肺结核病人心理健康研究

Psychological Health of Tuberculosis Patients

目的研究肺结核及咯血患者心理健康状况,为完善肺结核病人的综合治疗提供心理学依据。方法随机抽取大连市结核病医院2004年4—12月住院的肺结核合并咯血患者50例,初治结核痰菌涂片阳性的肺结核病人30例,共80例为研究对象。年龄范围22～69岁,平均年龄(42.55±16)岁,其中男性56人,女性24人。采用了一般状况调查表、症状自评量表(SCL-90)对上述80例肺结核病人进行测试,建数据库,分析采用t检验、单因素方差分析(ANOVA)及多元线性回归分析。结果肺结核病人SCL-90测定结果中,9个因子与常模比较,差异均有统计学意义(P<0·05),其中强迫症状、人际关系敏感、偏执、敌对和精神病性5个因子得分比常模低(P<0·01),而躯体化、抑郁、恐怖因子和焦虑因子得分比常模高;除抑郁以外,所有的因子得分示男性均低于女性(P<0·01);咯血病人的躯体化、人际关系敏感、抑郁、焦虑、敌对、恐怖、偏执、精神病性、附加项目及总症状指数得分均高于非咯血者(P<0·05);除强迫因子外,咯血量依存性的SCL-90个因子分值增加(P<0·05);以SCL-90总分为因变量,性别、咯血量、家庭支持、朋友支持和面对因子进入了危险因素(P<0·05)。结论肺结核病人心理问题较多,特别是躯体化症状、抑郁、焦虑、恐惧等问题。女性肺结核病人的心理问题较严重,大量咯血者的心理问题严重。

[ Objective] To study the psychological health status of tuberculosis patients and provide scientific basis for a comprehensive treatment. [ Mcthods]50 cases of tuberculosis with emptysis and 30 cases of primary positive bacterium were collected from April 2004 to December 2004 in Dalian tuberculosis hospital. The cases were aged from 22 to 69 with an average age of （42.55 ± 16） , among which 56 cases were males and 24 cases were females. General questionnaires, symptom check list-90 （ SCL-90 ） were applied for the detection; database was established; the result was analyzed with t test, one-way ANOVA and multiple linear regression. [Results]The SCL-90 detection showed significant difference in all the 9 factors compared with the norm （P 〈0.05）, among which obsessive-compulsive, sensitive interpersonal relationship, paranoid, aggressiveness and psychosis suggested lower scores than the norm （ P 〈 0. 01 ） ; somatization, depression, phobia and anxiety were higher than the norm （ P 〈 0. 01 ） ; all the factors except depression were higher among the males than among the females （ P 〈0. 01 ） ; the scores of somatization, sensitive interpersonal relationship, depression, anxiety, phobia, aggressive, paranoid, psychosis, affixation index and all symptom indexes among the emptysis patients were all higher than that of the non-emptysis patients （ P 〈 0.05 ）. [ Conclusion ] Tuberculosis patients have a lot of psychological problems, particularly somatization, depression, anxiety and phobia.