北京通州台湖地区65岁以上高血压老人心理健康现况及影响因素研究

Mental health status and its impact factors among hypertension patients over 65 years old in Taihu,Tongzhou,Beijing area: a cross-sectional study

目的调查北京市通州区台湖地区65岁以上高血压老人的心理健康状况并探索其影响因素。方法采用横断面的研究设计,选取台湖地区1 500名65岁以上高血压老人开展问卷调查。依据因变量类型分别采用多元逐步线性回归及逐步Logistic回归进行影响因素分析。结果本研究应答率为93.9%,研究对象中共计502名老人患有不同程度的焦虑症状,焦虑的患病率为35.6%;426名老人患有不同程度的抑郁,抑郁患病率为30.2%,其中重度抑郁的患病率为4.6%。通州台湖地区高血压患者的主观幸福感平均水平为(64.755±15.321)分。焦虑的影响因素分析结果显示:独立程度(OR=0.094,P<0.001)、用药是否有不良反应(OR=0.002,P<0.001)、血压控制是否满意(OR=0.055,P=0.001)、睡眠质量(OR=0.173,P<0.001)、服药依从性(OR=0.038,P<0.001)有统计学意义。抑郁的影响因素分析结果显示:婚姻状况(OR=2.408,P=0.007)、独立程度(OR=0.354,P<0.001)、疾病认知程度(OR=1.719,P=0.042)、脑血管病史(OR=0.347,P=0.026)、用药是否有不良反应(OR=0.291,P=0.001)、血压控制是否满意(OR=0.306,P=0.002)、睡眠质量(OR=0.233,P<0.001)、服药依从性(OR=0.241,P=0.001)有统计学意义。主观幸福感影响因素分析结果提示:婚姻状况(β=-3.432,P<0.001)、独立程度(β=5.814,P=0.001)、环境满意度(β=0.748,P=0.001)、焦虑(β=-0.454,P<0.001)、抑郁(β=-0.718,P<0.001)、脑血管病史(β=3.896,P<0.001)、用药是否有不良反应(β=-5.788,P<0.001)、血压控制是否满意(β=5.292,P<0.001)、睡眠质量(β=1.052,P<0.001)、服药依从性(β=3.893,P<0.001)有统计学意义。结论北京市通州区台湖地区高血压老年患者的心理健康状况较好;焦虑和抑郁往往伴随发生;通过提高疾病认知程度、选择不良反应小的高血压控制药物、改善睡眠质量,督促患者服药可能有助于缓解焦虑抑郁发生;焦虑抑郁的发生与主观幸福感的降低有很大关联性,通过调节焦虑抑郁可能有助于间接提升主观幸福感。

Objective To investigate the mental health status of hypertension patients aged 65-year-old or above and to explore the potential impact factors. Methods A cross-sectional study was designed,with 1 500 hypertension patients participated in. Logistic regression and linear regression were applied respectively according to the dependent variables. Results The response rate was 93. 9%,and 502（ 35. 6%） patients had anxiety and 426（ 30. 2%） patients had depression symptoms. The average subjective well-being score was64. 755 ± 15. 321. Results of multiple analysis on anxiety showed that the degree of independence（ OR = 0. 094,P〈0. 001）,side-effects of anti-hypertension drugs（ OR = 0. 002,P〈0. 001）,satisfaction on control of hypertension（ OR = 0. 055,P = 0. 001）,sleeping quality（ OR = 0. 173,P〈0. 001） and drug therapy compliance（ OR = 0. 038,P〈0. 001） were statistically significant. Results of multiple analysis on depression showed marital status（ OR = 2. 408,P = 0. 007）,degree of independence（ OR = 0. 354,P〈0. 001）,knowledge of hypertension（ OR = 1. 719,P = 0. 042）,history of cerebrovascular diseases（ OR = 0. 347,P = 0. 026）,side-effects of anti-hypertension drugs（ OR = 0. 291,P = 0. 001）,satisfaction on control of hypertension（ OR = 0. 306,P = 0. 002）,sleeping quality（ OR = 0. 233,P〈0. 001） and drug therapy compliance（ OR = 0. 241,P = 0. 001） were statistically significant. Results of multiple analysis on subjective well-being showed that marital status（ β =-3. 432,P〈0. 001）,degree of independence（ β = 5. 814,P〈0. 001）,environment satisfaction（ β = 0. 748,P = 0. 001）,anxiety（ β =-0. 454,P〈0. 001）,depression（ β =-0. 718,P〈0. 001）,history of cerebrovascular diseases（ β = 3. 896,P〈0. 001）,side-effects of anti-hypertension drugs（ β =-5. 788,P〈0. 001）,satisfaction on control of hypertension（ β = 5. 292 P〈0. 001）,sleeping quality（ β = 1. 052,P〈0. 001）,drug therapy compliance（ β = 3. 893,P〈0. 001） were statistically significant. Conclusion The mental health of hypertension patients aged 65-year-old or above in Taihu,Tongzhou,Beijing area was good. Anxiety and depression comes up together; By choosing anti-hypertension drugs with small side effect,improving the knowledge of hypertension,improving the sleeping and compliance of taking drugs,the probability of getting anxiety or depression will decline. Anxiety and depression had negative effect on subjective well-being.