胸腔积液患者心理状态分析

Psychological analysis in patients with pleural effusion

目的探讨胸腔积液患者心理状态及其影响因素,以及相关护理对策。方法选择2015年6月至2016年6月50例胸腔积液患者(研究组)及50名同期健康体检者50名(对照组)。收集所有胸腔积液患者的基本临床资料,同时采用抑郁自评量表(SDS)、焦虑自评量表(SAS)及社会支持量表(SSRS)对所有研究对象进行心理测评,确诊时、出院前各1次。比较2组焦虑、抑郁及社会支持程度差异,分析胸腔积液患者焦虑、抑郁、社会支持的相关因素。结果确诊时,研究组SAS、SDS评分均低于对照组,SSRS评分高于对照组(P<0.05)。与确诊时比较,出院前研究组SAS、SDS评分明显升高,SSRS明显降低(P<0.05),接近对照组水平。SAS、SDS评分与主观支持、客观支持、支持利用度及SSRS评分均呈负相关(P<0.05)。<50岁患者的焦虑患病率高于≥50岁患者,患者焦虑、抑郁患病率及低社会支持率随着家庭月收入的增加而降低,有配偶患者低于未婚、离异或丧偶的患者(P<0.05)。多因素Logistic回归分析显示,年龄是焦虑的独立危险因素,家庭月收入是焦虑、抑郁及低社会支持的独立保护因素,婚姻状况是焦虑、抑郁及低社会支持的独立危险因素(P<0.05)。结论胸腔积液患者普遍存在不同程度的焦虑、抑郁及社会支持度低等不良情绪,SAS、SDS及SSRS联合检测有助于量化评估患者的心理状态,筛选出存在心理不良隐患的高危人群,并实施有效的护理干预。

Objective To investigate the psychological status and its influence factors in patients with pleural effusion,and analyze the nursing countermeasures.Methods Fifty patients with pleural effusion（research group）and health physical examination subjects（control group）were chosen from June 2015 to June 2016.The basic clinical data of all patients with pleural effusion was collected,and SAS,SDS and SSRS scale were used to psychologically evaluate all the research subjects at diagnosisand discharge.The levels of anxiety,depression and social support between two groups were compared,related factors of anxiety,depression,social support of pleural effusion were analyzed.Results At diagnosis,SAS,SDS scores in research group were significantly lower than those in control group,SSRS score was significantly higher（P〈0.05）.Compared with the time of diagnosis,the SAS,SDS scores at discharge increased significantly,SSRS score significantly decreased（P〈0.05）,close to the control group.SAS,SDS scores were significantly negatively correlated with subjective support,objective support,support utilization degree and SSRS score（P〈0.05）.The prevalence of anxiety in patients less than 50-year-old was significantly higher than that more than 50-year-old,the prevalence of anxiety,depression and low social support were significantly reduced with the increase of family income,and lower in patients with a spouse than single,divorced or widowed patients（P〈0.05）.Multiariable logistic regression analysis showed that,age was independent risk factor of anxiety,low family income was independent protection factor of anxiety,depression and low social support,marriage was independent risk factor of anxiety,depression and low social support（P〈0.05）.Conclusion Different degrees of anxiety,depression,and low social support is common in patients with pleural effusion,combination detection of SAS,SDS and SSRS can help to quantitatively assess patient＇s mental state,to select high-risk groups of psychological hidden trouble,and implement effective nursing intervention.