.85)分,(54.71±7.51)分,(54.00±8.10)分;对照组:(57.98±8.11)分,(56.71±7.51)分,(55.00±8.11)分,F=4.501,P<0.05],心理干预组SDS分较无干预组下降明显(P<0.05)。②SAS分值具有随治疗时间逐渐下降的趋势[心理干预组:(50.10±9.41)分,(48.20±6.82)分,(47.29±7.84)分;对照组:(51.23±10.10)分,(50.10±7.24)分,(48.29±7.38)分,F=1.801,P<0.05],两组SAS分下降程度类似(P>0.05)。3.治疗前后心理干预组在生理机能、躯体疼痛、精力、情感职能四个方面较无心理干预组改善明显。结论1.影响强直性脊柱炎患者生存质量因素包括性别、受教育程度、家庭人均收入、社会支持、应对方式(回避和屈服)和人格特质。2.心理干预可以明显缓解强直性脊柱炎患者抑郁情绪和生存质量。

Objective To analyze the living quality of ankylosing spondylitis（AS） patients and the effect of psychological intervention. Methods A total of 82 AS patients were performed one-month follow-up investigation by adopting case-control method, 42 of them were accepted combined psychological intervention, the other 40 cases were accepted treatment as routine. All cases were investigated on their common information and physiological indexes by filling out the short form 36 health survey questionnaires （SF-36） , self-rating depression scale （SDS） and self-rating anxiety scale （SAS）. Results 1. The stepwise regression analysis on influencing factors of SF-36 included gender, education level, average family income, social support, coping modes （ avoidance and surrender） and personality trait. 2.①The SDS scores on two groups decreased gradually with the treatment （ Intervention group ：57.24 ± 8.85/54.71 ± 7.51/54. 00 ± 8.10. Control group ： 57.98 ± 8. 11/56.71 ± 7.51/55.00 ±8.11. F = 4.501, P 〈 0. 05 ） , while there was remarkable descending of SDS score in patients of psychological intervention group （ P 〈 0. 05 ）. ②The SAS scores on two groups decreased gradually with the treatment （ Intervention group ： 50.10 ±9.41/48.20 ± 6.82/47.29 ±7.84. Control group ： 51.23 ± 10.10/50. 10 ± 7.24/48.29 ±7.38. F=1.801,P〈0.05）. And it show did not adifference on two groups （P〉0.05）. 3.The four factors scores including physical functioning,bodily pain , vitality and social functioning on intervention group went up（ P 〈0.05）, Compare with intervention group,the only two factor scores of bodily pain and social functioning were improved （ P 〈 0.05 ）. Conclusion 1.The influencing factors of living quality in AS patients are including gentler, education level, average family income, social support, coping modes （avoidance and surrender） and personality trait. 2. The living quality of patients with AS can be promoted significantly by psychological intervention.