脑卒中后偏瘫患者心理健康状况及相关因素分析

Analysis of psychological health status and related factors in post-stroke hemiplegia patients

目的了解脑卒中后偏瘫患者心理健康水平及相关因素,为促进脑卒中后偏瘫患者的心理健康提供理论依据。方法采用随机数字表法选取2012年1月至2013年12月重庆市涪陵中心医院住院及门诊的脑卒中后偏瘫的120例患者为研究对象,采用自编一般项目及临床症状自评量表(SCL-90)进行检测,比较不同性别、年龄、婚姻状况、文化程度、肢体功能障碍程度的偏瘫患者心理障碍筛查阳性率以及SCL-90各因子均分的差异。结果女性脑卒中后偏瘫患者恐怖、躯体化、抑郁等因子均分均高于男性;离异或丧偶脑卒中后偏瘫患者抑郁、躯体化、人际关系等因子均分均高于已婚患者;肢体功能障碍程度严重组脑卒中后偏瘫患者躯体化、抑郁、焦虑、精神病性因子均高于较轻组。不同年龄以及不同文化程度脑卒中后偏瘫患者各因子均分差异无统计学意义。所有研究对象心理障碍筛查阳性检出率87.5%,以女性,年龄≥60岁的离异或丧偶且为小学及以下文化程度,严重肢体功能障碍的脑卒中后偏瘫患者心理障碍筛查阳性检出率高(均P<0.05)。结论脑卒中后偏瘫患者心理状况差,以女性、年龄≥60岁,离异或丧偶,文化程度较低,严重肢体功能障碍的脑卒中后偏瘫患者的更容易出现躯体化、抑郁、焦虑、精神病等心理健康问题。

Objective To explore the mental health status and related factors,and to provide theoretical basis for promoting mental health of post-stroke hemiplegia patients. Methods One hundred and twenty patients with post-stroke hemiplegia in Fuling Central Hospital of Chongqing from January 2012 to December 2013 were enrolled in this study. Self-designed general items and the symptoms checklist-90（ SCL-90） were used in this study. The differences in the positive rates of psychological disorder screening and SCL-90 scores were compared among hemiplegic patients with different genders,ages,marital status,educational levels and degrees of limb dysfunction. Results The scores of horror,somatization and depression were higher in female patients with hemiplegia than in male patients; the scores of depression,somatization and interpersonal factor score of hemiplegic patients after divorce or in widowhood were higher than those of married patients; the scores of somatization,depression,anxiety and psychotic factor score in hemiplegia patients with severe limb dysfunction were significantly higher than those with mild limb dysfunction. There were no significant differences in the scores of hemiplegia patients after stroke at different age groups and educational levels. The positive rate of psychological disorder screening was 87. 5% in all the subjects; the positive rate of psychological disorder screening was high in post-stroke hemiplegic patients with severe limb dysfunction who were women with age≥60 years,divorced or widowed,and with primary school education and below（ P〈0. 05）. Conclusion Post-stroke hemiplegic patients with poor psychological state were more likely to suffer from somatization,depression,anxiety,psychosis and other mental health problems who were women aged ≥60,divorced or widowed,with low educational level and severe limb dysfunction.