老年慢性病患者抑郁、焦虑障碍认知情况及与身心疾病识别的相关性研究

Correlation between cognition of depression and anxiety and recognition of physical and mental illness in hospitalized elderly patients with chronic diseases

目的：调查老年慢性病住院患者对抑郁和焦虑障碍的认知情况、对慢性躯体性疾病和心理疾病的识别情况，并分析两者的相关性，为老年慢性病住院患者常规进行抑郁和焦虑心理评估提供理论依据。方法采用横断面研究的方法，以简易精神状态检查量表（MMSE）、汉密尔顿抑郁量表（HAMD）、焦虑自评量表（SAS）以及老年慢性病患者调查问卷作为测量工具对某三甲医院的206例老年慢性病住院患者进行调查。结果老年慢性病住院患者对抑郁认知总水平得分为（5．95±3．05）分，焦虑认知总水平得分（4．92±3．20）分，对慢性病判断正确率为（97±8）％，对心理疾病判断正确率仅为（47±29）％。抑郁认知总分和心境、思维、精神3个维度与对心理疾病的识别呈正相关（P ＜0．01）；对焦虑认知总分和情绪、其他症状两个维度与对心理疾病的识别呈正相关（P ＜0．01），而抑郁、焦虑认知中躯体维度与对心理疾病判断正确情况无显著相关性（P ＞0．05）。结论老年慢性病住院患者抑郁、焦虑认知水平低，且对以躯体症状为主要表现的抑郁、焦虑障碍识别能力低，将心理疾病误认为是慢性躯体性疾病，严重影响疾病的治疗和预后。因此，护士应为老年慢性病患者常规进行抑郁、焦虑心理健康评估，早期识别心理健康问题，避免延误心理干预和治疗的最佳时间。

Objective To investigate the cognition of depression and anxiety and recognition of physical and mental illness,and analyze their correlation in hospitalized elderly patients with chronic diseases. Methods A cross-sectional study was performed.A total of 206 hospitalized elderly patients with chronic diseases from a hospital were investigated using mini mental state examination （MMSE）,Hamilton depression rating scale （HAMD）,self rating anxiety scale （SAS）and elderly patients with chronic diseases questionnaire. Results The total scores in cognition of depression and anxiety were （5.95 ±3.05）and （4.92 ±3.20）.The correct recognition rate of chronic disease was （97 ±8）%,and the correct recognition rate of mental illness was （47 ±29 ）%.The recognition of mental illness was positively correlated with the total cognition score of depression and three dimensions of thinking,spirit and mood （P 〈0.01 ）.It was also positively correlated with the total scores of cognition in anxiety and two dimensions of emotion and other symptoms （P 〈±0.01 ）. However,there was no significant correlation between recognition of mental illness and physical dimension of depression （P 〉0.05）.There was no significant correlation between recognition of mental illness and physical dimension of anxiety （P 〉0.05）.Conclusions The cognitive level and cognition of depression and anxiety are low in elderly patients with chronic diseases.They tend to recognize the mental illness as chronic physical disease.Therefore,nurses should make depression and anxiety evaluation as routine assessment for the elderly patients with chronic diseases.Early identification of mental illness can avoid the delay of psychological intervention and acquire the best time of treatment.