江苏地区耐多药肺结核患者社会支持及心理健康状况研究

Analysis on the Social Support and Mental Health Status of Multidrug-resistant Tuberculosis Patientsin Jiangsu Province

目的了解江苏省耐多药结核病(MDR-TB)患者社会支持和心理健康状况,探究其影响因素。方法采用电话调查和面对面调查的方法,使用社会支持评定量表(SSRS)及Kessler10(K10)量表调查2011—2016年江苏省徐州和宿迁两市登记、治疗的耐多药结核患者。结果共纳入106例MDR-TB患者,平均社会支持总得分为(29.10±8.73)分,其中主观支持、客观支持以及支持利用度平均得分分别为(16.72±6.38)分,(6.25±2.62)分和(6.13±2.04)分。多因素线性回归分析显示文化程度越高,社会支持总得分越高。未婚患者社会支持总得分显著低于已婚患者。耐多药结核患者平均K10量表得分为(19.21±6.65)分。多因素logistic回归分析结果显示不良反应是心理健康状况的危险因素,痰涂片转阴时间每晚一个月,心理状况较差出现的概率就增加39.70%。社会支持总得分与K10量表得分呈负相关,社会支持总得分越低的患者K10量表得分越高。结论江苏省MDR-TB患者缺乏社会支持且心理健康状况较差,应该加大对于未婚及文化水平较低患者的社会支持,对治疗效果不佳的患者给予更多的心理辅导及关怀。

OBJECTIVE To understand the social support and mental health status of MDR-TB patientsin Jiangsu Province, and try to analyze the impact factors. METHODS All the registered and treated MDR-TBduring 2011 to 2016 were recruited as participant. Tele- phone interview and face-to-face survey, using social support rating scale（SSRS） and Kesslerl0 （K10） scale, were conductedto collect information. RESULTS A total of 106 patients with MDR-TB were enrolled. The average social support score was 29.10 ± 8.73, while the subjective support score, the objective support score and the support-seeking behavior score were 16.72 ± 6.38, 6.25 ± 2.62, and 6.13± 2.04 respectively. Multivariate linear regression analysis showed that the higher the education level was, the higher the total score of social support was. Participants who were unmarried reported lower social support rating scale scores than those married.The average K10 score for MDR-TB patients was 19.21 ± 6.65. Logistic regression analysis showed that adverse effect was a risk factor for poor mental health. The probability of poor mental health increased by 39.7% once a month delayed of sputum smear negative time.SSRS score was negatively correlated with K10 score. The lower SSRS score was, the higher K10 score was. CONCLUSION MDR-TB patients in Jiangsu had a low level of socialsupport and mental health. It should provide more support to MDR-TB patients with low level of education or those unmarried and give more psychological counseling and care for patients with poor treatment.