鼻内窥镜手术患者心理状况、应对方式与生活质量现况调查及相关性分析

Cross-sectional study and correlation analysis of mental health,coping style and quality of life in patients undergoing nasal endoscopic surgery

目的分析鼻内镜手术患者心理状况、应对方式及生活质量的现况,并探讨患者心理健康、应对方式与生活质量三者之间的关系。方法本研究为横断面研究,选取广安市广安区鼻内镜手术患者155例,采用症状自评量表(SCL-90)、医学应对问卷(MCMQ)和世界卫生组织生活质量测定量表简表(WHOQOL-BREF)分别对患者的心理健康状况、应对方式和生活质量状况进行测评。结果鼻内镜手术患者SCL-90自评量表总分为(179.9±51.3)分,平均分≥2分的前5位的阳性因子分别为:焦虑、躯体化症状、抑郁、人际关系紧张、恐怖。患者应对方式的3个因子得分从高到低依次为:面对、回避和屈服因子。鼻内镜手术患者与正常对照组相比在生理、心理、独立性、社会关系和总的生活质量与健康状况得分最低(P<0.05);环境和精神支柱与个人信仰得分则高于正常对照组(P<0.05)。鼻内镜手术患者SCL-90总分与患者总体生活质量、生理领域、心理领域得分呈正相关;应对方式中,面对因子与总体生活质量和健康状况、生理领域、心理领域得分呈正相关;屈服因子与总体生活质量和健康状况、心理领域得分呈负相关。结论鼻内镜手术患者心理问题主要表现在焦虑、躯体化症状、抑郁、人际关系紧张、恐怖等方面,多数患者采用积极的面对方式,患者生活质量较低。

[Objective] To analyze the status of mental health, coping style and quality of life in patients undergoing nasal endoscopic surgery, explore the relationship among them. [ Methods I By the cross-sectional survey, 155 patients undergoing nasal endoscopic surgery in Guang＇an District of Guang＇an City were collected to evaluate the mental health, coping style and quality of life by the symptom self rating scale （SCL-90）, World Health Organization Quality of Life （WHOQOL-BREF） and Medical Coping Modes Questionnaire （MCMQ）.[Results] The total score of SCL-90 in patients undergoing nasal endoscopic surgery was （179.9±51.3） points, and the top five factors which the average score is greater than or equal to 2 points were anxiety, somatization symptom, depression, interpersonal relationship tension, and phobia. The three factors of the coping style from high to low were confrontation, avoidance, and surrender. The scores of physiology, psychology, independence, social relations and total scores of quality of life and health status in patients undergoing nasal endoscopic surgery were lower than those in the control group （P〈0.05）, while the scores of environment and spiritual pillar were higher than those in the control group （P〈0.05）.The total scores of SCL-90 in patients undergoing nasal endoscopic surgery was positively correlated with scores of quality of life, physiological field and psychological field. In coping style, the confrontation factor was positively correlated with scores of quality of life and health status, physiological field and psychological field, while surrender factor was negatively correlated with scores of quality of life and health status, and psychological field. [Conclusion] The psychological problems of patients undergoing nasal endoscopic surgery are mainly manifested in the aspects of anxiety, somatization symptom, depression, interpersonal relationship tension, and phobia. Most patients adopt a positive coping style, and their quality of life is not satisfactory.