职业病诊断后患者焦虑抑郁状况及影响因素

Anxiety and depression status of patients after occupational disease diagnosis and its influencing factors

目的探讨职业病诊断患者在职业病诊断后焦虑抑郁状况及可能影响因素。方法采用自编相关因素问卷对2016年6—12月间,在深圳市某职业病诊断机构完成职业病诊断并收到职业病诊断证明书(1~2个月内)的89例患者进行调查,同时使用综合医院焦虑抑郁量表(HAD)对他们进行心理测评,并对数据进行非条件logistic回归分析。结果职业病诊断患者焦虑总均分为10.43±4.73,抑郁总均分为9.62±4.94。焦虑症状55例(61.8%)、抑郁症状53例(59.6%),其中焦虑合并抑郁41例(46.1%)。职业病诊断患者焦虑的主要影响因素为文化程度,OR值0.145(95%CI:0.032~0.658);疾病认知分,OR值4.004(95%CI:2.068~7.750);单位客观支持评分,OR值0.406(95%CI:0.252~0.652)。抑郁的主要影响因素为年龄,OR值2.457(95%CI:1.182~5.107);收入开支情况,OR值0.133(95%CI:0.042~0.425)。焦虑合并抑郁的主要影响因素为收入开支情况,OR值0.239(95%CI:0.080~0.712);疾病认知分,OR值2.040(95%CI:1.264~3.293);单位客观支持评分,OR值0.590(95%CI:0.403~0.863)。结论职业病诊断患者在职业病诊断后焦虑抑郁状况患病率高,自觉疾病严重预后差、年龄增大是罹患焦虑抑郁的可能危险因素,而文化程度高、家庭收入开支平衡而有结余、用人单位主观支持度高可能是保护因素。

[Objective]To explore the status of anxiety and depression of patients after occupational disease diagnosis and their possible influencing factors.[Methods] A total of 89 patients,who conducted the diagnosis of occupational disease and received medical certificate of occupational disease in a prevention and treatment hospital for occupational disease in Shenzhen from June2016 to December 2016,were tested with the hospital anxiety and depression scale（HAD） and the self-developed related factors questionnaire.Unconditioned logistic regression was used to analyze the data.[Results] The survey found that the average scores of anxiety were 10.43±4.73 and depression were 9.62±4.94.Fifty-five cases（61.8%）were diagnosed as anxiety,53（59.6%）were depression,and 41 cases（46.1%） were diagnosed anxiety combined with depression among them.The anxiety and depression scores were significantly correlative to the following factors：educational level,OR value was 0.145（95% CI =0.032-0.658）;selfperception of disease,OR value was 4.004（95%CI=2.068-7.750）;Employer＇s subjective support,OR value was 0.406（95%CI=0.252-0.652）.The depression scores were significantly correlative to the following factors：age,OR value was 2.457（95% CI =1.182-5.107）;income and expenditure situation,OR value was 0.133（95%CI=0.042-0.425）.Anxiety combined with depression：income and expenditure situation,OR value was 0.239（95% CI = 0.080-0.712）;self-perception of disease,OR value was 2.040（95%CI=1.264-3.293）;employer＇s subjective support,OR value was 0.590（95%CI=0.403-0.863）.[Conclusion] The prevalence of anxiety and depressive of patients after occupational disease diagnosis are high.The potential risk factors for the psychological problems may be the high self-perception of disease and increased age.While the high level of education,balance of householdincome expenditure and high subjective support of employers are likely to be protective factors.