心理社会应激与综合健康效应的多组病例对照研究

A multi-team case-control study on the effects of psychosocial stress to overall health

目的 量化评价心理社会应激因素对人群健康不同损害程度的作用强度。方法 以四川省简阳市三组人群 978人 (门诊病例 177例 ,住院病例 2 14例及健康对照 5 87人 )为研究对象 ,进行多组病例对照研究。分别收集一般人口学特征 ,用各量表测量心理社会应激因素及健康损害程度。进行秩和检验 ,方差分析 ,聚类分析 ,多类结果logistic回归模型拟和以及有序结果logistic回归模型拟和。结果 有序结果logistic模型示 ,负性事件刺激量OR =1.335 (P <0 .0 1)。社会支持利用对健康损害程度有保护作用 (OR =0 .5 13)。结论 负性生活事件刺激量是危害综合健康的主要因素 ,与健康的损害程度成剂量 效应关系 ;社会支持利用是健康的维护因素。

Objective To explore the quantitative relationship between the intensity of psychosocial stress and the degree of overall health damages. Methods A multi-group case-control study was designed and implemented. The cases included two groups of out-patients (177) and in-patients (214) in a hospital in Jianyang city, and controls (587) were from the follow-up cohort in the same city. Three groups were studied on the following contents: general demographic characteristics, psychosocial factors and the degree of health damages including mental, physical, and social status. Major statistical analyses were as follows: ranks test, ANOVA, cluster analysis, multinomial logistic regression and ordered-logit regression. Results Ordered-logit regression model showed that the odds ratio of negative life-events on degree of health damages was 1.335 (P< 0.01). This result showed that there was a positive dose-effect relationship between the negative life-events score and overall health damages. The utility of social support to overall health had protective effect (OR= 0.513). Conclusion Negative life-events were the major risk factors to overall health, and there was a dose-effect relationship between negative events and health damages. Function of social support played a protective factor for health.