申请职业病诊断患者焦虑-抑郁状况及其影响因素研究

Investigation on anxiety and depression status of patients with suspected occupational disease

[目的]探讨申请职业病诊断患者焦虑抑郁状况及其可能的影响因素,为干预改善患者身心健康和改进职业病诊断工作提供科学依据。[方法]采用现况研究方法,选择2015年11月至2016年6月在深圳市职业病防治院申请职业病诊断患者199例开展问卷调查,同时使用综合医院焦虑抑郁量表(HADs)进行心理测评,并对数据进行非条件logistic回归分析。[结果]申请职业病诊断患者焦虑评分为(10.03±4.68)分,抑郁评分为(8.94±4.56)分;有焦虑症状患者122例,抑郁症状107例,焦虑合并抑郁85例,检出率分别为61.3%、53.8%和42.7%。申请职业病诊断患者焦虑、抑郁的可能影响因素为:对职业病诊断顺利公正性越担忧[OR值1.523(95%CI:1.136~2.043)],越容易发生焦虑;收入开支状况越好[OR值0.618(95%CI:0.370~0.933)]、单位主观支持评分越高[OR值0.850(95%CI:0.758~0.952)],越不容易发生焦虑。患病后月收入越少[OR值1.468(95%CI:1.035~2.082)]、对职业病诊断顺利公正性越担忧[OR值1.531(95%CI:1.161~2.020)],越容易发生抑郁。年龄越大[OR值2.028(95%CI:1.304~3.155)]、患病后月收入越少[OR值1.494(95%CI:1.010~2.209)]、对职业病诊断顺利公正性越担忧[OR值1.420(95%CI:1.047~1.925),越容易发生焦虑合并抑郁;单位主观支持评分越高[OR值0.840(95%CI:0.744~0.949)],越不容易发生焦虑合并抑郁。[结论]申请职业病诊断患者焦虑、抑郁状况患病率高。应多方合作,尽量保证职业病诊断的顺利和公正,保护患者的经济利益,并重点关注年龄较大患者的身心健康;用人单位应主动提高对患者的主观支持,减少患者负面情绪的发生。

[Objective] To investigate the prevalence of anxiety and depression of cases with suspected occupational disease.[Methods] Totally 199 suspected cases,who applied for the diagnosis of occupational disease in the Shenzhen Prevention and Treatment Hospital for Occupational Disease during November 2015 to June 2016,were investigated with the hospital anxiety and depression scale（HAD） plus self-designed questionnaire. Binary unconditional logistic regression was used to analyze the association between the psychological conditions and the potential affecting factors. [Results] The survey showed that the average scores of HAD-anxiety and HAD-depression of these cases were（10.03 ± 4.68）and（8.94 ± 4.56）,respectively. It was showed that 122（61.3%）,107（53.8%） and 85 cases（42.7%） were diagnosed with anxiety, depression and anxietydepression,respectively. The survey showed that the worry about the fairness in diagnosis procedure was a important reason for both anxiety and depression,the OR value was 1.523（95%CI,1.136-2.043）for anxiety,1.531（95%CI,1.161-2.020）for depression and 1.420（95% CI, 1.047-1.925）for anxiety-depression, respectively. Good balance of payment and the employers＇ subjective support were protective factors for anxiety;the OR value was 0.618（95%CI,0.370-0.933） and 0.850（95%CI,0.758-0.952）,respectively. The decreased monthly income after being illness was risk for depression and the OR value was 1.468（95%CI,1.035-2.082）. The elder and decreased monthly income after being illness were the risk factors for anxiety-depression and OR value was 2.028（95%CI,1.304-3.155） and 1.494（95%CI,1.010-2.209,respectively;while employers＇ subjective support was protective factor and OR value was 0.840（95% CI,0.744-0.949）. [Conclusion] The prevalence of anxiety and depressive of patients with suspected occupational disease were high and more attention should be given to such cases.