影响类风湿性关节炎患者心理健康的因素

Influencing Factors of Mental Health Status of Patients with Rheumatoid Arthritis.

目的探讨类风湿性关节炎患者心理健康状况及其影响因素,为进一步的护理干预提供科学依据。方法用自编的一般情况调查表、症状评定表、社会支持量表(SSRS)和症状自评量表(SCL-90)对80例类风湿性关节炎患者进行现况调查,比较本组患者SCL-90评分与国内常模的差别,分析患者一般资料、病情、SSRS评分与SCL-90评分之间的关系。结果本组患者SCL-90评分除人际关系和精神病性2个因子外,其余各因子分和总分以及阳性项目数显著高于国内常模(t=10.282,6.256,5.188,4.260,2.914,9.749,2.163,8.232,5.707;P<0.05);SCL-90总分与患者户籍、婚姻状况、职业、付费类别有明显关联(t=2.849,2.417,16.351,24.163;P<0.05);与患者年龄、关节疼痛、关节肿胀、功能障碍评分和晨僵时间及血沉速度呈显著正相关(t=0.250,0.896,0.847,0.766,0.778,0.730;P=0.001或0.000);与文化程度、经济状况和SSRS评分呈显著负相关(r=-0.300,-0.663,-0.555;P=0.001或0.000)。结论类风湿性关节炎患者心理健康状况较差,年龄较长、无配偶、农村、农民、低文化程度、经济状况和社会支持较差、病情较重患者,心理健康状况相对更差。

Objective To explore the mental health status of patients with rheumatoid arthritis and its influencing factors,and offer scientific basis for further nursing intervention.Methods A total of 80 patients with rheumatoid arthritis were investigated with the questionnaire about general condition and were evaluated with the Symptom Assess Scale,the Social Support Rating Scale（SSRS）and Symptom Checklist 90（SCL-90）.To compare and analyze the difference of the scores of SCL-90 between the group and the Chinese norm along with the relationship between the scores of SCL-90 and the general data,condition of illness and scores of SSRS.Results Factors and total scores along with the positive projects of SCL-90 in the group were significantly higher than the Chinese norm but the interpersonal sensitivity and psychotic factor（t=10.250,6.848,5.179,6.013,2.914,9.749,2.163,7.679,5.707;P0.05）.The total score of SCL-90 was significantly related to the household,marital status,profession and pay category of patients（t=2.849,2.417,16.351,24.163;P0.05）.It had a significantly positive correlation with the age,scores of the joint pain,swelling,dysfunction and time of morning stiffness along with erythrocyte sedimentation rate（t=0.250,0.896,0.847,0.766,0.778,0.730;P0.01）.It had a significantly negative correlation with the degree of education,financial situation and score of SSRS（r=-0.300,-0.663,-0.555;P0.01）.Conclusion The mental health status of patients with rheumatoid arthritis is rather bad.Patients who are old,rural,farmers,to have no spouse or have a lower degree of education,a poorer social support and financial situation,more serious condition of illness have worse mental health status.