安徽省某农村社区高血压患者抑郁和焦虑现状及其影响因素

The depression or anxiety and influencing factors of hypertension patients in a rural community of Anhui province

目的了解安徽省农村社区高血压患者抑郁和焦虑现状,并探索影响抑郁和焦虑的因素,为患者心理健康促进提供科学依据。方法于2015年11-12月,采用多阶段分层随机抽样方法,以肥西县基本公共卫生服务系统中年龄≥18岁的978例高血压患者为调查对象,通过面对面问卷调查收集研究对象一般社会人口特征、患慢性疾病情况,采用患者健康状况抑郁量表(PHQ-9)和广泛性焦虑问卷(GAD-7)分别评价患者抑郁和焦虑发生情况。采用SPSS 20.0统计软件包进行数据分析,用χ2检验和非条件多因素logistic回归分析抑郁和焦虑发生的影响因素。结果高血压患者抑郁检出率为23.72%(232/978),焦虑检出率为13.60%(133/978)。除婚姻状况外,不同性别、年龄、文化程度、经济状况、居住方式、患者类型和患病年限的高血压患者的抑郁检出率差异均有统计学意义(P<0.05,P<0.01);除年龄和文化程度外,不同性别、婚姻状况、经济状况、居住方式、患者类型和患病年限的高血压患者的焦虑检出率差异均有统计学意义(P<0.05,P<0.01);logistic回归分析显示,女性、经济状况不好、患者类型为高血压合并糖尿病或其他慢性病、独居是抑郁和焦虑发生的共同危险因素。结论社区高血压患者抑郁和焦虑问题应引起关注,公共卫生服务人员应重点关注女性、独居、经济水平差及同时患有多种慢性病的患者心理健康。

Objective To understand the status of depression and anxiety among patients with hypertension in rural community of Anhui province, to explore its influencing factors and to provide the scientific basis for promoting mental heahh. Methods The multiple stage stratified sampling method was used to select 978 hypertension patients （ ≥ 18 years old） from the local basic public health service system of Feixi county as the subjects from November to December of 2015. The investigation was performed by face-to-face questionnaire to collect the information of the demographic characteristics, smoking or drinking and chronic diseases. PHQ-9 and GAD-7 were used to evaluate the depression and anxiety of subjects. The X2 test and unconditional multivariate logistic regression analysis were conducted to indentify the influencing factors. All data were analyzed with SPSS 20.0 software. Results The detection rates of depression and anxiety among subjects were 23.72% （232/978） and 13.60% （133/978）,respectively. There were significant differences of depression rate in subjects with different gender, age, education levels, income levels, lifestyle, disease types and disease course （P〈0.05, P〈0.01 ）. There were significant differences of anxiety rate in subjects with different gender, marriage status, income levels, lifestyle, disease types and disease course （P〈0.05, P〈0.01）. The unconditional multivariate logistic regression analysis showed that female, income level, hypertension with diabetes or other chronic diseases and living alone were the common risk factors for depression and anxiety. Conclusion More attention should be paid to the depression and anxiety of hypertension patients in the community, and to the psychological health of those patients （female, living alone, low income and chronic diseases ）.