永久性结肠造口患者述情障碍与残障接受度的关系

Relationship between alexithymia and disability acceptance of patients with permanent colonic fistula

目的探讨永久性结肠造口患者述情障碍及残障接受度影响因素及相关性。方法选择2013年2月~2015年5月于海口市人民医院进行永久性结肠造口的患者157例为研究对象,采用多伦多述情障碍量表（TAS-20）、残障接受度量表（中文版）进行调查。结果文化程度、婚姻状况、费用支付与述情障碍有关（P〈0.05）,文化程度越高、已婚、医保的患者述情障碍程度较轻;文化程度、婚姻状况、费用支付、造口术后时间与残障接受度有关（P〈0.05）,文化程度越高、已婚、医保、造口术后时间越长的患者残障接受度较好。157例患者述情障碍的识别情感障碍为（26.34±4.93）分,描述情感障碍为（11.34±3.14）分,外向型思维为（22.93±5.34）分;残障接受度扩大维度为（60.23±8.34）分,服从维度为（14.02±4.23）分,控制维度为（52.93±5.93）分,转变维度为（53.02±6.93）分;经Pearson直线相关分析,识别情感障碍、描述情感障碍、外向型思维及述情障碍总分与扩大、服从、控制、转变及残障接受度总分均呈负相关（P〈0.05）。多元线性回归分析显示,识别情感障碍、描述情感障碍、外向型思维及述情障碍总分与残障接受度有较强相关性,是重要的影响因素（P〈0.05）。结论永久性结肠造口患者普遍存在述情障碍,述情障碍对患者残障接受度有明显的负面影响。

Objective To discuss the influence factor of alexithymia and disability acceptance of patients with permanent colonic fistula and its correlation. Methods 157 cases of patients underwent permanent colonic fistula in People＇s Hospital of Haikou City from February 2013 to May 2015 were selected as research objects. The Toronto Alexithymia Scale（TAS-20）, disability acceptance scale（Chinese Version） were used for survey. Results Education level, marital status, cost payment were related with alexithymia（P〈 0.05）, patients with higher education, married, medical insurance accompanied mild alexithymia. Education level, marital status, cost payment, postoperative time of neostomy were related with disability acceptance（P〈 0.05）, patients with higher education, married, medical insurance, longer time after neostomy accompanied better disability acceptance. Among 157 cases of patients, the scores of alexithymia as follow： the identification of emotional disorder was（26.34±4.93） points, the description of emotional disorder was（11.34±3.14） points, the extroverted thinking was（22.93 ±5.34） points; the scores of disability acceptance as follow： the expanded dimension was（60.23±8.34） points, the obedience dimension was（14.02±4.23） points, the control dimension was（52.93±5.93） points, the change dimension was（53.02±6.93） points. Pearson linear correlation analysis showed that,identification of emotional disorder, description of emotional disorder, extroverted thinking, the total score of alexithymia were negative related with expanded, obedience, control, change and the total score of disability acceptance（P 〈0.05）. Mult-variable linear return analysis showed that identification of emotional disorder, description of emotional disorder, extroverted thinking and the total score of alexithymia had strong correlation with disability acceptance,they were the important influence factors（P 〈0.05）. Conclusion Patients with permanent colonic fistula widely have alexithymia, and alexithymia has negative effects on disability acceptance obviously.