中老年糖尿病周围神经病变患者焦虑抑郁现状及其影响因素

Status and influencing factors of anxiety and depression in elderly patients with diabetic peripheral neuropathy

目的评估焦虑、抑郁在中老年糖尿病周围神经病变患者中的发病情况,并分析其影响因素。方法运用一般资料调查问卷、综合医院焦虑抑郁量表、社会支持评定量表进行问卷调查,并从中选取有代表性的患者进行一对一访谈。结果量性研究结果显示,社会支持越低(β=-0.282,P<0.001)、糖尿病病程越短(β=-0.308,P<0.001)、年龄越年轻(β=-0.141,P=0.007)、月收入3 000元及以下(β=-0.352,P=0.001)、月收入3 000~5 000元(β=-0.220,P=0.027)以及不坚持规律运动(β=-0.158,P=0.001)的糖尿病周围神经病变患者,焦虑症状越严重。社会支持越低(β=-0.189,P=0.001)、糖尿病病程越短(β=-0.261,P=0.001)以及患有中度非增殖性视网膜病变(β=0.175,P=0.001)的中老年糖尿病周围神经病变患者,抑郁症状越严重。质性研究结果显示,焦虑抑郁影响因素包括家庭影响因素、社会影响因素、照顾与支持因素。结论应采取措施提高中老年糖尿病周围神经病变患者的社会支持情况,加强健康教育,促进规律运动,提高其自我管理能力,从而改善其焦虑、抑郁症状。

Objective To evaluate the status of anxiety and depression in elderly patients with diabetic peripheral neuropathy and analyze the influencing factors of anxiety and depression with the combination methods of quantitative research and qualitative research.Methods A investigation was conducted by using general condition questionnaire,hospital anxiety and depression scale,social support scale.Representative patients with purposive sampling were taken into qualitative research.Results The quantitative research showed that patients with lower social support（ β =-0. 282,P 〈 0. 001）,shorter duration of diabetes（ β =-0. 308,P 〈 0. 001）,younger age（ β =-0. 141,P = 0.007）,monthly income lower than 3 000 yuan（ β =-0.352,P = 0.001）,monthly income from 3 000 to 5 000 yuan（ β =-0.220,P = 0. 027）and lower adhere to the regular exercise（ β =-0.158,P = 0.001） had more severe anxiety. Patients with lower social support（ β =-0.189,P= 0.001）,shorter duration of diabetes（ β =-0.261,P = 0.001） and moderate non-proliferative diabetic retinopathy（ β = 0. 175,P = 0. 001）had more severe depression. The qualitative research showed that the influencing factors of anxiety and depression among patients with diabetic peripheral neuropathy included family factors,social factors and care supports. Conclusions Actions should be taken to improve social support and health care should be strengthened to promote the adherence of regular exercise and self-care ability,in order to improve the anxiety and depression in elderly patients with diabetic peripheral neuropathy.