维持性血液透析病人心理健康状况的调查

MENTAL HEALTH IN PATIENTS UNDERGOING MAINTENANCE HEMODIALYSIS

目的调查维持性血液透析(MHD)病人的心理健康状况。方法采用症状自评量表(SCL-90)对267例MHD病人的心理健康状况进行调查,并与68例健康人进行比较。结果 MHD病人SCL-90(除外敌对和精神病性)因子评分明显高于对照组,差异有显著性(t′=2.053～9.183,P<0.05、0.01);女性病人SCL-90(除外人际敏感、精神病性)因子评分明显高于男性,差异有显著性(t′=3.486～6.759,P<0.01);青年组、中年组与老年组强迫、人际敏感、恐怖和偏执因子评分比较差异有显著性(F=21.894～35.457,q=3.289～11.792,P<0.01);中年组躯体化、焦虑和抑郁因子评分明显高于老年组和青年组,中年组精神病性因子评分明显高于老年组(F=3.127～35.457,q=2.886～11.792,P<0.01);农民组病人SCL-90(除外抑郁、敌对和精神病性)因子评分明显高于其他组(F=3.183～11.551,q=2.997～8.179,P<0.05、0.01)。随着透析时间的延长,SCL-90(除外敌对和精神病性)因子评分逐渐增高,差异有显著性(F=9.552～14.556,q=3.511～7.540,P<0.05、0.01);不同文化程度病人SCL-90(除外敌对、恐怖和精神病性)因子评分比较,差异有显著性,以中专及高中文化程度病人SCL-90评分最高(F=9.440～14.684,q=2.948～7.600,P<0.05、0.01)。结论 MHD病人存在明显的心理障碍,这是影响其治疗效果、生活质量的主要原因之一。

Objective To investigate the mental health status in patients undergoing maintenance hemodialysis（MHD）.Methods By using Symptom Checklist 90（SCL-90）,the mental health of 267 MHD patients were surveyed,and compared with that of 68 healthy individuals.Results The SCL-90 score（except the score of hostility and psychotic） of the patients was significantly higher than that in the control group（t′=2.053-9.183;P〈0.05,0.01）;the SCL-90 score（except interpersonal sensitivity and psychotic） of female patients was significantly higher than that of male patients（t′=3.486-6.759,P〈0.01）.A comparison of scores of coercion,interpersonal sensitivity,phobias and paranoia factor among youth group,middle-aged group and older-aged group was significantly different（F=21.894-35.457,q=3.289-11.792,P〈0.01）.The SCL-90 score of somatization,anxiety and depression of middle-aged group was dramatically higher than that in older-aged and youth group,and in middle-aged group,the score of psychotic factor was higher than that in older-aged group（F=3.127-35.457,q=2.886-11.792,P〈0.01）.In farmers,the SCL-90 score（except depression,hostility and psychotic） was significantly higher than that in other groups（F=3.183-11.551;q=2.997-8.179;P〈0.05,0.01）.With the extension of MHD duration,the SCL-90 score（except hostility and psychotic） gradually increased（F=9.552-14.556;q=3.511-7.540;P〈0.05,0.01）.There were significant differences of the SCL-90 score（except hostile,terror and psychotic） in patients with different educational background,of whom,the highest score of SCL-90 was in those received technical secondary school and senior high school education（F=9.440-14.684;q=2.948-7.600;P〈0.05,0.01）.Conclusion There is apparent mental disorder in patients receiving MHD therapy,which is one of the reasons contributing their therapeutic efficacy and quality of life.